Somatic Symptoms

1. Q: What is the shared feature of all somatic symptom and related disorders?

A: Prominent focus on somatic symptoms and/or illness anxiety causing distress or impairment.

2. Q: In DSM-5-TR, what is somatic symptom disorder primarily based on?

A: Presence of distressing symptoms + maladaptive thoughts/behaviors (not lack of medical explanation).

3. Q: What shifted from DSM-IV to DSM-5 in this chapter?

A: Focus moved from “medically unexplained symptoms” to “psychological response to symptoms.”

4. Q: What is the core requirement of Criterion A for somatic symptom disorder SSD?

A: One or more distressing somatic symptoms disrupting daily life.

5. Q: What type of symptoms define SSD—physical or psychological?

A: Physical symptoms + excessive psychological response.

6. Q: What must accompany somatic symptoms in SSD (Criterion B)?

A: 1+ Excessive thoughts, feelings, or behaviors about symptoms.

8. Q: What kind of thoughts qualify under SSD Criterion B1?

A: Disproportionate thoughts about seriousness of symptoms.

9. Q: What type of emotional response is required under SSD Criterion B2?

A: Persistently high health anxiety.

10. Q: What behavior qualifies under SSD Criterion B3?

A: Excessive time/energy devoted to symptoms.

11. Q: What duration defines SSD (Criterion C)?

A: Persistent state (typically >6 months).

12. Q: Does the symptom have to be continuously present in SSD?

A: No—state of being symptomatic must persist.

13. Q: What does “with predominant pain” indicate?

A: Main symptom is pain.

14. Q: What defines “persistent” SSD specifier?

A: Severe symptoms + impairment + >6 months duration.

15. Q: What defines mild SSD?

A: Only one Criterion B symptom.

16. Q: What defines moderate SSD?

A: Two or more Criterion B symptoms.

17. Q: What defines severe SSD?

A: ≥2 Criterion B symptoms + multiple (or one severe) somatic symptoms.

18. Q: What is the central feature of illness anxiety disorder (IAD)?

A: Preoccupation with having/acquiring serious illness.

19. Q: Are somatic symptoms prominent in IAD?

A: No—absent or mild.

21. Q: What must be true if a medical condition exists in IAD?

A: Anxiety is excessive/disproportionate.

22. Q: What emotional state is required in IAD?

A: High health anxiety.

23. Q: What behavioral pattern must be present in IAD?

A: Excessive checking OR avoidance.

24. Q: What is an example of checking behavior?

A: Repeated body checking.

25. Q: What is an example of avoidance behavior?

A: Avoiding doctors/hospitals.

26. Q: What duration is required for IAD?

A: ≥6 months.

27. Q: Can the feared illness change over time in IAD?

A: Yes.

28. Q: What rule-out is essential for IAD diagnosis?

A: Not better explained by another mental disorder.

29. Q: What defines care-seeking type (IAD)?

A: Frequent medical visits/tests.

30. Q: What defines care-avoidant type (IAD)?

A: Avoids medical care.

31. Q: What defines Criterion A for conversion disorder (functional neurological symptom disorder, or FNSD)?

A: Altered voluntary motor or sensory function.

32. Q: What is the key diagnostic feature of FNSD (Criterion B)?

A: Incompatibility with known neurological conditions.

34. Q: What must be ruled out for FNSD?

A: Other medical or mental disorders.

35. Q: What level of impact is required for FNSD?

A: Distress, impairment, or need for evaluation.

36. Q: Give one motor symptom example.

A: Weakness or paralysis.

37. Q: Give one movement symptom example.

A: Tremor or gait disorder.

38. Q: Give one sensory symptom example.

A: Anesthesia or sensory loss.

39. Q: Give one seizure-type symptom.

A: Psychogenic seizures.

40. Q: What defines acute episode (FNSD)?

A: <6 months.

41. Q: What defines persistent (FNSD)?

A: ≥6 months.

42. Q: Does conversion disorder require a stressor?

A: No (specifier optional).

44. Q: What is the key feature of psychological factors affecting medical conditions (PFAMC)?

A: Psychological factors worsen the condition.

45. Q: What are the ways psychological factors affect illness?

A: Alter disease course, Interfere with treatment (e.g., nonadherence), Increase health risk, Affect pathophysiology

49. Q: What must be ruled out for PFAMC?

A: Another mental disorder explaining the behavior.

50. Q: What defines mild severity (PFAMC)?

A: Increased medical risk.

51. Q: What defines moderate severity (PFAMC)?

A: Aggravates condition.

52. Q: What defines severe severity (PFAMC)?

A: Hospitalization/ER visit.

53. Q: What defines extreme severity (PFAMC)?

A: Life-threatening risk.

54. Q: What is the defining feature of factitious disorder (FD)?

A: Intentional falsification or induction of symptoms.

55. Q: What must be present psychologically? (FD)

A: Deception.

56. Q: (FD) Deception persists in even in the absence of _____?

A: External rewards.

57. Q: How does the person present themselves? (FD)

A: As ill, impaired, or injured.

58. Q: Who is diagnosed in factitious disorder imposed on another?

A: The perpetrator (not the victim).

59. Q: What behavior defines this type? (Imposed FD)

A: Falsifying/inducing illness in another person.

60. Q: What defines recurrent episodes? (FD)

A: Two or more falsification events.

62. Q: What is an example of “other specified” somatic disorder?

A: Brief illness anxiety (<6 months).

63. Q: What is pseudocyesis?

A: False belief of pregnancy with symptoms.

65. Q: SSD vs IAD — key difference?

A: SSD = prominent symptoms; IAD = minimal symptoms but high anxiety.

66. Q: SSD vs Factitious — key difference?

A: SSD = symptoms not intentionally produced; Factitious = intentional deception.

67. Q: Conversion disorder (FNSD) vs SSD — key difference?

A: Conversion = neurological inconsistency; SSD = distress about symptoms.