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36 Cards in this Set
- Front
- Back
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What term was first used in the DSM III for somaticdisorders? Why has it changed? |
Somatoform disorders(medically unexplained symptoms) Ancient Greece“Histeria” DSM V acknowledgesthat there is uncertainty of causality De-emphasis on whetherit’s medically explained |
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What is the focus of somatic disorders in the DSM V? |
Abnormal reactions tosomatic symptoms Combination ofprominent preoccupation, worry and excessive help seeking |
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What’s involved in dissociative disorders? |
Loss of normalintegration of identity, memory, perception or consciousness |
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Explain the term dissociation (disconnection) which isthought to be a similar mechanism underlying somatic and dissociative disorders |
Dissociation betweenmental awareness and normal mental system |
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What dissociation exists in somatic disorders anddissociative disorders? |
Somatic - Spit offbetween sensory or motor system Dissociative - Spitoff between “higher” mental functions (psychological dissociation) |
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Define Psychosomatic disorders |
Patient presenting physicalillness contributed to by psychological factors (which some have physiologicallinks e.g. hormonal, stress…) |
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Define Hypochondriasis |
Disorder entailingintense anxiety regarding the belief that one has a serious medical conditionthat one clearly does not have |
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What factors help identify somatic and related disorders asmental disorders rather than medical? |
Number and persistenceof symptoms Degree of bodilypreoccupation Intensity of illnessworry Forceful seeking ofmedical/healthcare Poor quality ofpatient-healthcare system relationship |
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What is the somatic symptom diagnosis criteria? |
One or moredistressing or debilitating somatic symptoms accompanied by abnormal thoughts,feelings and behaviours in relation to these somatic symptoms. Being symptomatic ispersistent or with predominant pain and any one somatic symptom may not beconsistently present 3 levels of severity |
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What are the 3 types of somatic symptoms? |
1) Disproportionateand persistent thoughts about seriousness of symptoms 2) Persistently highlevels of anxiety about health or symptoms 3) Excessive time andenergy spent devoted to symptoms or health concerns (e.g. excessive health careutilisation) |
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What are the 5 types of somatic symptom and relateddisorders? Add prevalence rates |
Somatic symptomdisorder (est. 5-7%) Illness anxietydisorder (est. 1 – 10%) Conversion disorder(functional neurological symptom disorder) 5% of neurology patients Psychological factorsaffecting other medical conditions Factitious disorder(1% of patients in hospital) |
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What disorder do most individuals with hypochondriasis(abnormal levels of anxiety regarding their health) meet? |
Somatic symptomdisorder |
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What is the difference between somatic symptom disorder andillness anxiety disorder |
Illness anxietydisorder patients preoccupied with having or acquiring illness – In the absenceof experiencing marked somatic symptoms |
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What are some of the elements in illness anxiety disorder? |
Disturbances in: Perception(hypersensitivity to bodily sensations) Affect (anxiety) Cognition (beliefsregarding threat or reality) Behaviour (excessivehelp and reassurance seeking) |
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Define Conversion Disorder (functional neurological symptomdisorder) |
Disorder marked by asudden loss of functioning in a sensory or motor part of the body (e.g.blindness) without an identifiable medical cause |
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Define factitious disorders |
Characterized bydeliberately faking physical or mental illness in order to gain medicalattention Another variant called“factitious disorder imposed on another” (e.g. child) Patient producessymptoms to gain medical attentions (e.g. create an infection)m |
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How are factitious disorders different to malingering? |
Malingering patientshave a recognisable external incentive such as financial compensation fordeliberately feigning symptoms |
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Which of the somatic disorders were added in the DSM V.Which is higher in females? |
Somatic symptom(higher in females) and illness anxiety disorder |
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What happens as number of unexplained somatic symptomsincrease? |
Proportion of patientswith depression and anxiety increases |
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What percentage of presenting symptoms to GP’s will remainunexplained even as they persist over time? |
30% |
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Describe 2 factors contributing to the aetiology of somaticsymptom and related disorders |
Hormonal StressResponse System – underactivity = fatigue Neurobiological Models– Gate Control Theory (neural gates in spinal cord can be opened or closed tovarying degrees to control flow of impulses from peripheral receptors in bodyto CNS, determining amount of pain) |
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Explain the possible roles of Trauma and Personality insomatic symptom and related disorders |
Trauma may benon-declarative (contained in emotions, reflex or bodily sensations) ratherthan declarative (conscious thought and facts) Personality –Alexithymia (diminished capacity to consciously experience/describe emotions)causing misinterpretations of bodily sensations as sign of physical illness |
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Describe the 4 processes in Somatosensory amplification(Cognitive/Behavioural factors) |
Perception of symptoms(attention directed towards body) Attribution regardingsymptoms (physical rather than psychological) Concerns/Anxiety aboutillness (hypochondriacal) Illness behaviour (e.g.seeking medical attention and hypervigilance) *the 3 later processesfeedback into the first, effectively “amplifying” perception of symptoms |
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Give examples of family, social and cultural factorsinvolved in somatic symptom and related disorders |
Family – parentalmodelling Healthcare – attentiongiven if diagnosis Cultural – culturebound syndromes (occur only in certain cultures) |
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Outline important aspects to treatment in somatic symptomand related disorders |
Comprehensive assessment(physical and psychological factors) Minimizing # ofclinicians to maximize consistency Identifying andminimizing reinforcers (maintenance factors) Treating comorbidmedical or psychological disorders |
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What is the difference between acute or chonic somaticsymptom and related disorders? |
Acute – Weaker illnessconviction Chronic – Multiplesomatic symptoms and strong illness conviction |
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While common ground on medical diagnoses is unlikely somaticsymptom and related disorders are likely to agree with you eventually on? |
Goals of minimizingsymptoms Maximizing functioning Finding enjoyment inlife Working onrelationships Treating co-morbidconditions |
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What are some useful treatment approached to somatic symptomand related disorders? |
CBTSelf-monitoring (dailyactivity diary recording # beh. and circumstances in which beh. occurs) Meds SSRIs – (Illnessanxiety disorder) |
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What are the 5 primary experiences that might be associatedwith dissociative disorders? |
Amnesia – absence ofmemory for sig. period of time Depersonalisation –change in individuals sense of self Derealisation – changein individuals sense of the world Identity confusion –feelings of uncertainty/conflict regarding ones identity Identity alteration –most extreme, objective behaviours during assumed alt. identities at differenttimes |
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Outline and describe the 3 primary dissociative disorders |
Depersonalisation/derealisationdisorder – repeated episodes of depersonalisation and/or derealisation Dissociative amnesia –loss of memory for important facts about one’s own life (usually stress/traumanature) Dissociative identitydisorder – individual develops more than one distinct identity (multiple PD) |
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Which dissociative disorder is characterised by acting withoutvolition (automaton) or as if in a dream? |
Depersonalisation/derealisationdisorder |
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Changed from multiple PD in DSM IV, Dissociative identitydisorder must not? |
Be a part ofreligious/cultural practices Related to imaginaryplaymates |
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Depersonalisation/derealisation not meeting criteria fordisorder in general population compared to those with lifetime prevalence of disorder? |
26-74% compared to 0.8-2.4 |
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30% of those who report childhood abuse also report whatdissociative disorder? What setting it also common in? |
Dissociative amnesia, alsocommon in war |
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The vast majority of individuals with dissociative identitydisorder report what? |
Experienced sometrauma, vast majority have PTSDSmall percentageiatrogentic (physician origin) by reinforcement via attention |
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Marijuana and hallucinogen use is tied to what dissociative disorder? |
Depersonalisation/derealisationdisorder |
