CH 8

20

___ % of doctor visits are for individuals worried something is wrong even though no medical cause is found

somatic symptom disorder

when concerns about symptoms is severe and leads to distress/impairment; over 6 months of symptoms; 'doctor shopping' 5-7% prevalence; more females and comorbid for depression and anxiety

dissociative disorder

'being out of it' is so persistent and recurrent person has memory deficits

no mental disorder

maggie has a lump and worries its cancer. she was unable to function. when she found out she does not have cancer, she felt better. maggie has___

real symptoms

somatic symptom disorder

imagined symptoms

illness anxiety disorder

common etiology

• genetic/biological vulnerabilities (increased sensitivity to pain)

• early traumatic experiences

• role modeling of the physical sick role

• learning non-medical help seeking may be rejected

• high deference to medical authorities

somatic symtom disorder

raul has ___. he may avoid accepting a psychological explanation for his problems

treatment for somatic symptom disorder

relaxation training, support validation of pain, schedule daily activities, reinforce 'no-pain' behavior

illness anxiety disorder

high anxiety about developing a serious illness; no/mild symptoms; care seeking or care avoiding; treatment goal is to diagnosis with mdd, gad, or ptsd

conversion disorder

presence of neurological symptoms in absence of neurological diagnosis (blind, deaf, etc.); previously hysteria as freud took anxiety and converted it to physical; common in WWI and WWIII and uneducated groups

la belle difference

person not concerned with symptoms in conversion disorder

factitious disorder

intentionally producing psychological/physical symptoms to obtain a benefit on the sick role; receives no external reward

malingering

motivated by external rewards exaggerating physical symptoms

munchausen's syndrome by proxy

factitious disorder imposed on by another

ways of avoiding anxiety

somatic and dissociative disorders commonality

dissociative disorder

conditions involving disruptions in a person's normally integrated functions of consciousness, memory, identity, or perception/involuntary intrusions

derealization

reality of outside world is temporarily lost

depersonalization

sense of one's self and reality is temporarily lost

derealization

sophie's dad died and she felt like she was in a movie but could function normally___

derealization/depersonalization

• equal in men and women

• age of onset about 16 years old

• stressors can trigger symptoms (early trauma and low support common)

treatment for derealization/depersonalization

solidify personal identity, teach coping skills, anxiety management skills, increase personal awareness, and meds as needed

dissociative amnesia

inability to remember for a period of time; 1.8% prevalence; sudden onset; can resolve quickly or last for years

dissociative fugue

actual flight; depart from home surroundings while being amnesic

dissociative identity disorder (did)

2+ personality states and recurrent amnesia (previously multiple personality disorder); medical/physical conditions can alter depending on identity present; impairment varies; little known treatment

5 primary features of did

disruption of identity, marked discontinuity of sense of self, changes in affect, behavior, memory, etc. (self reported or observed), gaps in recall with 'self,' and not part of culture

amnesic features of did

remote memory of life events, lapes in dependable memory, evidence of actions but having no memory of actions

70%

how many clients with did have attempted suicide

prototypical case

apparent to others

host identity

person's real name/most frequently encountered

alter identities

fragments of a single person

3-9x

___ females treated more than men (men often deny symptoms) and females with more alters

controversies with did

• number of alters has increased over time and more bizarre

• used by defendants to escape punishment for crimes

• real memories of abuse? (repressed memories may be false by leading questions and suggestions)

• inclusion of possession more applicable to more people

trauma theory

attempt to cope in childhood starting as a child

sociocognitive theory

highly suggestible person learns to adopt and enact roles of multiple personalities by clinicians who reinforce them; diathesis-stress model; variant of ptsd

amok

behave uncontrollably/disruptively

treatment for dissociative disorders

hypnosis, some medications help, focus on uncovering trauma, and integrate separate alters for did (treatment prolonged for years to be successful)

it is common

which is true for opposite sex alters in did?

little is known

when it comes to the effectiveness of treatment for dissociative disorders...

retrograde amnesia

partial or total inability to recall or identify previously acquired information or past experiences

anterograde amnesia

partial or total inability to retain new information