Abnormal: Dissociative, Somatic, EDs, and Sleep

Dissociative Disorders

The primary feature of these disorders is “a disruption of and/or discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior.”

DID

This disorder is characterized by the presence of two or more distinct personality states or an experience of possession in a single individual

DID

This disorder involves recurrent gaps in the recall of everyday events, personal information, or traumatic experiences that cannot be explained by ordinary forgetfulness; the dissociation (e.g., possession) must not be an expression of religious or cultural beliefs

Dissociative Amnesia

This disorder involves an inability to recall important personal information that cannot be attributed to ordinary forgetfulness. It is often related to a traumatic event, with types of amnesia including localized, selective, etc.

Localized Amnesia

This is the inability to remember all events related to a period of time

Selective Amnesia

This is the inability to remember some events related to a period of time

Generalized Amnesia

This is a loss of memory that encompasses a person’s entire life

Continuous Amnesia

This is the inability to recall events from a period through the present

Systematized Amnesia

This is the inability to recall memories related to a certain category of information (e.g., a person’s spouse)

Dissociative Fugue

This is a specifier for Dissociative Amnesia; it involves apparently purposeful travel with an inability to remember some or all of one’s past

Depersonalization/ Derealization Disorder

This disorder is characterized by persistent or recurrent episodes of depersonalization or derealization

True

True or False: Reality testing remains intact during Depersonalization/ Derealization Disorder episodes

Depersonalization

This is a sense of unreality, detachment, or being an outside observer on one’s thoughts, feelings, etc.

Derealization

This is a sense of unreality or detachment involving one’s surroundings

Somatic Symptom Disorder

This disorder is characterized by the presence of one or more somatic symptoms that cause distress or disruption, accompanied by excessive thoughts, feelings, or behaviors related to the symptoms

Somatic Symptom Disorder

This disorder involves at least one of the following: Persistent and disproportionate thoughts about the seriousness of the symptoms, persistently high level of anxiety about one’s health or symptoms, and excessive time and energy devoted to health concerns or symptoms

Somatic Symptom Disorder

This disorder typically lasts more than six months (persistent), although one symptom may not be consistently present; predominant pain specifier is used when pain is the primary symptom

True

True or False: People with Illness Anxiety Disorder may seek out or avoid health information

Illness Anxiety Disorder

This disorder is characterized by a preoccupation with having a serious illness, an absence of somatic symptoms (or only mild somatic symptoms), a high level of anxiety about one’s health, and performance of excessive health-related behaviors or maladaptive avoidance of doctors, hospitals, etc.

Illness Anxiety Disorder

This disorder must be present for at least six months, although the serious illness of focus/ concern may change over time

Functional Neurological Symptom Disorder

This disorder is characterized by disturbances in voluntary motor or sensory functioning that suggest a serious neurological or other medical condition (e.g., paralysis, seizures, blindness, loss of pain sensation, etc.) but with incompatibility between the symptom and recognized neurological or medical conditions

Conversion Disorder

This is another name for Functional Neurological Symptom Disorder

Functional Neurological Symptom Disorder

Specifiers for this disorder include symptom type (e.g., weakness, abnormal movement, etc.), course (e.g., acute vs. persistent), and presence of absence of a stressor

Factitious Disorder Imposed on Self

This disorder occurs when a person falsifies physical or psychological symptoms that are associated with their deception (e.g., presenting depression after a death that did not occur); presents themselves to others as ill or impaired; and engages in this behavior despite no obvious external reward

Factitious Disorder Imposed on Others

This disorder occurs when a person falsifies physical or psychological symptoms in another, present that person to others as being ill or impaired, and engage in deceptive behavior in the absence of a clear external reward

Factitious Disorder

In this disorder, symptoms may be feigned, exaggerated, simulated, or induced

Malingering

This occurs when a person intentionally produces physical or psychological symptoms for the purpose of obtaining an external reward (e.g., avoiding work, financial compensation, getting drugs, etc.)

Malingering

When compared to Factitious Disorder, this is more likely when a person is receiving evaluation for legal reasons, has discrepancies between symptoms and objective measures, lacks cooperation with diagnostic or treatment process, or has Antisocial Personality Disorder

False

True or False: People with Factitious Disorder often seek treatment on their own accord

True

True or False: The therapeutic relationship and consistency can help address symptoms of Factitious Disorder

Pica

This disorder is characterized by persistent eating of non-nutritive, non-food substances (e.g., paint, plaster, insects, clay, etc.)

1 Month

Symptoms of Pica must be present for at least __

True

True or False: Pica can occur at any age but is most common in children

Anorexia Nervosa

This disorder involves a restriction of energy intake that leads to a significantly low body weight, fear of gaining weight or being fat, and a disturbance in how a person perceives their weight. A person may also have behaviors that interfere with weight gain or lack recognition of how serious their low weight is

Anorexia Nervosa

Specifiers for this disorder include type (e.g., restricting or binge-eating/purging), course (e.g., remission), and severity (e.g., mild, moderate, etc.)

Anorexia Nervosa

This disorder is often associated with excessive exercise, self-induced vomiting and/or laxative use, preoccupation with food (e.g., collecting recipes), preparing elaborate meals for others, and hoarding food

Anorexia Nervosa

More than half of people with this disorder meet criteria for an anxiety disorder at some point during their life; onset usually precedes the eating disorder

Anorexia Nervosa

Physical changes associated with this disorder include constipation, cold intolerance, abdominal pain, lethargy, bradycardia, amenorrhea; with purging, there can be anemia, impaired renal functioning, cardiac abnormalities, dental problems, and osteoporosis

90

__% of Anorexia Nervosa occurs in girls and women

Anorexia Nervosa

This eating disorder is often associated with perfectionism, and onset often co-occurs with a stressful event

Anorexia Nervosa

This eating disorder is associated with genetics and higher-than-normal levels of serotonin (such that restricting alleviates unpleasant feelings)

Anorexia Nervosa

In some studies (but not others), this disorder is associated with high levels of family conflict; parents who are overprotective, rigid, and overly concerned with thinness; mothers who are depressed and domineering; and fathers who are physically or emotionally absent

Restoring Weight

The first priority in treatment for Anorexia Nervosa is

False

True or False: Family-based treatment, in which the patient and family meet together with a therapist, is beneficial for all adolescents with Anorexia Nervosa

High

[Low/High] levels of expressed emotion in families can complicate family-based treatment for Anorexia Nervosa

CBT

This is considered a first-line therapy for Anorexia Nervosa

Bulimia Nervosa

Key features of this disorder include recurrent episodes of binge eating that are accompanied by a sense of lack of control; inappropriate compensatory behavior to prevent weight gain (e.g., fasting, vomiting, excessive exercise, etc.); and self-evaluation that is unduly influenced by body shape and weight

Binge Eating

In Bulimia Nervosa, this is often triggered by interpersonal stress or dysphoric mood, involves high-calorie foods, and continues until the person is uncomfortably full

Once; three

In Bulimia Nervosa, binge eating and compensatory behaviors must occur at least __ weekly for __ months

Compensatory Behaviors

The severity of Bulimia Nervosa is based on the average number of episodes of ___ per week

Depression

This is the most common co-morbidity of Bulimia Nervosa

Bulimia Nervosa

Complications of this disorder often include fluid and electrolyte disturbances, metabolic alkalosis (blood pH rises – from vomiting), metabolic acidosis (blood pH decreases – from laxative use), dental problems, menstrual abnormalities, cardiac arrhythmia or arrest

Bulimia Nervosa

This disorder often begins during or after a period of dieting, and 90% of cases are girls and women

Bulimia Nervosa

This eating disorder is associated with low levels of endogenous opioid beta-endorphin and neurotransmitter abnormalities, especially low serotonin

Bulimia Nervosa

Treatment for this disorder often involves nutritional counseling, CBT, self-distraction during periods of high-risk for binge eating, and medication (e.g., imipramine and fluoxetine)

Weight

This is the main differential between binge/ purge Anorexia Nervosa (AN-BP) and Bulimia Nervosa

Binge Eating Disorder

This disorder is characterized by recurrent episodes of binge eating that involves a sense of lack of control over eating

Binge Eating

This involves a period of eating more rapidly than usual, eating until feeling uncomfortably full, and/or eating alone due to feeling embarrassed about the amount of food consumed

Once; Three

In Binge Eating Disorder, binges must occur at least __ weekly for at least __ months

Enuresis

This disorder involves repeated voiding of urine into the bed or clothes at least twice weekly for three or more consecutive months

5

The minimum age for Enuresis is __ years

Enuresis

Specifiers for this disorder include nocturnal only, diurnal only, or both

Enuresis

Treatment for this disorder often involves the bell-and-pad method, which is effective in 80% of cases; although around 1/3 have some relapse within 6 months

Enuresis

Treatment for this disorder can be enhanced with behavioral rehearsal and overcorrection, as well as imipramine or desmopressin (synthetic antidiuretic)

Involuntary

Enuresis is usually (although not always) [voluntary/involuntary]

Encopresis

This disorder involves repeated involuntary or intentional passage of feces into places not appropriate for that purpose

4

The minimum age for Encopresis is __ years

Once

Episodes of Encopresis must occur at least __ monthly for three months

Encopresis

Specifiers for this disorder include with constipation and overflow incontinence (or without)

Insomnia

This disorder is characterized by dissatisfaction with sleep quantity or quality, as associated with at least one of the following: Difficulty initiating sleep, difficulty maintaining sleep, early-morning awakening with an inability to return to sleep

Three

Insomnia must occur at least __ nights per week for at least three months

Insomnia

Treatment for this disorder often includes sleep-hygiene education (e.g., avoiding naps, avoid caffeine in the evenings, etc.), stimulus control (e.g., going to bed only when tired, only using bed for sleep and sex, getting up at the same time each day, etc.), and relaxation training (e.g., PMR, guided imagery, etc.)

Hypersomnolence Disorder

This disorder is characterized by excessive sleepiness despite a main sleep period of at least seven hours with at least one of the following: Recurrent periods of sleep within the same day, a prolonged but non-restorative sleep period of more than nine hours each day, difficulty becoming fully awake after an abrupt awakening

Narcolepsy

This disorder is characterized by attacks of an irrepressible need to sleep with lapses into sleep or daytime naps that occur at least three times per week for at least three months

Narcolepsy

This disorder involves at least one of the following: Cataplexy (loss of muscle tone), a hypocretin deficiency, and rapid eye movement latency less than or equal to 15 minutes as measured by nocturnal sleep polysomnography

Hypnagogic Hallucinations

These are vivid hallucinations while falling asleep

Hypnopompic Hallucinations

These are vivid hallucinations as you wake up

Obstructive Sleep Apnea Hypopnea

This is diagnosed when there is evidence by polysomnography of at least five obstructive apneas or hypopneas each hour, plus breathing disturbances (e.g., snoring, gasping, etc.)—or at least 15 obstructive apneas or hypopneas each hour

Obstructive Sleep Apnea Hypopnea

This is typically treated with CPAP, oral appliances, or a tracheostomy surgery

Non-Rapid Eye Movement Sleep Arousal Disorder

This disorder involves recurrent episodes of incomplete awakening that usually occur during the first third of the major sleep episode (most often Stage 3 or 4); it is accompanied by (and includes specifiers for) sleepwalking and/or sleep terror

False

True or False: People with sleepwalking and sleep terrors often have clear memories of the episodes

True

True or False: Non-Rapid Eye Movement Sleep Arousal Disorders are most common in children, often spontaneously remitting in adolescence

Nightmare Disorder

This disorder is characterized by repeated occurrences of extended, extremely dysphoric, and well-remembered dreams that usually involve efforts to avoid threats to survival, security, or physical integrity

Second

Nightmares usually occur in REM sleep in the [first/second] half of the major sleep period; usually people are fully alert after a nightmare

REM Sleep Behavior Disorder

This disorder is characterized by repeated episodes of arousal during REM sleep that are often accompanied by complex motor behavior or vocalizations that are consistent with the content of a dream.

Less

Research evaluating the effects of imipramine as a treatment for Enuresis suggests that it is [more/less] effective than the bell-and-pad in terms of long-term effects.

Localized and Selective

The two most common forms of amnesia for Dissociative Amnesia are __ and __