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Abnormal- Chapter 6
Somatoform and Dissociative Disorders
| Question | Answer |
|---|---|
| soma | pertaining to the body |
| The DSM-IV-TR lists five basic somatoform disorders: | Hypochondriasis, Somatization disorder, Conversion disorder, Pain disorder, Body dysmorphic disorder |
| What are some features of hypocondriasis? | physical complaints without a clear cause, severe anxiety on the possibility of having a serious disease, medical reassurance does not seem to help, preoccupied with bodily symptoms and misinterprets them as signs of illness or disease |
| What is the difference between hypocondriasis and an illness phobia? | People with hypochondriasis fear the possibility of already having a disease. People with an illness phobia are fearful of developing a disease. |
| Gender ratio for hypocondriasis is ___________. | about equal |
| The onset of hypocondriasis can occur at any age but usually peaks when? | adolescence, middle age (40-50), and after age 60 |
| What are some causes for hypocondriasis? | Cognitive perceptual distortions, Familial history of illness, Genetics vulnerabilities, overreaction to stress, tendency to view negative life events as unpredictable and uncontrollable, Modeling of adults with hypochondriasis. |
| People with hypocondriasis may develop the disorder in the context of: | stressful life events, experience a disproportionate incidence of familial disease during childhood, receive substantial attention for illness-related behaviors |
| What is the treatment for hypocondriasis? | challenge illness-related misinterpretation |
| Somatization disorder | a chronic condition in which a person has physical symptoms that involve more than one part of the body,but no physical cause can be found. The pain and other symptoms people with this disorder feel are real, and are not created or faked on purpose |
| What are some features of somatization disorder? | symptoms become a major part of their identity, extended history of physical complaints before age 30, substantial social and occupational impairment |
| True or false: Somatization disorder is rare. | true |
| Onset of somatization disorder usually occurs during ____________. | adolescence |
| Who is mostly affected by somatization disorder? | unmarried, low SES women |
| What is the main cause behind somatization disorder? | family history of illness |
| True or false: no effective treatment has been found for people with somatization disorder. | true. The best that can be done is to reduce the person's tendency to visit medical specialists, assign "gatekeeper" physician, reduce the supportive consequences of relating to significant others on the basis of physical symptoms |
| Conversion disorder | physical malfunctioning without any physical or organic pathology (i.e., paralysis, blindness) |
| Features of conversion disorder | usually precipitated by some stressful event. People with conversion symptoms of blindness can avoid objects but they will tell you they cannot see. People with symptoms of paralysis of the legs might suddenly get up and run in an emergency. |
| Freud popularized the term “conversion,” believing that anxiety from unconscious conflicts somehow converted into physical symptoms to find expression | i.e., anxiety is displaced onto a more acceptable object, in this case physical problems |
| 3 types of differential diagnoses | malingering, factitious disorder, factitious disorder by proxy |
| malingering disorder | They are deliberately faking symptoms. They are trying to get out of something (i.e. work), or gain something. They are fully aware of what they are doing. |
| factitious disorder | symptoms are faked and under voluntary control, but without any obvious reason for doing so aside from to assume the sick role and gain attention |
| factitious disorder by proxy | caregiver making others sick; sometimes referred to as munchausen syndrome by proxy |
| Facts and stats for conversion disorder | Rare condition, with a chronic intermittent course, Seen primarily in females, Onset usually in adolescence |
| What are some causes for conversion disorder? | Freud's theory is still popular, Anxiety continues to increase/threatens to emerge into consciousness.person converts conflict into physical symptoms, thereby relieves the pressure of dealing directly w/the conflict, individual receives attention/sympathy |
| What are the treatments for conversion disorder? | The core strategy is to attend to trauma, remove sources of primary and secondary gain |
| Primary gain | reduction in anxiety that maintains the conversion symptoms |
| Secondary gain | attention and sympathy from loved ones |
| Body Dysmorphic Disorder (BDD) | involves a preoccupation with some imagined defect in appearance despite reasonably normal appearance |
| Features of Body Dysmorphic Disorder | Many become fixated on mirrors/frequently check appearance.Other show phobic fear/avoidance of mirrors.Suicidal ideation/attempts/suicide frequent,Display ideas of reference (think events in the world relate to them),severe disruption in daily functioning |
| Facts and stats about Body Dysmorphic Disorder | Seen equally in males and females, Onset usually in early 20s, Most seek out plastic surgeons, Usually runs a lifelong chronic course |
| What are some causes of Body Dysmorphic Disorder? | Little is known about the causes, Obsessive-compulsive disorder tends to co-occur with BDD, both disorders share similar features (e.g., intrusive thoughts, checking). |
| Treatments for BDD | (treatment similar to OCD), Medications (i.e., SSRIs), Exposure/response prevention is also helpful |
| As many as ____% of people requesting plastic surgery meet criteria for BDD. | 25 |
| True or false: people with BDD don't benefit from plastic surgery | true. Preoccupation with imagined ugliness may actually increase following plastic surgery |
| Dissociative disorder | are characterized by alterations or detachments in consciousness or identity involving either dissociation or depersonalization |
| 4 Types of DSM-IV Dissociative Disorders | depersonalization disorder, dissociative amnesia, dissociative fugue, dissociative identity disorder |
| Depersonalization disorder | distortion in perception - a sense of reality is lost, a psychological mechanism whereby one dissociates from reality |
| True or False: depersonalization is found in other disorders. | True. When it is the primary problem, the person meets the criteria for depersonization disorder |
| Depersonalization disorder has high comorbidity with ____________ and ______________. | anxiety and mood disorders |
| When is the typical onset of Depersonalization Disorder? | 16 years |
| What are some causes and treatments for depersonalization disorder? | little is known |
| dissociative amnesia | unable to recall anything, including one's identity, may be lifelong or a period in the more recent past |
| What are the 2 types of dissociative amnesia? | generalized type (inability to remember anything, including one's identity) and localized or selective type (failure to recall specific, usually trumatic, events) |
| What are the features of dissociative fugue? | Take off to a new place, Unable to remember the past, Unable to remember how they arrived at a new location, Often assume a new identity |
| Dissociative Amnesia and Fugue usually begins in _____________. | childhood |
| True or false: Dissociative Amnesia and Fugue show rapid onset and dissipation. | True |
| Dissociative amnesia and fugue are mostly seen in ___________. | females |
| Causes for dissociative amnesia and fugue | little is known/trauma and life stress can serve as triggers |
| Treatments for dissociative amnesia and fugue | most get better without treatment, most remember what they have forgotten |
| Features of Dissociative Identity disorder | Formerly known as multiple personality disorder, Defining feature – Dissociation of personality, Adopt several new identities (as many as 100), Identities show unique behaviors, voice, and posture |
| DID: Alters | different identities or personalities |
| DID: Host | typically the identity that seeks treatment identity that tries to keep fragments of identity together, the host identity often develops later than the other identities, may get overwhelmed taking care of the other identities |
| DID: Switch | The transition from one personality to another, often a switch is instantaneous and may include physical transformation (i.e. facial expression, posture) |
| Average number of identities for dissociative identity disorder | close to 15 |
| Ratio of females to males with dissociative identity disorder is __________. | high (9:1) |
| Onset of DID can occur in __________, as young as _______ years of age. | children, 4 |
| Prevalence of DID in the US | 3 to 6% |
| True or false: DID tend to run a chronic lifetime course if left untreated. | true |
| Main causes for DID | Many people who are diagnosed with DID have histories of some sort of abuse, lack of support during abuse |
| It is believed that DID is a natural tendency to __________ or dissociate from the severe abuse. | escape |
| ____% of patients with DID report significant trauma | 90 |
| DID may be a very extreme subtype of what? Why? | PTSD; both feature strong emotional reactions to severe trauma |
| DID: Treatment | focus on integration of identities, identify and confront the early trauma and gain control over memories of horrible events. |
Created by:
Ellemkay
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