Somatic Syptoms and Dissociative disorders

Question 1

what is a hypocondriac

Answer 1

someone who exaggerates the slightest physical symptom which is normally harmless

Question 2

what are somatic symptom disorders overview

Answer 2

excessive or maladaptive response to physical symptoms or associated health concerns
accompanied by distress and impairment
medical explanations not necessary or important
typiclaly presents medically

Question 3

name the 7 DSM-5 classifications of somatic disorders

Answer 3

somatic symptom
illness anxiety
conversion
psychological factors affecting other medical condition
factitiuous
other specified
unspecified

Question 4

somatic symptom disorder clinical description

Answer 4

somatic symotom that is distressing or significantly disrupts daily life
excessive thoughts, feelings or behaviours related to symptoms or concerns such as
-persistent thoughts about seriousness
-persistently high illness of sympptom anxiety
-excessive time and energy spent on helath or concern
persistent (6 months)
simple absence of medical diagnosis is not enough
missattribution of bodly sensations
repeated checking / seeking help - medical reassurance doesnt help

Question 5

somatic symptom disorder statsq

Answer 5

prevalence around 5-7%
chronic
can occur at any age but usually adolescence
diagnosis in eldery = tricky
depression is common

Question 6

risk factors for developing somatic symptom disordeR

Answer 6

negativity
depression
anxiety
low SES
low education
female

Question 7

somatic symptom disorder causes

Answer 7

familial history of illness
stressful life events
sensitivity to physical sensations
secondary reinforcement

Question 8

treatment of somatic symptom disorder

Answer 8

CBT best
limit hospital visits through assigning gatekeeper physician
behavioural approaches

Question 9

illness anxiety disorder description

Answer 9

preoccupied with having or catching a serious illness
physical symptoms absent of very mild
disease conviction
repeated helth-related behaviours or avoidance
6 month duration

Question 10

illness anxiety stats

Answer 10

most prior cases of hypocondriasis = somatic symotom dis, only 25% were illness anxiety
so prevalence = 1.3-10%
chronic and relapsing

Question 11

risk factors for developing illness anxiety disorder

Answer 11

exposure to major stressor or scare
history of child abuse
history of childhood illness

Question 12

what is disease conviction

Answer 12

i have this specific diseasw

Question 13

what is illness conviction

Answer 13

disproportionate preoccupation with physical symptoms

belief i am sick, not what is causing it

Question 14

causes of illness anxiety

Answer 14

cognitive perceptual distrotions - unpredictable and uncontrollable world
overly attentive to physical sensations
misinterpretation of sensations
interpersonal influences - trigger event, family history of illness

Question 15

illness anxiety treatment

Answer 15

change illness-related misinterpretations
substantial and sensitive reassurance
stress management and coping strategies
antidepressants (SSRIs) offer some help, but typically CBT = more lasting gains

Question 16

integrativemodel of causes of hypocondriasis

Answer 16

trigger leads to perceived threat
perceived threat is part of vicious circle
increased body focus, physiological arousal and checking behaviour
preoccupation with perceieved bodily state and sensations
misinterpretation od bodily sensations as indicating severe illness

Question 17

clinical description of conversion disorder

Answer 17

1 or more symptoms altered voluntary motor or sensory function
findings incompatible with medical conditions
la belle indifference
retain most normal functions but unaware

Question 18

stats of conversion disorders

Answer 18

rare
chronic intermittent course
2 to 3 times more liekly in women
onset at any time

Question 19

causes of converstion disorder

Answer 19

psychodynamic view
trauma, conversion and secondary gain
detatchment from the trauma and negative reinforcement

Question 20

treatment to conversion disorder

Answer 20

similar to somatic symptom
attend to the trauma
behavioural approaches

Question 21

citeria for psychological factors affecting other medical conditions

Answer 21

medical symptom or condition
psychological or behavioural influences - interpersonal coping, denial, no treatment
influence condition - course, treatment interference, increasing health risk

Question 22

stats of psychological factors affecting other medical conditions

Answer 22

prevalence not known, less than somatic symptom

can occur at any time

Question 23

treatment of psych factors affecting other medical conditions

Answer 23

similar to somatic symptom disorder

CBT

Question 24

factitious disorder features

Answer 24

falsification of physica or psych symptoms
induction of injury or disease
deception
presents patient as ill, injured, impaired
no evidence of external rewards
patient my be self or another

Question 25

statistics on factitiout disorder

Answer 25

prevalence unknown. perhaps 1% in hospital setting intermittent course onset in ealry adulthood

Question 26

treament of facticious disorder

Answer 26

not well identified | similar to somatic symptom

Question 27

what is conversion hysteria according to freud

Answer 27

unexplained physcial symptoms = conversion of unconscious emotional conflicts into a more acceptable form

Question 28

what is neurosis by psychoanalytic theory

Answer 28

specific but unproven cause - we dont use this anymore

Question 29

somatic disorder cognitive features

Answer 29

disorder of cognition or perception with strong emotional contributions very act of forming attention to bodily sensations increases aruosal aand makes physical sensations more intense stroop test - enhanced perceptual sensitivity to illness cues ambigious stimuli as threatening better safe than sorry restrictive concept of health as symptom free unspecified genetic personality tendencies

Question 30

koro

Answer 30

belief / fear genitals are retracting into abdomen chinese male central imporatnce of sexual functioning typical sufferes = guilty about excessive masturbation, unsatisfactory sex, promiscuity

Question 31

pa-leng

Answer 31

chinese fear about cold wind in ones body context ying and yang

Question 32

dhat

Answer 32

indian losing semen disiness, weakness and fatigue

Question 33

kyol gocu

Answer 33

cambodia wind overload closely resembles panic disorder

Question 34

shinkeishitsu

Answer 34

japan resembles western anxiety headaches, blushing worry about symptoms hurting others

Question 35

what does functioning

Answer 35

symptom without an organic course

Question 36

malingering

Answer 36

deliberate faking of a physical pr psych disorder motivated by gain - so how can we tell the difference

Question 37

freud's 4 basic processes in development of conversion disorders

Answer 37

traumatic event = unacceptable unconscious conflict conflict repressed as unacceptable anxiety increases and threatens to emerge into consciousness so person "converts" into physical symptoms = presence of dealing with conflict relieved. this is primary gain or reinforcing event that maintains the symptom attention and sympathy = secondary gain

Question 38

overview of dissociative disorders

Answer 38

``` severe alterations or discontinuities in identity, memory or consciousness fragmentations of identity depersonlizations derealization amnesia reality testing intact variations of normal to be a disorder = experiences are distressing or interferences with life functioning ```

Question 39

what is depersonalization

Answer 39

distortion in perception of one's mind, self or body

Question 40

derealization

Answer 40

detachment from one's surroundings

Question 41

depersonalization disorder facts and stats

Answer 41

prevalence 2% comorbidity with anxiety and mood disorders is extremely high onset is typically around age 16, rare after 40 usually runs lifelong course

Question 42

causes of depersonalization disorder

Answer 42

childhood trauma severe stress show cognitive deficits in attention, short term memory and spatial reasoning cognitive deficits correspond with reports of tunnel vision and mind emptiness

Question 43

treatment of depersonalization disorder

Answer 43

attend to the trauma | integrate the personalities

Question 44

key features of dissociative amnesia

Answer 44

psychogenic memory loss generalized = inability to recall anything including their identitiy localized or selective = failure to recall specific (usually traumatic) events

Question 45

define dissociative fugue

Answer 45

purposeful travel or wondering associated with amnesa | such presons may assume a new identity

Question 46

stats on dissociative amnesia

Answer 46

``` sudden onset progressive prevalence - 1.8% more common in women all ages, kids more difficult typically rapid onset and dissipation ```

Question 47

causes of dissociative amnesia

Answer 47

violent/ abusive childhood trauma | dissociation in general may have genetic diathesis

Question 48

DID clinical description

Answer 48

adoption of 2 or more identities identities display unique behaviours voice and posture gaps in memory dissociation of certain aspects of personality

Question 49

three unique things of DID explained

Answer 49

alters - different identities host - identitiy that seeks treatment and tries to keep fragile elements together switch - often instantaneous from one personality to another

Question 50

prevalence od DID

Answer 50

3-6% average number of identities around 15 female : male 9:1but DSM says almost equal onset is almost always in childhood high comorbidity rates with a lifelong course 70% attempt suicide

Question 51

DID causes

Answer 51

child abuse PTSD relation most are highly sugestible - genetic

Question 52

treamtnet of DID

Answer 52

reintegration of genetics | identify and neutralize cues/ triggers

Question 53

false memories and therapists

Answer 53

can be very easy to suggest during therapy | therapist must be aware of this

Question 54

depersonalization - derealization disorder

Answer 54

individuals lose sense of reality to both their external world and their own body intense panic attacks - 50% of people will experience feelings of unreality chronic course DDD = distinct cognitive profile with deficits in attention, information processing, short term memory, spatial reasoninig = easily distracted and slow to process new info deficits in perception, emotion and HPA axis

Question 55

amok

Answer 55

transitive state often brutally attack/ assault sometimes killing humans and animals if alive at the end of state dont remeber

Question 56

dissociative trance disorder

Answer 56

altered state of consciousness in which people fimly believe they are possessed by spirits; considered a disorder only where there is distress and dysfunction

Question 57

how to test faking of DID

Answer 57

transient microstrabismus that are not observed in other personalities difficult to fake for exmaple physiological responses different to emotionally laden words - eg sweat glands and eeg fMRI = change at the switch malingerers tend to be eager to demonstrate their symptoms and do so in a fluid fashion

Question 58

autohypnotic model

Answer 58

people who are suggestible may use dissociation as a defense against extreme trauma

Question 59

bio contribution to dissociatoin

Answer 59

definite link | heritable traits - tension, responsiveness, like PTSD

Question 60

genital exam in 3yo girsl example

Answer 60

girls given medical, half = genital exam, other half no children were inaccurate in reporting where doctro touched them 60% of those touched in the genitals refused to indicate this 60% in control indicated genital insurtions where none had occured