Test 2 (Case Study Quiz) - Chapter 29 - Somatic Symptom and Dissociative Disorders

Question 1

______ _____ disorders are characterized by phsyical symptoms suggesting medical disease BUT without demonstrable organic pathology.

Answer 1

Somatic symptom D/O

classified as mental DO

Question 2

T or F: We should rule out medical with SSDO.

Answer 2

True. Rule out medical, then send to psych

Question 3

Is the pain felt in SSDO real or imagined?

Answer 3

real

remember that kid was wiling to be cut open…. it was very real.

Question 4

This DO may be defined as unrealistic or inaccurate interpretation of physical symptoms or sensations leading to preoccupation and fear of having a serious disease. These people may be called hypochondriacs.

Answer 4

Illness Anxiety DO

disease is not present.

A patient might have a rapid heart rate but insist that they have heart disease.

must have for 6 months

there are care seeking and care avoidant types

Test results cannot reassure the patient that nothing is wrong

Question 5

A woman sees her husband having sex with another woman and goes blind… This DO is called…

Answer 5

conversion disorder

the impaired function is related to a psychological conflict

usually involves sensory organs or voluntary motor function; examples are blindness, paralysis and loss of ambulation

Question 6

T or F: A person suffering from conversion disorder seeks immediate medical attention.

Answer 6

False, they ignore it and don’t care about it. This DO is how they deal with their conflict. They can avoid the stressor AND gain support from others due to the new problem.

Question 7

This DO involves CONSCIOUS, INTENTIONAL faking of physical or psychological symptoms. Individuals may aggravate existing symptom, induce new ones or even inflict painful injuries on themselves.

Answer 7

Factitious DO

Question 8

What does it mean to have factitious DO imposed on another?

Answer 8

caregiver either fabricates or causes symptoms in another person to gain sympathy or attention for themselves. (Remember the mom who was injecting kid with pond water?)

Question 9

How can you prevent a patient with somatic symptom DO from overtaking a group meeting?

Answer 9

Set a time limit on how long they are allowed to discuss physical complaints.

Question 10

What are some interventions for somatic symptom DO ?

Answer 10

1. refocus & distract
2. Do not commiserate with client (No saying things like ‘Oh you poor thing.’)
3. Do not challenge the symptoms or suggest it is psychological - will cause worsening and lead to increased anxiety (Never remove someone’s defense, remember?)
4. Give attention when symptom IS NOT present (sort of like not rewarding a child for crying)
5. Treat with SSRIs and TCAs

Question 11

What is amnesia?

Answer 11

pathological loss of memory; a phenomenon in which an area of experience becomes inaccessible to conscious recall.

Question 12

What is dissociative amnesia?

Answer 12

One or more episodes of memory loss of important personal information.

THe person suddenly becomes aware they have total loss of memory for events over a few days to a lifetime.

example: can’t remember three years in life of sexual abuse or cannot remember car accident.

Question 13

Sudden, unexpected travel away from customary place of daily activities or by bewildered wandering with the inability to recall some or all of one’s past. This person my not be able to recall personal identity and sometimes assumes a new identity

Answer 13

Dissociative Amnesia with Dissociative Fugue (think refugee who are forced to leave due to persecution)

Levy gets in car to drive home but ends up in Vegas, dealing blackjack. You see her but she has no idea who you are and doesn’t answer to Levy anymore.

Question 14

THis DO is characterized by the presence of 2 or more distinct personalities within one individual.

Answer 14

DID (Dissociative Identity Disorder)

Formerly known as multiple personality DO

Each personality takes full control of the person’s behavior.

Question 15

What causes an alter (a personality to emerge)?

Answer 15

stress

Question 16

What is the goal in treatment of DID?

Answer 16

goal is integration of personalities

Question 17

What is the term for remembering WHILE/WITH feeling past traumas?

Answer 17

abreaction

may cause client to cry, scream, feel the pain from the past

Question 18

T or F: There is amnesia for the events that took place when another personality is in the dominant position.

Answer 18

true

transition may start with rapid eye blinking and changes in voice or facial expression.

Question 19

What is believed to be the way DID is caused?

Answer 19

Traumatic event was taking place and client took themself out of the situation and “went elsewhere” in the mind.

The split is then fixated and there is continued dissociative experiences

Formations of alters takes place

Question 20

________ is one or more episodes of feeling detached from one’s self, thoughts, feelings, sensations, body or actions. Reality is lost. Client may say they feel like an outside observer.

Answer 20

Depersonalization - Derealization Disorder

• The client may feel “dream-like,” “going crazy,” sense of “strangeness.”
• Cannot express emotion/feel
• Feelin

Question 21

What is the difference between depersonalization and derealization?

Answer 21

Depersonalization = disturbed perception of oneself
Derealization = unreality related to surrounding, dreamlike foggy, visual distortion.

Question 22

In regard to somatic symptom disorder, what is primary and secondary gain?

Answer 22

primary gain - sick person learns that he or she may avoid stressful obligations, may postpone unwelcome challenges, and is excused from troublesome duties.

secondary gain - the sick person becomes the prominent focus of attention because of the illness. There is also TERTIARY gain, which is when the sick person becomes the focus of the family - shifting the focus away from th real issue.

These types of positive reinforcement will certainly guarantee repetition of the response.