Module Seven Flashcards
- What are Somatic Symptom and Related Disorders according to the DSM-5?
They are a group of disorders where somatic (physical) symptoms cause significant distress or impairment, and may or may not be associated with a diagnosed medical condition.
- Name the primary disorders within the Somatic Symptom and Related Disorders category in DSM-5.
They include Somatic Symptom Disorder, Illness Anxiety Disorder, Conversion Disorder (Functional Neurological Symptom Disorder), Psychological Factors Affecting Other Medical Conditions, Factitious Disorder, Other Specified Somatic Symptom and Related Disorder, and Unspecified Somatic Symptom and Related Disorder.
- How do these disorders differ from purely medical conditions?
These diagnoses emphasize the psychological, cognitive, or behavioral components – such as excessive worry, anxiety, or thoughts about health – rather than solely the presence of physical symptoms or lab findings.
- What does DSM-5 mean by ‘emphasis on positive symptoms and behaviors’ in these disorders?
It focuses on patients’ distress, excessive thoughts, feelings, or behaviors about the symptoms, rather than requiring that symptoms lack a medical explanation.
- Define Somatic Symptom Disorder (SSD) in the DSM-5.
SSD involves one or more distressing somatic symptoms plus excessive thoughts, feelings, or behaviors related to those symptoms, lasting typically more than 6 months.
- According to the DSM-5, what three manifestations can indicate ‘excessive thoughts, feelings, or behaviors’ in Somatic Symptom Disorder?
(1) Disproportionate and persistent thoughts about the seriousness of one’s symptoms, (2) persistently high anxiety about health, and (3) excessive time and energy devoted to health concerns.
- How does DSM-5 specify severity for Somatic Symptom Disorder?
Mild requires one symptom from the ‘excessive thoughts or behaviors’ group, moderate requires two, and severe requires two or more plus multiple somatic complaints or one severe somatic symptom.
- When is the specifier ‘With Predominant Pain’ used for Somatic Symptom Disorder?
It is used when pain is the main focus of the somatic symptoms in SSD.
- What is ‘Persistent’ Somatic Symptom Disorder?
It refers to severe and marked somatic symptoms persisting for more than 6 months, causing high levels of impairment.
- Give an example of a common cognitive distortion in Somatic Symptom Disorder.
Catastrophic interpretations of normal bodily sensations (e.g., interpreting a minor headache as a sign of a brain tumor).
- Why might individuals with SSD frequently seek multiple medical consultations?
They often feel dissatisfied with care and believe their symptoms are not adequately addressed, leading to repeated doctor visits or ‘doctor shopping.’
- What is the estimated general adult prevalence of Somatic Symptom Disorder?
It is estimated to be about 5% to 7% in the general population.
- How might SSD present in older adults?
They might attribute real or perceived physical symptoms to normal aging, and their complaints may be overlooked or misinterpreted by providers.
- What are some risk and prognostic factors for Somatic Symptom Disorder?
Negative affectivity (neuroticism), low socioeconomic status, stressful life events, history of abuse, and concurrent medical or psychiatric conditions can raise risk.
- What is Illness Anxiety Disorder (IAD)?
It involves preoccupation with having or acquiring a serious illness, with high health-related anxiety but either mild or no actual somatic symptoms present.
- How long must this preoccupation last for IAD diagnosis?
At least 6 months, although the specific illness feared can change over that period.
- Differentiate Illness Anxiety Disorder from Somatic Symptom Disorder.
In Illness Anxiety Disorder, actual somatic symptoms are mild or not present, whereas in SSD, there are notable somatic symptoms that cause distress. IAD focuses more on the fear of having an illness.
- Describe how individuals with IAD might behave regarding their health concerns.
They may frequently check their body for signs of illness or exhibit maladaptive avoidance of medical care, worrying excessively despite negative evaluations.
- What is the typical prevalence range for Illness Anxiety Disorder?
Community surveys suggest a prevalence from 1.3% to 10%, with higher rates in medical settings.
- What characterizes Conversion Disorder (Functional Neurological Symptom Disorder)?
One or more symptoms of altered voluntary motor or sensory function that are not fully explained by neurological conditions, with evidence of internal inconsistency or incompatibility on examination.
- Give an example of a possible Conversion Disorder symptom.
Paralysis of an arm that does not follow typical anatomical patterns or normal neurological pathways and lacks consistent neurological signs upon testing.
- Which factors often precede or accompany Conversion Disorder?
Psychological stress or trauma, dissociative symptoms, or conflicts may be involved, though the DSM-5 no longer requires explicit demonstration of a psychological stressor.
- How common is Conversion Disorder in neurology settings?
It accounts for about 5% of neurology outpatient referrals.
- What improves prognosis in Conversion Disorder?
A shorter duration of symptoms, a clear acute onset, acceptance of the psychological nature of the disorder, and strong therapeutic rapport can aid recovery.
