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Persons with this disorder present with multiple complaints of physical ailments over a long period. Also known as Briquet's Syndrome.
- Diagnosis of Somatization Disorder requires reporting of symptoms in four categories:
- 2. Gastrointestinal
- 4. Pseudoneurological (suggestive of a neurological condition but without basis; examples include paralysis, difficulty swallowing, loss of sensation, or dissociation)
Deliberate faking of a physical or psychological disorder motivated by gain. Type of factitious disorder.
Somatization disorder vs Hypochondriasis
: Onset can be at any age. The key feature is an abnormal concern that one has or is developing a serious illness. These persons may not claim particular symptoms but are often preoccupied with health and avoidance of germs.
Major Differences between Somatization Disorder and Hypochondriasis
- Characteristic Somatization Disorder Hypochondriasis
- Focus of complaint Symptoms Implication of symptoms, i.e., hidden disease
Style of complaint Vague but colorful Precise but affectless
Interaction with clinician Attentive, seductive, grateful, trusting Demanding, ungrateful, unreassurable
Age 20s-30s 30s-40s
Sex ratio Usually female Balanced or slightly more often male
Physical appearance Often attractive Often unattractive
Personality style Hysteroid (dramatic, excitable) Obsessive
Manifests with significant pain without physical basis or with pain that greatly exceeds what is expected on the basis of injury.
There is sensory/motor dysfunction in the absence of a physical basis. These persons tend to present with numbness of limbs, limb paralysis, speech problems, blindness or hearing loss.
La Belle Indifference
This refers to the tendency of these persons to appear relatively unconcerned about the physical problem, quite in contrast to the concern shown by persons with similar physical problems that are truly medical. This idea may not be supported.
The sensory/motor loss does not follow neurological function (e.g., glove anesthesia). The loss may come and go with stress/functional need. For example, when the patient is startled or suddenly awakened, the loss may be briefly gone.
Body Dysmorphic Disorder
A preoccupation with an imagined physical defect in appearance or a vastly exaggerated concern about a minimal defect. For diagnosis, the preoccupation must cause significant impairment in the individual's life, with the person thinking about the defect for at least an hour per day.
The loss of the ability to access information normally in consciousness.
Amnesia refers to loss of recall. Retrograde amnesia refers to loss of memory for events prior to onset of amnesia (problems of memory access). Antereograde amnesia refers to inability to form new memories (problem of memory formation).
Refers to memory loss in the absence of organic cause, essentially always retrograde in form.
Psychogenic amnesia can vary in specificity of memory lost and in time frame. Types include:
- -Localized: Can't remember what happened during a specific (usually short) period of time.
- -Selective: Forgets some, but not all of what happened during a specific period.
- -Generalized: Loss of memory for entire life.
- -Continuous: Remembers nothing beyond a certain point.
Involves flight to new surroundings without others knowing. In fugue, individuals may "find" themselves days to years later in a new place wondering how they got there.
Depersonalization and Derealization
Depersonalization: a sense that you or the world around you is not real
Derealization: a sense that the world is distorted, unstable, or indistinct.
Dissociative Identity Disorder
Formerly known as "Multiple Personality Disorder," it was changed to more clearly emphasize the dissociative element and to appease critics who challenged the idea that the "alters" were actually complete personalities (like another being lurking inside a person). The essential idea, however, is that the person presents with a "host" or core personality and "alters" which have important critical differences. Usually the host presents as completely unaware of the alters, who may or may not be aware of the host and each other. As few as one alter can be present, but the average in diagnosed persons is about 15.
Three kinds of alter awareness of it's host
- 1. Inferential: Most indirect, based solely on inference from "signs" of other personalities.
- 2. Mnestic: More direct in that one personality has access to another's memory traces.
- 3. Perceptual: One personality claims to be "co-conscious" of another, i.e., aware and able to observe.
Prominent Symptoms in DID, by Gender
SYMPTOMS Female% Male%
Depressions 90 78
Amnesias 85 64
Dazed states 83 50
Nightmares 83 59
Suicide attempts 81 77
Multiple phobias 75 59
Severe anxieties or panics 69 61
Early sexual abuse 60 27
Auditory hallucinations 54 45
Headaches 50 36
Early physical abuse 40 32
- 1. Self (name, address, occupation)
- 2. People in one's life (names, visual recognition)
- 3. Personalized past experiences (loss of history)
Primary gain v Secondary gain
Primary: Freudian notion that anxiety reduction is the principal reinforcement obtained for the display of psychological symptoms.
Secondary: Additional reinforcers beyond primary gain that a person may obtain by the display of symptoms. These may include attention, sympathy, and avoidance of unwanted responsibilities.