psych 239: somatic and dissociative disorders

catastrophizing

Always thinking the worst and being certain that it will happen.

Over generalization

if its true in one case, it applies to any case that is even slightly similar

using selective abstraction

Taking seriously only events that represent failures, deprivation, loss, or frustration

taking excessive responsibility

Feeling responsible for all bad things that happen to you or others

assuming temporal causality

Assuming that if it has been true in the past, it's always going to be true.

making excessive self references

feeling at the center of everyone else's attention and assuming everyone can see your flaws and errors

engaging in dichotomous thinking

seeing everything as either one extreme or another

diagnostic considerations

- rule out of

- ___ of onset

- d

- i

- f

- i

medical explanations

age

duration

intensity

frequency

impairment

diagnostic criteria for somatic symptom disorder (a)

- _________ somatic symptoms that are __________ or result in _____

one or more

distressing

disruption of daily life

diagnostic criteria for somatic symptom disorder (b)

- excessive (3), related to the (2)

thoughts feelings behaviours

somatic symptoms

associated health concerns

health concerns as manifested by at least one of the following

1. (2) about the seriousness

2. persistently high levels of

3. excessive (2) devoted to these symptoms or health concerns

disproportionate and persistant thoughts

anxiety

time and energy

diagnostic criteria for somatic symptom disorder (c)

although any one symptom many not be ________, the state of being symptomatic is _________

continuously present

persistent

diagnostic criteria for somatic disorders: specific if (for pain)

- p

- m

- m

- s

persistent

mild

moderate

severe

persistent (pain) (3)

severe symptoms

impairment

long duration

mild (pain)

only one criterion b symptom

moderate (pain)

two or more b

severe (pain) (2)

two or more symptoms and one or more very severe somatic complaint

illness anxiety diagnostic criteria (a)

- preoccupation with

having or acquiring a serious illness

illness anxiety diagnostic criteria (b)

- somatic symptoms are ________ , or if present are _______

- if another condition is present OR high risk of developing, the preoccupation is _________

not present

only mild in intensity

clearly excessive

illness anxiety diagnostic criteria (c)

- high level of ______ about health

- individual is easily ______

anxiety

easily alarmed about personal health status

illness anxiety diagnostic criteria (d)

- performs excessive

- exhibits

health related behaviours

maladaptive avoidance

health related behaviours

repeatedly checking for signs of illness

maladaptive avoidance

Avoiding medical appointments due to anxiety

illness anxiety diagnostic criteria (e)

- illness preoccupation has been present for at least _____ but the__________ that is feared may change over time

6 months

specific illness

illness anxiety diagnostic criteria (f)

- illness related preoccupation is not better explained by _________

another mental disorder

illness anxiety: specify whether (2)

care seeking

care avoidant

care seeking type

medical care is frequently used

care avoidant

medical care is rarely used

functional neurological symptom disorder

marked by a sudden loss of functioning in body

FNSD usually follows a

extreme psychological stressor

fictitious disorder imposed on self criteria (a)

- _________ of signs or symptoms

- ______ of injury

- associated with _______

falsification

induction

identified deception

fictitious disorder imposed on self criteria (b)

- individual presents (3)

to others as ill, impaired, injured

fictitious disorder imposed on self criteria (c)

- deceptive behaviour is evident even in the absence of

obvious external rewards

fictitious disorder imposed on self criteria (d)

- behaviour not better explained by a

another mental disorder

other mental disorders that would explain illness anxiety behaviours

- s

- p

- g

- o

- d

somatic symptom

panic

GAD

body dysmorphic

OCD

delusions

other mental disorders that would explain fictitious disorder imposed on self

- d

- p

delusional

psychotic

specify if (2): fictitious disorder imposed on self

single episode

recurrent episodes

fictitious disorder imposed on another (a)

falsification of physical or psychological signs or symptoms, or induction of injury in ___________, associated with

another

identified deception

fictitious disorder imposed on another (b)

- the individual presents another

individual to others as ill, impaired, or injured

fictitious disorder imposed on another (c)

- deceptive behaviour evident even in

the absence of obvious external rewards

fictitious disorder imposed on another (d)

- behaviour not better

explained by another mental disorder

malingering- intentional production of ______

motivated by _____, such as

false or exaggerated physical or psychological symptoms

external incentives

avoiding work

malingering is strongly considered if any combination of the following is noted:

1. m

2. marked _______ between the claimed stress or disability and observations

3. lack of

4. presence of

medicolegal context

discrepancy

cooperation during evaluation

antisocial personality disorder

diagnostic criteria for dissociative amnesia (a)

- inability to

recall important information

dissociative amnesia most often consists of (2)

selective amnesia for a specific event

generalized amnesia for identity and life history

diagnostic criteria for dissociative amnesia (b)

symptoms cause significant distress in (3)

social

occupational

other important areas of functioning

diagnostic criteria for dissociative amnesia (c)

the disturbance is not attributable to (2)

effects of a substance

medical condition

diagnostic criteria for dissociative amnesia (d)

disturbance is not better explained by

other disorder

other explanations for dissociative amnesia

d

p

a

s

n

dissociative identity

PTSF

acute stress

somatic symptom

neurocogntive disorder

diagnostic criteria for dissociative amnesia specific if

with dissociative fugue

dissociative fugue:

purposeful travel associated with amnesia for identity

psychogenic amnesia vs organic - caused by:

psychological factors

biological factors

psychogenic amnesia vs organic - anterograde amnesia

seldom

often

psychogenic amnesia vs organic - retrograde amnesia

can involve

can involve

psychogenic amnesia vs organic - retrograde amnesia for

personal info

both personal and general

diagnostic criteria for DID (a)

disruption of identity characterised by

two or more distinct personality states

diagnostic criteria for DID (a) the directive in indemnity involves marked

accompanied by

discontinuity in sense of self and agency

alterations in functioning

diagnostic criteria for DID (b)

recurrent (3)

gaps in the recall of

everyday events

personal info

traumatic events

diagnostic criteria for DID (c)

symptoms cause significant distress or impairment in (3)

social

occupational

important areas of functioning

diagnostic criteria for DID (d)

disturbance is not a normal part of

accepted culture or religious practice

diagnostic criteria for DID (d) in children, symptoms not better explained by

imagination

diagnostic criteria for DID (e)

symptoms not attributable to (2)

substances

medical condition

diagnostic criteria for depersonalization/derealization disorder (a)

the presence of ______ or _______ experiences of depersonalization, derealization, or both

persistant

recurrent

depersonalization: experiences of (3)

unreality

detachment

being an outside observer

derealization: experiences of

unreality or detachment with respect to surroundings

diagnostic criteria for DID (b)

during the depersonalization or derealization experiences, reality testing remains

intact

diagnostic criteria for DID (c)

the symptoms cause clinically significant distress in (3)

social

occupational

functioning

diagnostic criteria for DID (d)

disturbance not attributable to

substances

medical condition

mental disorder

other explanations for derealization/depersonalization

s

p

m

a

p

d

schizophrenia

panic

major depressive

acute stress

PTSD

dissociative disorder