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Mental Health
Somatoform and Dissociative Disorders
| Question | Answer |
|---|---|
| somatoform disorders occur where on the mental health continum? | from moderate to severe |
| A group of disorders in shich physical symptoms suggest a pjysical disorder for which ther is no demonstrable base, and a strong presumption that the symptomsare linked to psychobiological factors. | somatoform disorders |
| The expression of psychological stress through physical symptoms. | somatization |
| The nurse needs to recognize that in somatoform disorders, the symptom are not | intentional or under the conscious control of the client |
| this involves a conscious process of intentionally producing symptoms for an obvious environmental goal. | malingering |
| An employee complaining ov back pain to get disability income is an example of | malingering |
| This refers to deliberate fabrication of symptoms or self-inflicted injury with the goal of assuming the sick role. | Facticious disorder |
| A client injecting saliva into the skin to for an abscess is an example of | facticious disorder |
| What is the most severe form of factitious disorder? | Munchausen Syndrome by proxy |
| When a caregiver injures a victim to get attention or sympathy for himself or herself. | Munchausen Syndrome by proxy |
| Somatoform disorders are differentiated from _______ in which there is evidence of a general medical condition that may be affected by stress or psychological factors. | pyschosomatic illness |
| The different somatoform disorders are: | Somatization disorder, undifferentiated somatoform disorder, conversion disorder, pain disorder, hyochondriasis, body dysmorphic disorder, somatoform disorder not otherwise specified. |
| What are the medical conditions that can be confused with somatoform disorders? | MS, brain tumor, hyperthyroidism, hyperparathyroidism, lupus erythematosus, myasthenia gravis. |
| What is the age of onset of conversion disorder? | Any age |
| What is the age of onset of somatization disorder? | Adolescence to thirties |
| What is the age of onset of hypochondriasis? | 20-30 years of age |
| What is the age of onset of pain disorder? | any age |
| What is the age of onset of body dysmorphic disorder? | adolescence to thirties |
| What is the gender pridilection of conversion disorder? | 2x as frequent in women |
| What is the gender pridilection of somatization disorder? | Women 80% and Men 20% |
| What is the gender pridilection of hypochondriasis? | Equal prevalence in men and women. |
| What is the gender pridilection of lain disorder? | Twice as frequent in women. |
| What is the gender pridilection of body dysmorhic disorder? | Equal prevalence in men and women. |
| History of many physical complaints beginning before 30 years of age, occuring over a period of years and resulting in impairment in social, occupational, or other important areas of functioning. | Somatization Disorder |
| For somatization disorder to be diagnosed the patient complaints must include what? | HX of pain at least 4 different sites or functions; HX of at least 2 gastrointestinal symptoms other than pain; HX of at least 1 sexual or reproduction symptom; HX of at least 1 symptom defined as or suggesting a neurological disorder. |
| Development of one or more symptoms or deficits suggesting a neurological disorder or grneral medical condition. | Conversion Disorder |
| Psycholical factors are associated with the symptom or deficit because the symptom is initiate or exacerbated by psychological stressors. | Conversion Disorder |
| Conversion disorder is not due to | malingering or factitious disorder and not culturally sanctioned. |
| This disorder cannot be explained by general medical condition or effects of a substance. | conversion disorder |
| This disorder causes impairment in social or occupational functioning, causes marked distress, or requires medical attention. | conversion disorder |
| For at least 6 months, the patient has a preoccupation with fears if having a serious disease, the preoccupation persists despite medical tests and reassurances, other disorders are ruled out and preoccupation causes significant impairment socially. | Hypochondriasis |
| pain in one or more anatomical site is a major part of the clinical picture in | pain disorder |
| This disorder causes significant impairment in occupational or social functioning or causes marked distress. | pain disorder |
| Psychological factors are thougth to cause onset, severity, or exacerbation of | pain disorder |
| The pain in pain disorders is associated with | psychological factors |
| In this disorder, symptoms are not intentionally produced or feigned. If there is a medical condition, it plays a minor role in accounting for pain. | pain disorder |
| Both psychological and/or medical condition are judged in diagnosing this disorder because they are important in onset, severity, exacerbation, and maintenance of pain. | pain disorder |
| Preoccupation with someimagined defect in appearance, and if the defect is present, concern is excessive. | Body Dysmorphic Disorder (BDD) |
| In tnis somatoform disorder, preoccupation causes significant impairment in social or occupational functioning or causes marked distress. | Body Dysmorphic Disorder (BDD) |
| Clients with anxiety or depressive disorders are at high risk for unexplained medical symptoms, because of | a tendency to amplify physiological events |
| When levels of serotonin and norepinephrine are abnormal, the person experiences | more sever pain |
| It is believed that the effect of antidepressants on pain is due to | the correction of altered serotoninor norepinephrine levels |
| Somatization is rarely seen in | US men |
| The belief that psychogenic complaints of pain, illness or loss of physical function are related to repression of a conflict and transformation of anxiety into a physical symptom that is symbolically related to the conflict. | Psychoanalytic Theory |
| Behaviorists suggest that somatoform symptoms are learned ways of | communicating helplessness and that they allow the individual to manipulate others. |
| These theorists believe that the client with somatoform symptoms focuses on body sensations, misinterprets their meaning, and then becomes excessively alarmed by them. | Cognitive Theorists |
| The most frequent symptoms of somatization disorder are: | pain, dysphagia, nausea, bloating, constipation, palpitations, dizziness, and SOB. |
| Anxiety and depression are common comorbid conditions with | somatization disorder |
| Clients with this disorder misinterpret innocent physical sensations as evidence of a serious illness. | Hypochondriasis |
| Many patients with hypochondriasis have a history of | sexual or physical trauma, parental upheaval, or absence from school during childhood for health reasons. |
| When testing rules out any organic cause for pain and the discomfort leads to significant impairment, what disorder is diagnosed? | pain disorder |
| This disorder is marked by the presence of deficits in voluntary motor or sensory functions. | conversion disorder |
| Common symptoms of conversion disorder are: | Involuntary movements, seizures, paralysis, abnormal gait, anesthesia, blindness, and deafness. |
| Common comorbid psychiatric conditions with conversion disorder include: | Depression, anxiety, other somatoform disorders, and personality disorders. |
| Benefits derived from the symptoms alone | secondary gains |
| The client with ________ exhibits more anxiety and an obsessive attention to detail, along with a preoccupation with the fear of serious illness. | hypochondriasis disorder |
| The patient with ________ is often rambling and vague about the details fo his or her many symptoms and gives a disorganized history. | somatization disorder |
| What are the basic level interventions for somatoform disorders? | Promote self care activities, health teaching, case management, and psychobiological interventions. |
| Disturbances in the normally well-integrated continuum of consciousness, memory, identity, and perception. | dissociative disorders |
| an unconscious defense mechanism to protect the individual against overwhelming anxiety. | dissociation |
| When the ability to integrate memories is impaired | dissociative amnesia |
| When the ability to maintain one's identity is affected the individual may develop a | dissociative fugue or dissociative identity disorder (DID) |
| When there is a persisten or recurrent disruption in perception, the individual has | depersonalization disorder |
| A feeling of detachment from the mind or body | depersonalization disorder |
| Dissociative identity disorder (DID) used to be referred to as | multiple personality disoder |
| Clients with dissociative disorders haf intact reality testing, they are not | delusional or hallucinating |
| Mood disorders and substance-related disorders are commonly associated with all of the | dissociative disorders |
| Dissociative amnesia may be comorbid with | conversion disorder or personality disorder |
| Dissociative fugue may co-occur with | PTSD |
| DID patients may also have | PTSD. borderly personality disorder, or sexual, eating, or sleep disorders. |
| Depersonalization disorder occurs with | hypochondriasis,anxiety disorder, and personality disorder. |
| Depersonalization disorder and dissociative fugue have a possible _______ link | neurological |
| What four major dissociative disorders are listed on the DSM-IV-TR? | Depresonalization disorder, dissociative amnesia, dissociative fugue, and DID. |
| A persistent or recurrent alteration in the perception of the self while reality testing remains intact. | Depresonalization disorder |
| How might the perosn experiencing depersonalization feel? | mechanical, dreamy, or detached from the body |
| The inability to recall important personal information, often of a traumatic or stressful nature that is too pervasive to be explained by ordinary forgetfulness. | dissociative amnesia |
| A person with generalized amnesia is unable to recall | information about his or her entire lifetime. |
| This dissociateve disorder is characterized by sudden, unexpected travel away from the customary locale and inability to recall one's identity and information about some or all of the past. | dissociative fugue |
| In rare cases of ______________ an individual assumes a whole new identity. | dissociative fugue |
| Usually a dissociative fugue is precipitated by | a traumatic event |
| The presence of two or more distinct personality states that recurrently take control of behavior. | Dissociative Identity Disorder (DID) |
| It is believed that severe sexual, physical, or psychological trauma in childhood predisposes an individual to the development of | DID |
| A patient with a dissociative disorder needs what characteristics included in their milieu therapy? | A quiet, simple, structured and supportive environment. |
| Advanced nurses may use _______ or ______ to treat dissociative disorders | cognitive-behavioral therapy or psychodynamic psychotherapy |
| Nurses woeking with clients with somatization and dissociative disorders can expect that these clients will fit on the continuum of psychobiological disorders at the | moderate to severe level |
| Mr. R presents with a history of having assumed a new identity in a distant locale and of having no recollection of his former identity. what diagnoiss can the nurse expect the psychiatrist to make? | dissociative fugue |
| Potential for violence is not a nursing diagnosis indicated for clients with | somatoform disorders |
| A physician describes a client as "malingering." The nurse knows this means the client | is falsely claiming to have the symptoms |
| Which neurotransmitter has been implicated as a possible causative factor in both pain disorder and body dysmorphic disorder? | serotonin |
| Dissociative identity disorder is characterized by | the existence of two or more subpersonalities, each with its own patterns of thinking |
| Clients with dissociative disorders do not have | voluntary control of symptoms |
| Voluntary control of symptoms has greater relevance when the nurse is assessing clients with | somatoform disorders |
| Clients with ______ disorder may use alcohol or other central nervous system depressants or anxiolytic drugs to self-medicate. | pain |
| An attitude of unconcern about a symptom that is unconsciously used to lower anxiety. | La belle indifference |
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