Overview of Somatic and Dissociative Disorders
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Questions and Answers

What is a defining characteristic of somatic symptom disorder?

  • Presence of multiple distinct personalities
  • Distress from a preoccupation with health or appearance (correct)
  • Excessive enjoyment of physical symptoms
  • Dissociation from memory or sense of reality
  • What did Pierre Briquet refer to when describing patients in 1859?

  • Somatic symptom disorder (correct)
  • Dissociative identity disorder
  • Generalized anxiety disorder
  • Hysterical neurosis
  • How is the duration of somatic symptoms characterized in somatic symptom disorder?

  • Intermittent throughout life
  • Varies significantly with each occurrence
  • Typically less than one month
  • Persistent for at least six months (correct)
  • Which of the following is NOT a criterion for somatic symptom disorder?

    <p>Chronic pain lasting less than six months (B)</p> Signup and view all the answers

    Which of the following describes the link between somatic symptom and dissociative disorders?

    <p>They share common features and historical context. (B)</p> Signup and view all the answers

    What constitutes 'excessive thoughts' in the context of somatic symptom disorder?

    <p>Overwhelming anxiety about health conditions (C)</p> Signup and view all the answers

    Which statement about the severity levels in somatic symptom disorder is true?

    <p>Mild involves only one of the symptoms in Criterion B. (B)</p> Signup and view all the answers

    In somatic symptom disorder, what is meant by 'maladaptive response'?

    <p>An inappropriate reaction to physical symptoms (B)</p> Signup and view all the answers

    Which of the following best describes Illness Anxiety Disorder?

    <p>Individuals often misinterpret mild bodily sensations as indicative of illness. (B), Individuals are highly anxious about having or developing a serious disease. (D)</p> Signup and view all the answers

    What is one key characteristic that distinguishes malingering from factitious disorder?

    <p>Motivation is usually external rather than internal. (C)</p> Signup and view all the answers

    What symptom level qualifies for a 'severe' classification in somatic symptom disorder?

    <p>Two or more symptoms along with multiple somatic complaints. (D)</p> Signup and view all the answers

    In factitious disorder imposed on another, what is the primary intent behind the behavior?

    <p>To make another person appear ill for attention. (C)</p> Signup and view all the answers

    What characteristic is NOT associated with Illness Anxiety Disorder?

    <p>Presence of multiple severe somatic symptoms. (C)</p> Signup and view all the answers

    Which criterion indicates that a symptom is not better explained by another medical disorder?

    <p>The symptom causes distress. (B)</p> Signup and view all the answers

    How long must illness preoccupation persist to meet the criteria for Illness Anxiety Disorder?

    <p>At least 6 months. (C)</p> Signup and view all the answers

    What defines factitious disorder according to its diagnostic criteria?

    <p>Fabrication of symptoms without external rewards. (B)</p> Signup and view all the answers

    What behavior might individuals with Illness Anxiety Disorder exhibit?

    <p>Avoidance of health-related information. (D)</p> Signup and view all the answers

    How do individuals with factitious disorder typically present themselves?

    <p>As ill, impaired, or injured. (C)</p> Signup and view all the answers

    Which of the following statements is true regarding the perception of doctors’ reassurances in Illness Anxiety Disorder?

    <p>Reassurances provide only temporary relief. (B)</p> Signup and view all the answers

    In Illness Anxiety Disorder, individuals tend to focus on which aspect more than actual symptoms?

    <p>The fear of developing a serious illness. (D)</p> Signup and view all the answers

    What distinguishes the motivation of a malingerer from a person with factitious disorder?

    <p>Malingerers may attempt to escape responsibility. (B)</p> Signup and view all the answers

    What might indicate a diagnosis of somatic symptom disorder instead of Illness Anxiety Disorder?

    <p>Experience of multiple moderate somatic symptoms. (A)</p> Signup and view all the answers

    Which statement about the symptoms of malingering is true?

    <p>Symptoms are often exaggerated beyond expected standards. (C)</p> Signup and view all the answers

    What is a common misconception regarding factitious disorder imposed on another?

    <p>It can only occur in familial relationships. (C)</p> Signup and view all the answers

    What distinguishes Conversion Disorder from other medical conditions?

    <p>Symptoms affect voluntary motor or sensory function without a medical explanation (B)</p> Signup and view all the answers

    Which of the following is an example of a psychological factor adversely affecting a medical condition?

    <p>A patient with asthma experiencing increased anxiety (D)</p> Signup and view all the answers

    What is the essential feature of Psychological Factors affecting a medical condition?

    <p>The presence of a diagnosed medical condition influenced by psychological factors (D)</p> Signup and view all the answers

    Which of the following best describes 'psychogenic non-epileptic seizures'?

    <p>Seizures without significant EEG changes (A)</p> Signup and view all the answers

    What is a common symptom of Conversion Disorder?

    <p>Loss of speech without any underlying neurological condition (C)</p> Signup and view all the answers

    How are the symptoms of Conversion Disorder described?

    <p>They are incompatible with recognized medical conditions (B)</p> Signup and view all the answers

    In which situation would a Care-seeking type individual likely seek medical help?

    <p>They frequently consult doctors and undergo tests (A)</p> Signup and view all the answers

    Which symptom is associated with globus hystericus?

    <p>The sensation of a lump in the throat affecting swallowing (A)</p> Signup and view all the answers

    What defines a depersonalization experience in dissociative disorders?

    <p>Experiencing disconnection from one's mental processes or body. (C)</p> Signup and view all the answers

    Which of the following characterizes derealization?

    <p>Experiences of unreality regarding one's surroundings. (B)</p> Signup and view all the answers

    What does reality testing refer to in the context of dissociative disorders?

    <p>The ability to accurately assess one's surroundings during episodes. (B)</p> Signup and view all the answers

    Which symptom is NOT characteristic of depersonalization-derealization disorder?

    <p>Complete loss of reality awareness. (B)</p> Signup and view all the answers

    Which statement accurately describes a common experience for individuals with dissociative disorders?

    <p>They may feel as if they are watching themselves in a dream. (C)</p> Signup and view all the answers

    What is a diagnostic criterion for depersonalization-derealization disorder?

    <p>Experiences must cause significant distress or impairment. (C)</p> Signup and view all the answers

    Which of the following is a type of dissociative disorder?

    <p>Dissociative identity disorder. (A)</p> Signup and view all the answers

    What is commonly experienced during episodes of dissociation?

    <p>Perceptual distortions in which shapes and sizes may seem altered. (B)</p> Signup and view all the answers

    Which type of amnesia involves an inability to remember specific events?

    <p>Localized or selective amnesia (B)</p> Signup and view all the answers

    What is a characteristic symptom of Dissociative Amnesia?

    <p>Inability to recall important autobiographical information (D)</p> Signup and view all the answers

    Dissociative Amnesia does NOT include symptoms that are better explained by which of the following?

    <p>Major depressive disorder (B)</p> Signup and view all the answers

    What constitutes dissociative fugue within Dissociative Amnesia?

    <p>Purposeful travel associated with amnesia (A)</p> Signup and view all the answers

    What is the primary objective of the diagnostic criteria for Dissociative Amnesia?

    <p>To rule out other psychiatric disorders (B)</p> Signup and view all the answers

    Which of the following is NOT a symptom that would indicate Dissociative Amnesia?

    <p>Psychotic episodes (B)</p> Signup and view all the answers

    The average number of identities in Dissociative Identity Disorder (DID) is approximately how many?

    <p>15 (B)</p> Signup and view all the answers

    Which type of amnesia involves general memory loss, affecting identity and life history?

    <p>Generalized amnesia (D)</p> Signup and view all the answers

    Flashcards

    Somatic Symptom Disorder

    A disorder where a person has one or more distressing physical symptoms causing significant disruption to daily life, with excessive worry about the seriousness of these symptoms.

    Briquet's Syndrome

    An outdated term for a condition now called Somatic Symptom Disorder. Patients repeatedly reported numerous physical symptoms, even after negative test results.

    Diagnostic Criteria (Somatic Symptom Disorder)

    The specific features that must be present for a diagnosis. It includes distressing physical symptoms and excessive worry about their seriousness, consuming a significant amount of time and energy.

    Somatic Symptom

    A physical symptom of a somatic symptom disorder. Can be pain or other complaints.

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    Excessive worry about symptoms

    A key component of Somatic Symptom Disorder. Patients are disproportionately concerned about the severity of their physical symptoms.

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    Disruption of daily life

    The extent to which the symptoms impair or affect a patient's routine and activities.

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    Persistent symptoms

    Symptoms in somatic symptom disorder typically last for at least 6 months.

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    Pain as a dominant symptom

    A possible specification in Somatic Symptom Disorder, emphasizing pain as the primary concern and symptom.

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    Psychological Factors affecting medical condition

    A diagnosed medical condition (e.g., asthma, diabetes, cancer) is negatively impacted by psychological/behavioral factors directly affecting its course or treatment.

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    Care-seeking type

    Frequent use of medical care, including visits, tests, and procedures, for a health issue.

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    Care-avoidant type

    Infrequent use of medical care for a health issue.

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    Conversion Disorder (Functional Neurological Disorder)

    A disorder with physical symptoms (e.g., paralysis, blindness) with no physical cause.

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    Functional symptom

    A symptom without an organic (physical) cause.

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    Psychogenic non-epileptic seizures

    Psychological seizures, without EEG changes to support them as an actual seizure.

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    Globus hystericus

    Sensation of a lump in the throat, causing difficulty swallowing, eating, or talking.

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    Incompatibility with medical disorder

    Symptoms do not align with known or recognized medical conditions.

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    Somatic Symptom Disorder (Severe)

    A disorder where two or more symptoms in Criterion B are met, additionally with multiple somatic complaints (or one extremely severe symptom).

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    Illness Anxiety Disorder (Formerly Hypochondriasis)

    A disorder where there's great worry about having a severe illness, despite minimal or absent physical symptoms. The focus is on the possibility of disease, not the symptoms themselves.

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    Illness Anxiety Disorder: Physical symptoms

    Minimal or absent physical symptoms are experienced in illness anxiety disorder. Focus is the fear of illness not physical symptoms.

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    Illness Anxiety Disorder and Somatic Symptom Disorder Difference

    If symptoms are severe and cause anxiety, it might be somatic symptom disorder; if anxiety is the overriding concern with minimal symptoms, it's illness anxiety disorder.

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    Illness Anxiety Disorder: Disease Conviction

    Reassurance from doctors has limited, often short-term impacts on the individual's beliefs about having a serious illness in illness anxiety disorder.

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    Illness Anxiety Disorder: Diagnostic Criterion A

    Preoccupation with fear of acquiring a serious illness.

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    Illness Anxiety Disorder: Diagnostic Criterion C

    High level of anxiety about health, easily alarmed about health status.

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    Illness Anxiety Disorder: Duration

    The preoccupation with illness must be present for at least six months, but the feared illness can change during that time.

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    Factitious Disorder

    A mental disorder where someone deliberately fakes symptoms, injuries, or diseases to gain attention or assume the sick role.

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    Malingering

    A condition where someone fakes symptoms to avoid responsibilities or gain something.

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    Factitious Disorder Imposed on Another

    Someone fabricates symptoms in another person to make them seem ill.

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    Diagnostic Criteria for Factitious Disorder

    Specific standards to diagnose Factitious Disorder (not a person, but a category).

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    Fabrication of symptoms

    Deliberately creating inaccurate signs or reports of illness.

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    Presenting as ill

    Acting like one is ill or injured.

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    No obvious external reward

    The deceptive behavior isn't driven by an apparent outside gain.

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    Not other mental disorders

    The symptoms are not better explained by a different mental disorder or medical condition.

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    Dissociative Disorders

    Conditions where individuals feel detached from themselves or their surroundings, experiencing feelings of unreality (like a dream or slow motion).

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    Depersonalization

    A dissociative experience characterized by a feeling of detachment from one's own mental processes or body, as if in a dream or watching oneself.

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    Derealization

    A dissociative experience characterized by a feeling of detachment from the external world, where surroundings seem unreal, distorted, or lifeless.

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    Depersonalization-Derealization Disorder

    A dissociative disorder where feelings of unreality are so severe and frequent they affect daily life and functioning.

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    Reality Testing

    The ability to distinguish between what is real and what is not during a dissociative episode.

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    Recurrent Episodes

    Two or more events of intentionally falsifying a medical illness or inducing an injury.

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    Single Episode

    A single instance of intentionally falsifying a medical illness or inducing an injury.

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    Dissociative Amnesia

    A dissociative disorder marked by a sudden loss of memory for personal information, often triggered by a traumatic event.

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    Generalized Amnesia

    A type of amnesia where individuals lose all memory of their past.

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    Localized/Selective Amnesia

    A type of amnesia where individuals lose memory for specific events or time periods.

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    Dissociative Fugue

    A subtype of dissociative amnesia involving unexpected travel and/or confusion about personal identity, often triggered by a specific event.

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    Dissociative Identity Disorder

    A disorder where a person exhibits multiple distinct identities or personality states.

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    Symptoms not explained by substance or medical condition

    The symptoms of the disorder are not caused by substance abuse, medication, or other medical conditions.

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    Criterion for Dissociative Amnesia

    The inability to recall important autobiographical information that cannot be explained by typical forgetting, and causes significant distress or impairment in life.

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    Excluding other disorders

    The diagnosis is not due to other disorders such as schizophrenia or post-traumatic stress disorder.

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    Study Notes

    • Individuals may have excessive preoccupation with health or appearance dominating their lives
    • Somatic symptom disorders involve an excessive or maladaptive response to physical symptoms or health concerns
    • Somatic symptom disorders historically linked to hysterical neurosis, and evidence suggests shared features with dissociative disorders
    • Dissociative disorders involve detachment from oneself, experiences of unreality, and loss of identity or memory. These experiences are intense and extreme, making functioning difficult.

    Somatic Symptom Disorder

    • In 1859, Pierre Briquet described patients with seemingly endless somatic complaints that persisted despite negative findings
    • This condition, once called Briquet's syndrome, is now known as Somatic Symptom Disorder.
    • Diagnostic criteria include one or more distressing somatic symptoms causing significant daily life disruption.
    • Patients’ thoughts, feelings, and behaviors regarding somatic symptoms or health concerns are excessive and persistent, often causing significant anxiety and excessive time/energy spent on health concerns
    • Symptoms are usually present for more than 6 months.
    • Specify whether the predominance is pain, and specify current severity
    • (Mild: only one symptom fulfilled in Criterion B; Moderate: two or more symptoms fulfilled in Criterion B)

    Illness Anxiety Disorder

    • Formerly known as hypochondriasis
    • Physical symptoms are not experienced strongly currently or are relatively mild and often involve intense concern about having or developing a serious illness.
    • Focused on the possibility of serious illness, rather than physical symptoms themselves
    • Anxiety and distress associated with other symptoms—if severe—would indicate Somatic Symptom Disorder instead
    • Characterized by anxiety or fear of illness, with misinterpretations of bodily sensations as indicative of illness.
    • Reassurance from doctors has a limited effect

    Conversion Disorder (Functional Neurological Disorder)

    • Symptoms involve physical malfunctioning (e.g., paralysis, blindness, aphonia) without an organic cause.
    • Includes a wide range of symptoms (e.g., total mutism or loss of touch)
    • Symptoms potentially include seizure-like episodes (psychogenic non-epileptic seizures) or swallowing difficulties.
    • Diagnostic criteria include one or more symptoms affecting voluntary motor or sensory function, that are inconsistent with recognized medical conditions/disorders, and significant distress or impairment in social / occupational functioning
    • Symptoms not explained by mental or other disorders; diagnosis warrants medical evaluation

    Malingering

    • Deliberate production of physical symptoms for an external gain (not inherent motivation)
    • May involve fabrication to avoid work, legal ramifications, or other difficulties

    Factitious Disorder

    • Symptoms intentionally produced to assume the sick role, sometimes even in family members
    • Characterized by intentional fabrication of physical or psychological symptoms or illness (or injuries), and deception
    • Internal motivation; symptoms are under voluntary control.

    Dissociative Disorders

    • Characterized by feelings of detachment from self or surroundings; sometimes described as dreaming or living in slow motion
    • Three types include depersonalization-derealization, dissociative amnesia, and dissociative identity disorder
    • Dissociative disorders involve disruptions in a person’s awareness, memory, or identity.

    Depersonalization-Derealization Disorder

    • Persistent feelings/experiences of detachment that are severe enough to dominate an individual's life and impair functioning
    • The individual experiences a sense of unreality about oneself or their surroundings, and this can significantly affect their daily lives
    • Reality testing remains intact during this experience.

    Dissociative Amnesia

    • Inability to recall important personal information, often relating to stressful or traumatic events
    • Ranges from localized (involving a single event) to generalized (involving identity and life history)
    • Could involve dissociative fugue, unexpected travel or bewildered wandering with loss of memory of personal identity

    Dissociative Identity Disorder

    • Characterized by existence of two or more distinct identities or personality states (alters), that function independently, sometimes with different physical characteristics (or voices)
    • Typically involve periods of inability to recall information
    • May include different alters that co-exist, sometimes with a host identity or dominant personality
    • Symptoms lead to distress or significant problems in social, work, or other important aspects of life

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    Description

    Explore the complexities of Somatic Symptom Disorders and Dissociative Disorders, including their historical context and diagnostic criteria. Understand how excessive health preoccupations can affect daily life and the intense experiences related to dissociation. This quiz aims to clarify these intertwined mental health issues.

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