Psychopathology Exam 3 Questions

After reading and watching the videos about Factitious Disorder imposed on another, describe your own feelings and reactions and what you learned from watching these that you did not learn from the website and lecture. What questions do you still have?

They pretend to be the most loving parents then turn to violence in order to bask in the attention again

Do you see any difference(s) between factitious disorder imposed on another and child abuse? How might one develop empathy for the parent?

They want one to see their child is struggling

They are tasked with a suffering child

They may just want to stay close or need extra childcare

Describe Factitious Disorder Imposed on Self and Factitious Disorder Imposed on Another. What may be some of the motives behind these?

Internal motivators: Seeking warmth, attention, and nurturing, as well as reducing loneliness, seeking attention, coping with stress, or enjoyment in stumping healthcare workers, the affection one may derive from the sick role, especially in those who sensed a lack of affection during childhood, seeking and maintaining relationships, enjoying being cared for by others, coping with a lack of identity  (injury imposed on one’s self)

Internal motivators: appear as a savior by being a dutiful parent, not wanting to be seperated from their child, believing they are truly ill, looking for help with care

External motivators: revenge on other parent (damage to someone else)

Briefly summarize therapy approaches for factitious disorders in this section.

Psychotherapy is the only known treatment, but addressing comorbid symptoms is also helpful 

The video about the woman who faked having cancer suggests she may have factitious disorder. What symptoms are consistent with that, and which symptoms are consistent with malingering? (Be sure to define malingering.)

Malingering is faking a disorder for external motivations/gains (like money). 

She says she has had headaches her whole life and thought something was wrong in her brain. Attention is consistent? She said she didn’t mean to cause harm.

Name and briefly describe each of the disorders contained in this category of the DSM 5 (see lecture especially). Note main symptoms, associated features, possible motivations, and diagnosing.

Conversion disorder: psychological pain being translated to physical symptoms, after a traumatic/stressful event, rule out any organic cause first

Somatic symptom disorder: “new hypochondria”, fear of becoming sick, doctor shopping

Illness anxiety disorder: previously known as hypochondria, has symptoms but over-interprets them, don’t say it’s all in their head (for any of these)

Conversion disorder

psychological pain being translated to physical symptoms, after a traumatic/stressful event, rule out any organic cause first

Somatic symptom disorder

“new hypochondria”, fear of becoming sick, doctor shopping

Illness anxiety disorder

previously known as hypochondria, has symptoms but over-interprets them, don’t say it’s all in their head (for any of these)

What are the main points of the article regarding re-categorizing hypochondriasis in the DSM 5?

It’s more so focused on the anxiety about health rather than the overarching worry about fears of health issues. It goed more into depth about the symtoms/criteria for diagnosis

What is noted in the article regarding somatic symptom disorder regarding why it is costly?

Healthcare is expensive, and these people are continuing to go to doctors to try to find the root cause of their symptoms, which don’t have an organic medical diagnosis, however, they still need to be checked for all possibilities before being diagnosed with somatic symptom disorder. 

It can also cost people their lives, they are more likely to commit suicide, with almost a 30% difference, becuase they aren’t getting relief from their (unexplainable) symptoms

Note 2 specific things you read in the "DSM changes paraphilias to paraphilic disorders" website that interested you and explain why.

Something that interested me from this article was the explanation of the criteria for being a paraphilia. It says that, along with having this atypical sexual practice, it must cause you distress. If you are not unhappy with having this atypical sexual behavior, you don’t have paraphilic disorder. This is interesting to me because it shows that you don’t need to just have this practice in order to be diagnosed with paraphilia disorder, but it needs to cause you unhappiness. It just shows that if you don’t want something to change or be “fixed” it, it won’t be diagnosed. This could be taken that only those actively seeking a diagnosis want a change to occur. Another thing that I found interesting is that they have added specifiers for this disorder. They added “in remission” and “in a controlled environment”. This was interesting to me because they are two ways to show that the disorder is being contained, but on opposite ends of the spectrum. The “in remission” specifier shows that this person has symptoms of this disorder that are decreasing or have disappeared. This is the end of the spectrum where the person is recovering well. The other specifier “in a controlled environment”, described as being incarcerated, shows that the person may not be doing well with this disorder, and this disorder may be the reason they are in jail. It is the other end of the spectrum, in which the disorder may have gotten them in legal trouble. This is a sign that the disorder has not been getting better and has been getting more invasive into a person’s life.

Briefly describe the main points of the gender and mental health article. What new information did you learn that has not yet been discussed in class?

The article talked about how a new report came out about gender equality in healthcare and clinical research. However, this report mentioned women an unproprationate amount of times compared to the amount of times men were mentioned. The proposed solutions focused mainly on women’s healthcare and the problem of men’s mental health was either ignored or blamed on their own actions. Men were blamed for women’s mental health issues. I learned more about the shocking statistics of men’s mental health. For example, over 75% of the suicides committed in Europe are men. Men also don’t utilize mental health services, with only 30% percent of users being men. There was also no mention of gay men when the report was talking about members of the LGBTQ+ community, even though in Europe, gay men have the highest suicide and self harm rates. These statistics are all the more reason that we need to work on destigmatizing mental health for men and improve our treatment of those who do seek out care.

What specific concerns have been noted with the diagnosis of pedophilia?

That the description of pedophilia as a sexual orientation suggests that an attraction to children is a normal variation of sexual desire

The person has to be in distress in order for it to be a disorder

What main points does the author make in the website regarding a Christian perspective of healthy sexuality?

You need to be attuned to your body: treating it right and regularly assessing how it’s being impacted

You need to know your heart and how it is growing towards others
You need to think about your perceptions and knowledge about sexuality 

Both genders need to have an equal relationship, less dualism (spirit above body)

Be genuinely concerned about the other person

Mutual respect!!!

The mind is slower to catch up than the body when growing

Know the main points of the “Hypersexuality: Sex Addiction” article

Hypersexual disorder is a proposed diagnosis for people who engage in sex or think about sex through fantasies and urges to the point of distress or impairment. It’s not in the DSM. It’s very dependent on your culture and views on sex. Childhood trauma can attribute to this

Note the main points of the article regarding the effects of psychotropic medications on sexual functioning. Why is this one reason many people may avoid taking their medications?

Psychotropic medications commonly have the side effect of sexual dysfunction. People don’t want this to be a part of their lives, becasue it is an issue and there is a stigma. Life would be easier if they didn’t need to deal with SD along with their medication.

Know the main differences between sexual dysfunctions versus paraphilic disorders in the DSM 5. Know the main symptoms of the various disorders within each of the two categories

Sexual dysfunctions refer to difficulties at some point in the sexual response cycle

Disorders of desire, disorders of excitement, disorders of orgasm

Paraphilic disorders refer to unusual sexual arousals or urges 

Fetishistic, transvestic (cross dressing), exhibitionistic (exposure), voyeuristic (peeping tom), frotteuristic (rubbing), pedophelia, 

and  pedophilic disorder

What ethical issues can you see regarding how to treat youth who identify as transgender?

Irreversible

God’s creation

Good age?
Bullying and discrimination

Other kids

Consider the parents’ perspective in transgender youth cases. What special challenges do they face?

Missing/Greiving their child

Bullying and harassment

Being supportive

What specific new things did you learn from watching these videos?

Some children know very young

Resentful towards siblings

Hard to find a stance for parents

High amounts of self harm

Name the lenses that Yarhouse describes for how Christians view transgender individuals

The integrity lens: Immoral, doesn’t match biblical descriptions of male and female

The disability lens: Result of living in a fallen world, holds biblical truth but still offers support, a more neutral position

The diversity lens: It’s something that can be honored and celebrated, deconstructing sex and gender, about finding who you are

Briefly describe the DSM 5 Gender Dysphoria, description, as noted in the APA Fact Sheet. What new things did you learn about this?

Having distress about a your gender and feeling as though it is not correct

I learned that there is a post-transition specificer applied after surgery
The desire to be a different gender must be present and verbalized in children
It is not a mental disorder to have gender noncomformity

Note the main steps and types of treatment for Gender Dysphoria, as noted in lecture (e.g., Triadic Approach, etc.). 

1. Real Life Experiences (changing name, dressing in clothes of opposite gender)

2. Hormonal (FTM- testosterone, MTF-anti-androgens & estrogen)

3. Surgery- preceded by counseling

What does research suggest about mental health in those who receive gender affirmation surgery, as noted in lecture? 

Experienced less psychological distress, smoking, and suicidal ideation

There are higher risks for suicidal behavior, mortality, and psychiatric disorder
41% attempt suicide

Face discrimination in the workplace and from friends and family

Can have significant depression, self-mutiliation, or attempt suicide

What is desistance, and what implications does this have for transgender youth?

Children outgrow transgendered behavior/identity

They will be taken less seriously and have less access to healthcare and surgery 

But it is also more likely to be a passing phase than if it is seen in an adult

Describe dialectical behavior therapy. For what type of disorders is this most effective?

• All things are interconnected.

• Change is constant and inevitable.

• Opposites can be integrated to get closer to the truth.

In other words, two seemingly opposite things can actually be true at the same time. It’s also about understanding how people’s symptoms arise and continue. You learn skills to change unhelpful thoughts or behaviors

Core mindfulness, Distress tolerance (Accepting things you don’t have control over), Interpersonal effectiveness, Emotional Regulation

Eating disorders (binge eating disorder), substance use disorder (adults and teens), co-occurring substance use and BPD, depression, bipolar disorder

What are some etiological factors of personality disorders, as noted in your reading?

Genetics, Childhood trauma (especially sexual trauma), Verbal abuse, high reactivity (to stilmuli), and peers (lack of heathly relationships)

What specific comorbidities are present with many personality disorders, as noted in your reading?

BPD typically coexists with depression, anxiety, and substance abuse

Also mood disorders, panic disorders, PTSD, Alcohol abuse or dependence, eating disorders (at times)

In the Narcissism Podcast:

 What are the four key characteristics of narcissism that the speaker noted?

Lack of empathy, grandiosity, a chronic sense of entitlement and a chronic need to seek out admiration from other people and validation from other people

Have an inability to regulate self-esteem

In the Narcissism Podcast:

What patterns in relationships are often seen with a person with narcissistic personality disorder?

A lack of empathy, often a lack of compassion, they often don’t listen very well, they’ll be prone to patterns like deceit and lying

In the Narcissism Podcast:

What does she specifically suggest for those in a relationship with a person with NPD?

In the Narcissism Podcast:

manage your expectations, be your best version of yourself for yourself, be a compassionate person, build up supportive networks around you

What are the main symptoms of Histrionic, Borderline, and Narcissistic Personality Disorders

Borderline PD: Unstable, causes conflict

Narcissistic PD: Extreme pride

Histrionic PD: Melodramatic, need attention

Borderline PD: instability in relationships, relatively frequent emotional displays in response to real or imagined abandonment, and stubborn, inflexible opinions (“I’m right!”). These  can all include unreasonably angry/rageful responses to perceived offenses, Polarization, i.e., they often view themselves and others in extremes (e.g., good/bad), and are often unable to accept that both qualities can reside within the same person. They also can often “split” people, Unstable identity/fluctuating views of themselves, also often “bait” people into conflict

Narcissistic PD: inflated sense of self (power, ability, etc.), Lack of empathy for others, Haughtiness, arrogance, Expect special treatment and believe that they are in some special class of people that others just don’t understand well, Exploit others for their own gain, Intolerant of criticism; tend to retaliate when confronted

Histrionic PD: They have intense, unstable emotions, and often display these openly and inappropriately, They have distorted self-images, and their self-esteem depends on the approval of others, They have an overwhelming desire to be noticed, and often behave dramatically or inappropriately to get attention, They often believe that relationships are more intimate than they actually are, They can act in overly seductive ways as part of their attention-getting behaviors, They are also quite impulsive