Abnormal Psyc- Chapter 6

Front 1

Hysteria

Back 1

Emotional excitability and physical symptoms in absence of organic cause.

Front 2

"Studies in Hysteria"

Back 2

Freud and Breuer. Trauma (often sexual) was predisposing factor for hysteria. Established association between dissociation and hypnotic-like states. Treat with hypnosis.

Front 3

Primary Gain

Back 3

Primary reinforcement maintaining somatoform symptoms. Avoidance of conflict via "conversion" of anxiety to more acceptable physical symptoms.

Front 4

Secondary Gain

Back 4

Hysterical symptoms could help to avoid responsibility and gain attention and sympathy. Benefits they knowingly/unknowingly seek by adopting sick role.

Front 5

Dissociative Disorders

Back 5

Severe maladaptive disruptions or alterations of identity, memory and consciousness beyond one's control.

Front 6

Dissociation

Back 6

Lack of normal integration of thoughts, feelings and experiences in consciousness and memory.

Front 7

2 Groups of Dissociative Experience

Back 7

1. Mild, non-pathological forms of dissociation. Absorption and imaginative involvement across continuum across general population.
2. Sever pathological types of experiences (amnesia, derealization, depersonalization and identity alteration). Not normally in general population.

Front 8

Dissociative Amnesia

Back 8

Can't recall significant personal information in absence of organic impairment. Follows trauma, no memory of trauma. In many cases it remits spontaneously in a few days or can be chronic/recurrent.

Front 9

5 Patterns of Memory Loss in Dissociative Amnesia

Back 9

1. Localized- Fails to recall information from specific time period.
2. Selective- Only parts of trauma forgotten.
3. Generalized- Forgets information from past
4. Continuous- Forgets informations from specific date until present.
5. Systematized- Only forgets certain categories if information (people or places).

Front 10

Dissociative Fugue

Back 10

Travels suddenly and unexpectedly away from home, loss of identity and past. They most likely left behind an intolerable situation. May end abruptly or gradually, Increase in times of stress.

Front 11

Depersonalization

Back 11

Feel a sense of unreality and detachment. Half of general population have this during times of stress. It is the 3rd most common reported clinical symptom after anxiety and depression.

Front 12

Depersonalization Disorder

Back 12

Sever depersonalization is the primary problem, persistent, recurrent episodes, living in a dream, observing and time moving slowly. Only dissociative disorder without memory loss or identity confusion/ Usually history of emotional abuse. High commorbidity with depression, anxiety and personality disorders.

Front 13

Derealization

Back 13

Common episodes in depersonalization disorder. Detachment and altered relationship to surrounding world. People and objects in environment are unreal, dreamlike or distorted.

Front 14

Dissociative Identity Disorder

Back 14

Two or more distinct personality stated that take control of behaviour.

Front 15

Host

Back 15

One personality occurring more often. "Lucid". May or may not be aware of alters.

Front 16

Alters

Back 16

The other personalities.

Front 17

Switching

Back 17

Changing form one personality to another. Occurs mainly as a response to stressful situation.

Front 18

Trauma Model

Back 18

Diathesis-stress formulation. Dissociative disorders are the result of severe childhood trauma accompanied by traits in personality that predispose the individual to dissociation as a defence or coping mechanism. May be adaptive but not if maintained as a habit in adulthood.

Front 19

Attachment Theory

Back 19

Why some are more vulnerable to dissociative disorders. Lack of sensitive responding by parents to the needs of the child leads to insecure attachment "disorganized pattern" inconsistent contradictory behaviours when stressed. This type of attachment may help develop pathological dissociation as an adult.

Front 20

Socio-Cognitive Model

Back 20

Form of role-playing, construe themselves as possessing multiple selves and act in ways consistent with therapists expectations.

Front 21

Iatrogenic

Back 21

Caused by treatment, part of socio-cognitive model. Therapists may plant suggestions, the media may effect or could be a learned social role.

Front 22

Psychotherapy

Back 22

Resolve emotional distress associated with past traumas, learn more effective ways to cope. Series of stages leading up to integration of personalities.

Front 23

5 Stages of Psychotherapy

Back 23

1. Establish trusting, safe environment.
2. Develop new coping skills.
3. Open communication between alters.
4. Remember and grieve the abuse
5. Integrate personalities.

Front 24

Hypnosis

Back 24

Used to confirm diagnosis, contact alters and uncover memories of traumatic childhood. Potential to confabulate memories and personalities.

Front 25

Medication

Back 25

Not generally useful, may use to treat commorbid disorders. "Truth Serum", sodium amytal helps to recall memories or additional alters.

Front 26

Somatoform Disorders

Back 26

Physical symptoms with no organic basis but reflect psychological factors. Don't consciously produce or control symptoms. Symptoms resolve when psychological factors are addressed.

Front 27

Malingering

Back 27

Deliberately adopt sick role to achieve some sort of objective.

Front 28

Factitious Disorders

Back 28

Fake or generate symptoms of illness to gain medical attention. Can fake psychological symptoms.

Front 29

Conversion Disorder

Back 29

Loss of function in parts of body, appears to be neurological or medical but no underlying abnormality. Patients may show inconsistencies over time or unusual symptom patterns. Dynamic Reorganization of brain circuits that link volition, movement and perception. Lead to inhibition or normal cortical activity. Dissociation is the lack of integration between conscious awareness and sensory processes or voluntary control over physiological symptoms.

Front 30

Glove Anasthesia

Back 30

Loss of all sensation throughout the hand, loss is sharply demarcated at the wrist.

Front 31

Somatization Disorder

Back 31

Multiple recurring somatic complaints that change over time and without a diagnosable basis. Resist suggestion of psychological or social factors. History of pain n at least 4 different sites, or during bodily functions, at least 2 gastrointestinal symptoms other than pain, at least one sexual or reproductive symptom other than pain and at least one symptom other that pain that suggests neurological problem.

Front 32

Pain

Back 32

Individual subjective experience, onset and course affected by psychological factors like anxiety, depression and degree of perceived control over situation.

Front 33

Pain Disorder

Back 33

Complaints of pain in one or more bodily sites or serious enough to warrant clinical attention. Psychological factors must have important tole in onset, exacerbation, severity or maintenance of pain. Run risk on addiction to prescription drugs.

Front 34

Hypochondriasis

Back 34

Long standing fears, suspicions or convictions about having a serious disease. Misinterpretation of bodily symptoms or bodily functions. Vaque and ambiguous physical sensations. Difference between Hypochondriasis and Panic Disorder: Panic is fear of immediate symptom-related disasters maybe during attack itself and Hypochondriasis focuses on long-term process of illness and disease.

Front 35

Body Dysmorphic Disordedr

Back 35

Preoccupation with imagined/exaggerated body disfigurement, maybe to a point of delusion. Excessive, significant distress and impairment. Preoccupations difficult to control. Begins in adolescence. Difference between BDD and OCD: BDD more severely disturbed, higher rates of suicide, ideation, delusions, major depression, substance abuse and social phobia. Difference between BDD and anorexia: Don't show the same gender distribution, familial patterns or response treatments.

Front 36

Etiology of Somatoform Disorders (Physiological)

Back 36

Chronic stress producers activation of hypothalamic-pituitary-adrenal axis, higher levels of cortisol which can adversely affect immune system, brain, fatigue and malaise. Perceive physical illness when experiencing stress.

Front 37

Etiology of Somatoform Disorders (Cognitive)

Back 37

Interpretations of meaning and significance of somatic events, uncontrollable preoccupation with somatic experiences and excessive bodily concerns and worry. "Somatic amplifications".

Front 38

Etiology of Somatoform Disorders (Personality Traits)

Back 38

Negative affectivity, tendency to suppress emotional expression, highly hypnotizable. Develop beliefs and attitudes about our physical well-being through personal experiences with illness and information form others about their experiences.

Front 39

Etiology of Somatoform Disorders (Early Like Experiences)

Back 39

Social learning theory, trauma in somatization and pain disorder is common. The sick role is positively reinforced by care, concern and attention received from others and negatively reinforced by allowing them to avoid burdensome work activities or uncomfortable social situations.

Front 40

Treatment of Somatoform Disorder

Back 40

Cognitive affective and social processes that maintain excessive/inappropriate behaviour.
1. Establish co-operative therapeutic environment.
2. Identify primary concerns, establish position that all symptoms are "real" and distressing.
3. Establish mutually acceptable treatment goal
4. Shift attention to life stresses or affective states.
5. Focus on symptom management and rehabilitation
6. Identify and treat commorbid disorders.