Somatic 肉体的Symptom Disorders
experiencing significant physical symptoms for which there is no apparent organic cause, but is as a result of psychological factors.
the diagnostic criteria for somatic symptom disorder includes A) one or more somatic symptoms that are distressing or result in significant disruption of daily life; B) excessive thoughts, feelings, or behaviors related to the somatic symptoms or associated health concerns, this is manifested by disproportionate and persistent thoughts about the seriousness of one’s symptoms, persistently high levels of anxiety about health or symptoms, excessive time/energy devoted to these symptoms or health concerns; C) although any one symptom may not be continuously present, this state of being symptomatic is persistent. It’s specified the somatic symptoms predominantly involve pain.
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Illness anxiety disorder
the worry that one will develop a serious illness, but does not experience severe physical symptoms.
A) a preoccupation with acquiring or having a serious illness;
B) somatic symptoms are not present – in the case of a preexisting medical condition, preoccupation全神贯注 is excessive, the preoccupation is clearly excessive or disproportionate;
C) a high level of anxiety about health and the individual is easily alarmed about personal health status;
D) the individual performs excessive health related behaviors or exhibits maladaptive适应不良的 avoidance; E) the illness preoccupation has been present at least 6 months, but the specific illness that is feared may change over that period of time; and
F) the illness-related preoccupation is not better explained by another mental disorder. You may have known this hypochondria or a hypochondriac. In the DSM-5 the label for this is Illness Anxiety Disorder.
Theories of somatic symptom disorder and illness anxiety disorder
Cognitive factors play a strong role. These can be dysfunctional beliefs about illnesses, paying too much attention to physical change, catastrophic thinking of symptoms.
Post-traumatic stress disorder influences those who have experienced a stressor.
Treatments:
Psychodynamic therapies provide insight into emotions that link to physical symptoms.
Behavioral therapies learn and eliminate reinforcements that individuals get from symptoms.
Cognitive therapies help to learn and challenge physical symptoms to help avoid catastrophizing them.
Belief systems help to engage in therapy to work on the physical symptoms.
Conversion disorder
dramatic type of somatic symptom disorder that causes patients to lose neurologic神经病学的 function in a certain part of the body with no medical cause.
For example, glove anesthesia is a loss of all feeling in the hand that wiped out physical sensation.
The theories of conversion disorder
Freudian, which comes from psychoanalytic theory, which says that the disorder is a result of the transfer of the psychic energy attached to repressed emotions, which can include primary and secondary gains.
In behavioral theory, it states that stress is alleviated by removing the individual from the environment.
Freudian, which comes from psychoanalytic theory, which says that the disorder is a result of the transfer of the psychic energy attached to repressed emotions, which can include primary and secondary gains.
In behavioral theory, it states that stress is alleviated减轻 by removing the individual from the environment.
Factitious 不自然的disorder
deliberate faking of an illness to gain medical attention.
It’s called Munchausen Syndrome. Malingering is faking a symptom or disorder in order to avoid unwanted consequences. Factitious disorder is falsifying illness in another person.
Dissociative disorders
the process where components of mental experience are split from consciousness, but remain accessible through dreams and hypnosis.
Dissociative identity disorder theories.
Treatment
DID is a result of coping strategies used by persons faced with trauma.
The sociocognitive model says that multiple identities are created to adopt an idea that fits the patient.integrating all alters into one coherent personality and helping to rebuild the capacity to trust healthy relationships.
Dissociative amnesia记忆缺失
Types of dissociative amnesia are organic amnesia caused by brain injury, organic amnesia can be along with the inability to remember new information for
anterograde amnesia; psychogenic心理性的 amnesia arises in the absence of any brain injury or disease and has psychological causes;
is a loss of the ability to create new memories after the event that caused the amnesia, leading to a partial or complete inability to recall the recent past, while long-term memories from before the event remain intact.
retrograde amnesia is the inability to remember information from the past, has both organic and psychogenic causes.
Dissociative fugue
treatment
a person suddenly moves away from home and assumes an entirely new identity, possesses no memory of previous identity, and occurs in response to some stressor.
help the person identify the stressors leading to the fugue state and learning better coping skills.
Depersonalization and derealization disorder
episodic feeling of detachment from one’s own mental processes or body, like an outside observer of one’s self.
The causes are a significant stressor, sleep deprivation, or the influence of drugs.
Diagnosis is episodes of frequent and distressing and interfere with the ability to function and having a history of childhood physical, emotional, or sexual abuse.
People with conversion disorder:
can be difficult to treat because they have difficulty believing that something is wrong with them psychologically.
Dissociative identity disorder was formerly known as _____.
multiple personality disorder
dissociative personality disorder
Loftus’s “lost at the mall” studies showed how easy it is to _____.
create a false memory
Unlike a person with dissociative identity disorder, a person in a fugue state:
actually leaves the scene of the trauma or stress.
Which of the following alters found in dissociative identity disorder offers advice to the other personalities or performs behaviors the host is unable to handle?
The helper
Vickianna’s doctor is trying to distinguish between illness anxiety disorder and somatic symptom disorder. According to the DSM-5, to make the distinction he should be determine if Vickianna _____.
has physical symptoms
Amnesia is categorized as either _____ or _____.
psychogenic; organic
People with conversion disorder:
have an inability to cope with distress or trauma in adaptive ways.
Robert has an accident when he is out trekking with his friends. He cannot recall anything that happened just before slipping and hitting his head on a boulder. He most likely has _____.
retrograde amnesia
The main difference between the amnesia in dissociative amnesia and dissociative fugue is that:
people with dissociative fugue typically leave home and create a new life for themselves in another area, while people with dissociative amnesia do not take flight and create new identities.
Which of the following is considered to be the most dangerous alter found in dissociative identity disorder?
The persecutor
Somatic symptoms and dissociative disorders are considered by some theorists to be the result of a psychological process known as _____, in which different parts of an individual’s identity, memories, or consciousness split off from one another.
dissociation
In Hilgard’s study on the “hidden observer” phenomenon, he argued that there are two modes of consciousness: the _____ and _____.
active mode; receptive mode
_____ was formerly known as hypochondriasis.
illness anxiety disorder
Which of the following techniques is heavily used to contact alters in the case of dissociative identity disorder?
Hypnosis
One complication that arises in diagnosing amnesias is the possibility that:
amnesias are being faked by people to escape punishment for crimes committed.
Many courts deny the use of hypnosis in the case of dissociative amnesia because of the possibility that:
hypnosis will “create” memories through the power of suggestion.
the hypnosis will cause more damage to the individuals’ well-being.
People diagnosed with somatic symptom disorder frequently have periods of all of the following EXCEPT _____.
psychotic disorders
Which of the following is the most common alter found in dissociative identity disorder?
The child
Which of the following represents one of the difficulties in diagnosing somatic symptom disorders?
The person may have a real physical problem that is difficult to detect
The inability to remember information from the past is known as _____.
retrograde amnesia
Sherry believes that she has a serious illness. She has had a headache for several days with no relief from traditional over-the-counter medicines. Her visit to the doctor revealed no organic reason for the headaches. Unsatisfied with the results, she goes to several other medical professionals for treatment. Sherry is most likely suffering from a(n) _____.
somatic symptom disorder
dissociative disorder
acute stress disorder
Experiences of unreality or detachment with respect to surroundings are typical of individuals diagnosed with:
derealization disorder.
People who develop dissociative identity disorder tend to be:
highly suggestible and hypnotizable.
Freud and his contemporaries viewed conversion symptoms as results of:
the transfer of psychic energy attached to repressed emotions or memories into physical symptoms.
Bertram has spent years being concerned about his health even though he has no symptoms or pain. Several years ago, he read an article on tumors and became preoccupied with thoughts about getting a tumor. He rarely seeks medical help and in fact avoids doctors and hospitals. Bertram is most likely experiencing a(n) _____.
illness anxiety disorder
Which of the following disorders may appear similar in their presentation?
Somatic symptom disorder and illness anxiety disorder
Which of the following statements is true of psychogenic amnesia?
.
It involves memory loss that is limited to personal information.
Candice faked her symptoms to gain medical attention. She exaggerated her symptoms to the point that exploratory surgery was conducted. Candice most likely has a _____.
factitious disorder
Amnesia is frequently seen in murder cases with _____ percent of people arrested for homicide claiming to have amnesia.
25-45
In the context of the theories of conversion disorder, which of the following best describes secondary gain?
The attention and sympathy received as a result of the conversion symptoms
According to DSM-5, which of the following is a diagnostic criterion for illness anxiety disorder?
The individual must perform excessive health related behaviors.
Some studies suggest that _____ may be more likely than other ethnic groups to experience dissociative symptoms in response to traumas.
Latinos
In dissociative identity disorder, an alter that inflicts pain or punishment on the other personalities by engaging in self-mutilative behaviors (such as self-cutting or self-burning) and suicide attempts is called _____.
the persecutor
n the context of the theories of conversion disorder, which of the following best describes secondary gain?
The attention and sympathy received as a result of the conversion symptoms
Which of the following is a reason an individual may develop dissociative identity disorder?
As a strategy to cope with traumas
Memories formed before the age of _____ tend to be sketchy.
3
Which of the following is a treatment goal for dissociative identity disorder?
Helping the client work through the trauma to integrate all the alternative personalities into one coherent personality
Which of the following is true of dissociative identity disorder (DID)
People diagnosed with DID claim to have significant periods of amnesia
People diagnosed with somatic symptom disorder frequently have periods of all of the following EXCEPT _____.
psychotic disorders
Which of the following statements is true of conversion disorder?
The conversion symptom develops after a trauma or psychological stressor.
Mary created an illness in her younger daughter to draw attention to herself. This is known as a _____.
factitious disorder by proxy
Family studies suggest that somatic symptom and pain disorders run primarily among _____ and _____ have higher rates of alcoholism.
female relatives; male relatives
Freyd and colleagues (2007) suggest that individuals who dissociate from, and forget, their abusive experiences are most likely to perform differently from other individuals on _____ that require divided attention.
cognitive tasks
Organic amnesia often involves the inability to remember new information, known as _____
anterograde amnesia
Which of the following techniques is heavily used to contact alters in the case of dissociative identity disorder?
Hypnosis
For most people, the active mode and receptive mode:
weave our experiences together so seamlessly that we do not notice any division between them.
Cognitive therapies for somatization disorder focus on:
challenging the client’s maladaptive interpretations of physical symptoms and teaching them techniques for appropriate interpretations.
Jaclyn has been complaining for several weeks that she has lost all feeling in her right hand. Her physical exam revealed no nerve damage. However, Jaclyn insists that something is wrong because she feels as though she has on a tight glove. Jaclyn is mostly experiencing _____ associated with _____ disorder.
glove anesthesia; conversion disorder
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