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99 Cards in this Set

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Somatoform disorders
Characterized by physical symptoms that suggest a physical disorder but for which there is 1) no organic findings to explain the symptom and 2) strong evidence or suggestion that the symptoms are linked to psycholgical factors or conflicts
What were somatoform disorders formally called?
hysterical neurosis or conversion reaction
Medically unexplained symptoms account for what percentage of problems confronted everyday by physicians?
25% to 50%
Pain Disorder
The experience of severe and prolonged pain that is either greatly in excess of what might be expected from the medical problem causing it, or that occurs without any organic symptoms discovered.
Complaints may be used to evoke social responses (i.e. attention). Can be acute or chronic.
Acute pain
Has a duration of less than 6 months. Overraction to pain, associated with some specific event or injury of recent origin.
Chronic pain
Having a duration of 6 months or longer. Overraction to pain that is enduring and becomes a focus of that persons life.
Fifth Century B.C.
Hippocrates theorized about the problem of pain in a persons Body Joints
Decartes; pain as a specific phenomenon occuring in nervous system.
19th century
Specificity theories- there are specific sensory receptors responisble for the transmission of specific sensations, such as pain warmth, touch and pressure.
Biopsychosocial model
Interactional view that emphasizes the interaction among biological, psychological, and social factors in determining behavior and body function.
Treating Acute Pain
Generally aimed at reducing the patients anxiety through a trusting Dr-patient relationship, and also through neducation for anxiety and depression.
Operant Conditioning
Clinicians who use this in treating pain focus on pain behaviors , and the conditions that strengthen or weaken these behaviors.
Cognitive Behavioral Therapy
Pain is a learned response. Occurs by means of observational learning and modeling. - expectancies reguarding pain intensity and behavioral responses to pain are partially based on prior learning history.
Where do cognitive behavioral focus their attention?
On strengthening coping stratagies that are useful in modifying the pain experience, elevating mood, and improving overall quality of life.
Provides a way of extending self control procedures to deal with a variety of physiological behaviors that were formerly thought to be involuntary responses, such as heart rate, blood pressure, and brain waves.
Swami Rama
A yoga practitioner; was able to speed up and slow dow heart rateat will, stop his heart from pumping for 17 seconds, to stop 2 areas of his palm a few inches apart to change temperature in opposite directions until their temp differed by 10 degrees F, and to produce widely differing brain patterns at will.
May be helpful in reassuring and encouraging patients suffering from pain to comply with recommend rehibilitation programs.
What are pain disoders
They are biobehavioral phenomenon
What is pertinent to understanding and treating pain patients?
the patients vulnerabilities, precipitating factors, and mainataining processes
Somatization disorders
(Briquet's syndrome) Disorders characterized by a variety of dramatic but vague complaints that are often chronic and which have no discernible cause.
Common complaints of Somatization disorders
Headaches, fatigue, heart palpitations, fainting spells, nausea, vomiting, abdominal pain, bowel troubles, allergies, menstraul and sexual problems
Complaints are usually presented in a dramatic, vague, or exagerated way.
DSM-IV-TR's criteria for this disorder
At least 4 pain symptoms in different body sites. 2 gastrointestinal symptoms w/o pain, 1 sex. symptom w/ pain, 1 symptom or defect suggesting a neurological symptom
Patients with somo. disorders
believe that they are sick, provide long and detailed histories in support of their belief, and take large quantities of meds.
focus on fear of having a specific disease or diseases.
Somatizing disorders mainly occur in...
Women and about 1% of women have it
Conversion Disorders
report of loss in part or all of some basic bodily function, i.e. blindness, deafness, paralysis
Onset of conversion disorders
Usually occurs after a stressful experience that is quite sudden
Hyteria or Hysterical disorders
Presence of a physical problem with no physical cause
Person has a persistant belief (lasting 6 months or longer) that he or she has a serious illness despite medical reassurance, a lack of physical findings, and failure to help the disease. Show poor insight that they do not recognize the concern is excessive.
Three major characteristics of Hypochondrasis
1)physiological arousal 2) a bodily focus and 3) behaviors designed to avoid or check for physical illness
Most theraputic apprioaches to the disorder
1) establish a theariputic relationship
2) acknowledge the distress caused by the individuals concerns 3) elicit the persons fears and beliefs about their physical health 4) present alternative rational explanations and explain why the persons ideas may be mistaken
Body Dysmorphic Disorders (BDD)
Have a definite preoccupation with an imagined defect or morbidly excessive concern about a minor unwanted feature of their physical appearence.
Esential feature of BDD
Belief in an imagined defect in appearance
BDD causes
distress or impairment in social situations
Muscle dysmorphia
A form of BDD; Preoccupation with extensively muscled physique as an ideal. Primarily found in men
Treatmen for BDD
Cognitive-behavioral therapy, therapist ususally respons to this problem by stressing the problem of BDD and the therapy is designed to change body image not appearence
Factitious disorders
Conditions are physical and psychological and are voluntarily self-induced by the patient- the only goal is the desire to assume the role of patient; manufature symptoms
When do Fact. Disorders typically begin and is found much more in?
Early adulthood, more in women than men
Munchausen Syndrome
extreme type of Factitious disorder; marked by repeated knowing, stimulation of disease for the sold purpose of obtaining medical attention.; they fake symptoms and tell incredible tales; named after Baron von Munchausen
Factitious disorder by proxy
A form of Munchausen syndrome, mother produces the symptoms of diease in her child.
They seek medical care and hospitalization in order to achieve some specific goal such as compensation, a disability pension, or evasion of the police
Diffuse, vague, very unpleasant feeling of fear and apprehension.
An Anxious person
Worries alot, particularly about unknown dangers.They show combos of rapid heart rate, shortness of breath, dizziness, sweating, sleeplessness, frequent urination, and tremors.
Difference between anxiety and fear is that people with fears can easily state what they are afraid of.
Characteristics of anxiety
uncertainty, helplessness, and physiological arousal
anxietas and angor
Roman words; anxietas indicates a lasting state of fearfullness
angor indicates a momentary state of intense fear- our concept of panic
Generalized anxiety disorder
marked by chronic anxiety over a long period (at least several months)- consists of prolonged, vague, unexplained, but intense fears that do not seem to be attached to any particular object.- resemble normal fears but there is no actual danger
Phobic disorders
Anxiety has an identifiable cause- when the stimulius is not present the tension level is relativley low. - their fears are out of proportion with reality and beyond their control.
Panic Disorder
consists of recurrent, sudden anxiety attacks in which the individual experiences intense terror and dread. - have a sudden onset.
Used to be used to desribe disorders marked by anxiety, personal dissatisfaction, and innapropriate but not psychotic behavior.
Anxiety Disorders
20% have been diagnosed with Anxiety disorders
They frequently co-occur with other conditions
In GAD anxiety persists for
6 months or longer
Symptoms of GAD
worry, hypervigilance, motor tension and excessive autonomic activity
% of population that a GAD in any given year


When it tends to become evidant
3%, between late teens and early 20's
In GAD both ___ and ____ seem to be involved
biology and enviornment
The brain center that plays an important role in the experience of anxiety
Panic Attack
A rapidly rising urge of intense anxiety that occurs suddenly, either with or without clear cues, in an unpredictable fashion.
The % of the population with panic disorder
1.7, it tends to run in families
What triggers panic attacks
Stressful life events
How the DSM-IV-TR defines panic disorder
recurrent, unexpected panic attacks at least 1 month of persistant concern over having them again- marks of panic attacks are severe palpaitations, extreme shortness of breath, chest pains or discomfort, and a feeling of helplessness- victims fear they are going to die, go crazy or do sumthing uncontrolled.
Panic disorder affects
women more than men and younger ages more than elderly
A person who has a panic attack develops anticipatory anxiety
he or she becomes worried and tnese and afraid that the panic attack will recur
drug used in treatment of depression, has been shown to prevent the recurrence of panic attacks, but no effect on anticipatory anxiety- means that people may feel anxious but wont experience a panic attack- decreases frequency of sodium lactate-provoked panic attacks
Stress is a triggering factor in panic attacks...
how well one copes with stress depends on vulnerability factors, and resiliance
fear, panic, dread, or fright
Most common fear-arousing stimuli
Animals, objects, or events that presented real dangerin the earlier stages of human evolution- they do not need the actual presence of the feared object to experience intense tension or discomfort
Soical Phobias
Characterized by fear and embaressment in dealings with others. often persons greatest fearis that signs of intense blushing, tremors of the hand, and quivering voices will be detected by ppl whom he/she comes into contact
Social phobias begin...
in late childhood or early adolescence, then may crystalize into a phobia in late adolenscence.
Prominent feature of Social Phobia
Diagnosis of social phobia
anxiety that is chronic, pervasive, and disabling across diverse situations that involve contact with others
fear of entering certain fear-evoking or unfamiliar situations, which often accompanies panic attacks - afraid of his or her own internal cues. - they dread the awful anxiety of a panic attack and is afraid of losing control in a crowd.
When does Agoraphobia begin
usually in late teens
How agoraphbic people are helped
when they learn from a therapist how to identify and correct maladaptive thoughts about anxiety and consequences- cognitive and behavioral techniques are effective
Association between childhood seperation anxiety and agoraphobia is stronger in?
more women than men
Obsessive-compulisve disorder
shows the driven quality od the thoughts and rituals seen in people with this condition- have recurrent obsession or compulsions that are severe enough to be time-consuming or cause marked distress or significant impairment
Obsessive behavior
Unable to get an idea out of the mind
Compulsive behavior
feel compelled to perform a particular act or series of acts over and over again
Obsessions ususally involve
doubt, hesitation, fear of contamination or fear of ones own aggression
Most common forms of compulsions are
checking, odering, counting, touching and washing
About ___ % of people with obsessive compulsive disorder have intrusive thoughts but do not act on them
United States and Canada's figures
1.9 to 3.1 cases per 100 people with the usual age of onset between ages 20 and 29
Obsessive Compulisve most common among...
upper-income individuals who are somewhat more intelligent than average, tends to begin in late adolecence and early adulthood, and males and females are =ly likely to suffer.
One of most dramatic forms of obsessive compulsive
Hoarding- they collect collect and collect
Four broad types of preoccupations of OC
1) checking 2) cleaning 3) slowness 4) doubting and conscientiousness - these often increase during times of stress
Peopl who suffer from OC
are very cautious, they unreasonably anticipate catastrophe and loss of control- they fear what might happen to them
DSM-IV-TR criteria for OC
having recurrent and persistant thoughts, impulses, or images that are not simply general worries and real-life problems
differential diagnosis
a decision as to which of several diagnoses is most appropriate
Whats helpful for patients with OCD
certain serotonin-related drugs (Prozac) are helpful with sum patients
Cognitive-behavioral therapies are promising
Posttraumatic Stress Disorder (PTSD)
Development of symptoms in response to events of such severity that most people would be stressed by them. Symptoms often include a feeling of numbness in response or psychological reexperiencing of the event in thoughts, dreams, and nightmares
PTSD percentage of the general population
.5% in men and 1.2% in women

Americans currently have a 5-10% chance of developing PTSD at some time during their lifetimes
DSM-IV-TR's criteria for PTSD
3 essential characteristics
hyperarousal, avoidance, and reexperience- the most distressing is reexperience
involves unwanted and disruptive thoughts that interfere with normal functioning
PTSD acute and delayed
acute= condition begins within 3 months of the trauma
delayed= symptoms emerge more than 6 months after the event
People are more vulnerable to PTSD when
they are socially withdrawn, inhibited, irritable, pessimistic, and impulsive, as well as have tendencies toward dissociation
Frequent characteristic of PTSD
Tendency to reexperience the event- painful intrustive recolections are common- painful guilt feelings are common, as are depression, restlessness and irritablility
Intrusive state
individual cannot stop having frightening thought related to the tramtic event
Denial State
individual ignores the implications of threats and losses, forgets important problems, and may show a withdrawal of interest in life
Treatments of PTSD
most widley used medications are antidepressants and benzodiazepine tranquilizers- help to reduce intrusive symptoms; psychotherapy is also good with this reducion; exposure therapy; cognitive behavioral therapy helps reduce anxiety; family and community based programs
Two important tasks that face clinicians
one is understanding the nature of the problem and the other is treating it