Somatic Symptom and Related Disorders – Review Flashcards

50 question-and-answer flashcards covering definitions, diagnostic criteria, distinctions, causes, and treatments related to Somatic Symptom Disorder, Illness Anxiety Disorder, Conversion Disorder, Factitious Disorder, and other specified somatic-related disorders.

What core feature defines Somatic Symptom Disorder (SSD)?

One or more distressing somatic symptoms combined with excessive thoughts, feelings, or behaviours related to those symptoms.

More than 6 months.

For how long must SSD symptoms persist to meet the duration criterion?

At what age does Somatic Symptom Disorder most often begin?

Often before age 30.

Who first documented patients with numerous unexplained physical complaints, laying groundwork for SSD?

Pierre Briquet.

Which type of physical complaint is most common among individuals with SSD?

Pain.

In SSD, with what do sufferers often come to identify?

They identify with their somatic symptoms.

Name one of the three categories of excessive reactions required for SSD diagnosis.

Disproportionate thoughts about seriousness, persistently high health-related anxiety, or excessive time/energy devoted to symptoms.

Give an example of a common comorbid disorder with SSD.

Depressive disorders (also acceptable: anxiety disorders, borderline personality disorder, substance use disorders, illness anxiety disorder).

What medication, specifically mentioned, can be prescribed for SSD?

Paroxetine (Paxil).

What psychotherapeutic approach is strongly supported for treating SSD?

Cognitive-Behavioural Therapy (CBT).

What is the key difference between SSD and Illness Anxiety Disorder with respect to somatic symptoms?

SSD involves real distressing somatic symptoms, whereas IAD has few or no somatic symptoms.

How does SSD differ from Conversion Disorder?

SSD may involve any bodily symptom, whereas Conversion Disorder specifically presents neurological symptoms incompatible with medical disease.

How does SSD differ from Factitious Disorder?

In SSD symptoms are genuine and distressing, while in Factitious Disorder symptoms are intentionally produced for sympathy or attention.

How does SSD differ from Malingering?

SSD symptoms are genuine and distressing, whereas in Malingering they are feigned for external gain such as money or avoiding duties.

What is the defining preoccupation in Illness Anxiety Disorder (IAD)?

Preoccupation with having or acquiring a serious illness.

How intense are somatic symptoms in Illness Anxiety Disorder?

They are absent or only mild in intensity.

What minimum duration is required for an IAD diagnosis?

6 months.

Give one example of an excessive health-related behaviour seen in IAD.

Repeated body checking, seeking multiple medical opinions, or frequent internet searches about disease.

What maladaptive pattern can replace excessive health seeking in some IAD patients?

Avoidance of doctors, hospitals, or medical information (care-avoidant behaviour).

What are the two DSM-5 specifiers for Illness Anxiety Disorder?

Care-seeking type and Care-avoidant type.

Describe the care-seeking type of IAD.

The individual frequently uses medical services, undergoing tests and physician visits.

Describe the care-avoidant type of IAD.

The individual rarely seeks medical care and avoids doctors despite health worries.

According to cognitive-perceptual theories, how do SSD/IAD patients interpret ambiguous bodily sensations?

They quickly focus on and misinterpret them as threatening or serious.

What modern DSM-5 name is given to Conversion Disorder?

Functional Neurological Symptom Disorder.

What did Freud believe was converted into physical symptoms in Conversion Disorder?

Anxiety arising from unconscious mental conflicts.

What type of symptoms characterise Conversion Disorder?

Altered voluntary motor or sensory function incompatible with neurological disease.

Give an example of a motor symptom that might appear in Conversion Disorder.

Paralysis, tremor, or abnormal gait.

What must clinical findings show to diagnose Conversion Disorder?

Incompatibility between the symptom and recognised neurological or medical conditions.

What term describes the ability of cortically blind individuals to respond to unseen stimuli, illustrating unconscious perception?

Blind sight or unconscious vision.

In Freud’s model, what is meant by “primary gain” in Conversion Disorder?

The reduction of internal anxiety achieved by converting conflict into a physical symptom.

What is “secondary gain” in Conversion Disorder?

External benefits such as attention, care, or escape from responsibilities that reinforce the symptom.

In which socioeconomic and educational groups is Conversion Disorder more commonly reported?

Less educated, lower socioeconomic groups.

Name one therapeutic focus used when treating Conversion Disorder.

Processing the underlying trauma or stressor.

Beyond addressing trauma, what is another treatment goal for Conversion Disorder?

Reducing reinforcing consequences of the symptoms (limiting secondary gain).

What is Factitious Disorder Imposed on Self?

Intentionally falsifying or inducing physical or psychological symptoms in oneself without obvious external rewards.

What distinguishes Factitious Disorder from Malingering regarding motivation?

Factitious Disorder lacks external incentives; the motivation is to assume the sick role.

What former term is synonymous with Factitious Disorder Imposed on Another?

Munchausen Syndrome by Proxy.

In Factitious Disorder Imposed on Another, who is presented as ill?

Another individual (the victim), typically someone under the perpetrator’s care.

What is Brief Somatic Symptom Disorder?

Somatic symptom disorder where the duration of symptoms is less than 6 months.

What is Brief Illness Anxiety Disorder?

Illness Anxiety Disorder in which the duration of health anxiety is less than 6 months.

What distinguishes “Illness Anxiety Disorder without excessive health-related behaviours”?

The individual’s anxiety meets criteria except that Criterion D (excessive behaviours or avoidance) is not present.

What is pseudocyesis?

A false belief of being pregnant accompanied by objective signs and reported symptoms of pregnancy.

What behavioural strategy can help control frequent help-seeking in SSD?

Assigning a “gatekeeper” physician to screen and manage all physical complaints.

Which personality disorder is commonly comorbid with SSD?

Borderline Personality Disorder.

Under DSM-5, what duration can a single somatic symptom be absent yet still allow SSD diagnosis if the overall symptomatic state persists?

Briefly absent, as long as the symptomatic state overall exceeds 6 months.

What term describes intentionally faking illness to obtain external incentives like money or avoiding work?

Malingering.

Which two broad categories contribute to the causes of SSD and IAD according to the lecture?

Disorders of cognition/perception and strong emotional contributions.

What pattern of attentional focus on bodily sensations is characteristic of SSD?

Hypervigilance toward normal physical sensations.

What psychopharmacological class does Paroxetine belong to?

Selective Serotonin Reuptake Inhibitor (SSRI).

What is the main diagnostic requirement that rules out other explanations in Conversion Disorder?

The symptom cannot be better explained by another medical or mental disorder.