PSYC3102 Week 12 – Somatic Symptom & Dissociative Disorders

Fifty question-and-answer flashcards covering definitions, diagnostic criteria, epidemiology, aetiology, differential diagnosis, and treatment of Somatic Symptom and Dissociative Disorders from PSYC3102 Week 12 lecture.

What central feature defines Somatic Symptom and Related Disorders?

Prominent somatic symptoms that lead to excessive distress or impairment.

Name three common somatic symptoms reported in these disorders.

Pain, fatigue, shortness of breath (others: weakness, light-headedness, digestive problems, etc.).

Approximately what proportion of primary-care patients present with somatic-symptom-related difficulties?

About 10–15 % of primary-care patients.

The functional impairment seen in Somatic Symptom Disorders is comparable to which two other DSM disorders?

Depressive disorders and anxiety disorders.

List the five Somatic Symptom & Related Disorders in DSM-5-TR.

1 Somatic Symptom Disorder, 2 Illness Anxiety Disorder, 3 Functional Neurological Symptom (Conversion) Disorder, 4 Factitious Disorder, 5 Psychological Factors Affecting Other Medical Conditions.

Somatic Symptom Disorder Criterion A requires what?

One or more distressing somatic symptoms that disrupt daily life.

In Somatic Symptom Disorder, Criterion B captures what type of responses?

Excessive thoughts, feelings, or behaviours related to the symptoms (e.g., disproportionate worry, high anxiety, excessive time/energy).

For a Somatic Symptom Disorder diagnosis, how long must the symptomatic state persist?

More than six months.

What specifier is commonly applied to Somatic Symptom Disorder?

With predominant pain.

Typical prevalence for Somatic Symptom Disorder is __ and is more common in which sex?

5–7 %; more common in females.

What health-care seeking behaviour is characteristic of Somatic Symptom Disorder?

“Doctor shopping” and an extensive medical history.

Illness Anxiety Disorder used to be known by what term?

Hypochondriasis.

Illness Anxiety Disorder Criterion A involves what principal concern?

Preoccupation with having or acquiring a serious illness.

In Illness Anxiety Disorder, how intense are any present somatic symptoms?

Either absent or only mild in intensity.

Illness preoccupation must last at least how long to meet DSM-5-TR criteria?

At least six months (though the specific feared illness may change).

Define “somatosensory amplification.”

Heightened perceptual sensitivity and attention to normal bodily sensations, interpreting them as illness cues.

Give two DSM criteria for Functional Neurological Symptom (Conversion) Disorder.

(1) One or more symptoms of altered motor or sensory function; (2) Clinical evidence of incompatibility with recognised neurological or medical conditions.

Are symptoms in Conversion Disorder intentionally produced?

No, they are not produced intentionally (distinguishes from malingering).

Conversion Disorder is diagnosed by what process?

Diagnosis by exclusion—ruling out known physical causes.

Name four illnesses once thought to be “psychological” but later found to have clear biological causes.

Lupus, AIDS, Multiple Sclerosis, Lyme disease.

Factitious Disorder requires what key element absent in most other somatic disorders?

Deliberate falsification or induction of symptoms without obvious external reward.

Which disorder typically presents with neurological-type symptoms?

Functional Neurological Symptom (Conversion) Disorder.

Which disorder allows symptoms that may be medically explained or unexplained?

Somatic Symptom Disorder.

Family studies show what about genetic contributions to Somatic Symptom Disorders?

Somatisation tends to run in families, but twin studies give little support for strong genetic effects.

What brain circuit has been tentatively implicated in somatisation?

Anatomical/functional abnormalities in the cortico-limbic-cerebellar circuit (findings mixed).

List two cognitive factors that predispose to somatic concerns.

Misinterpretation of bodily sensations; belief that negative life events are unpredictable and uncontrollable.

Negative Affectivity (NA) is linked to which aspects of somatisation?

Greater severity of symptoms; worry, pessimism, and fear of uncertainty.

According to Freud, what is the ‘primary gain’ in Conversion Disorder?

Relief from anxiety by converting conflict into physical symptoms.

Name one cultural factor associated with higher rates of somatisation.

Cultures that stigmatise open discussion of psychological problems may show more somatic presentations.

Which therapeutic approach has the strongest evidence base for health anxiety and somatic symptoms?

Cognitive-Behaviour Therapy (CBT).

What CBT technique involves deliberately confronting bodily sensations without seeking reassurance?

Exposure and response prevention.

Give two additional CBT components used for Somatic Symptom Disorders.

Relaxation training and cognitive restructuring (also reinforcement of adaptive behaviours).

Provide the DSM definition of Dissociative Disorders as a group.

Disorders involving disruption in normally integrated functions of consciousness, memory, identity, or perception.

Name the three major Dissociative Disorders in DSM-5-TR.

Dissociative Identity Disorder, Dissociative Amnesia, Depersonalisation/Derealisation Disorder.

Dissociative Identity Disorder (DID) Criterion A requires what?

Two or more distinct personality states with marked discontinuity in sense of self.

DID is often first diagnosed when and why?

In late adolescence or young adulthood, often after overwhelming stress triggers symptoms.

Average number of alternate personalities (‘alters’) in DID?

Around 13, with reported ranges from 2 to 60.

Approximately what percentage of individuals with DID have attempted suicide?

Over 70 %.

List two ways sub-personalities may differ from one another.

Different demographics (age, gender), abilities/preferences, physiological responses, or personality traits.

What is ‘iatrogenesis’ in the context of DID?

Creation or shaping of the disorder through therapeutic suggestion or expectations.

How is fragmented sleep related to dissociative symptoms?

Sleep disturbance correlates with dissociation; improving sleep can reduce dissociative experiences.

What recent neuroimaging finding supports a biological basis for DID?

Pattern-recognition classifiers can differentiate DID brains from controls with ~72 % sensitivity and 74 % specificity.

According to the psychodynamic view, what core mechanism underlies dissociation?

Repression of traumatic memories; dissociation acts as a defence against painful events.

Behavioural theory suggests dissociative behaviours are maintained by what?

Selective reinforcement and social modelling that reward the dissociative role.

Name one similarity between psychodynamic and behavioural explanations of Dissociative Disorders.

Both see disorders as precipitated by trauma and functioning to avoid intolerable anxiety.

Name one difference between the two theories.

Psychodynamic: dissociation is purposeful from onset; Behavioural: dissociation starts accidentally and is later reinforced.

Outline the Dissociation-Trauma model’s basic sequence for DID development.

Severe early trauma ➔ child uses imaginative escape/dissociation ➔ distinct memory/affect packages ➔ later stress reactivates alter identities.

Give two diathesis factors that increase risk for Dissociative Disorders.

High fantasy proneness, high hypnotisability, or history of childhood trauma.

Primary treatment goal for DID.

Integration of sub-personalities into a single, coherent identity.

List two therapeutic principles when working with DID sub-personalities.

Treat each alter with empathy and fairness; encourage cooperation and recognition that all are parts of one person.