PSYC 316 1st EditionExam # 3 Study Guide Lectures: 22-38Lecture 22 (March 16): - Review - unit 1 & 2Lecture 23 (March 18): Disorders Featuring Somatic Symptoms Symptoms are based on view that psychological factors can  illness or bodily complaints in many different ways (This view has a long history, but has not garnered as much attention in theUS until recently)- DSM-5 has a number of disorders in which bodily symptoms/concerns are primary feature:o Factitious Disordero Conversion Disordero Somatic Symptom Disordero Illness Anxiety Disordero Psychophysiological DisordersFactitious DisorderWhen there is no medical explanation for symptoms, consider either:- Malingering: intentionally fake illness for secondary gaino Ex: financial compensation or deferment from military service- Factitious Disorder – intentionally produce or fake symptoms out of a wish to play the patient roleo “Munchausen syndrome” is a factitious disorder Go to extremes to create the appearance of illness (inject themselves with toxins) Often impressively informed about their “illness” Child abuse: Munchausen by proxy (parents/ caregivers make up or produce physical illness in their children) o More common in: those with extensive medical history, often in childhood those with a grudge against med profession nurses, lab techs, med aidesHow/why does Factitious Disorder develop?- Depression or other mental health condition- Unsupportive environment or relationship with parents- Extreme need for supportNot well-liked or understood by medical profession- Often believe that they are wasting time- Yet…those with the disorder often feel out of control, misunderstood, and very distressedConversion Disorder- Called “conversion” because it was believed that psychological needs are being converted to physical symptoms/needsVoluntary motor control (ex: paralysis) or sensory functioning (ex: blindness) with no known medical cause- Neurological-like symptoms with no neuro basis (glove anesthesia)- RareHard to detect… as a doctor, you would never want to “miss” something- Use oddities in medical history to try to rule out- Or oddities from a medical perspective (ex: glove anesthesia)How does it differ from factitious disorder?- Don’t consciously want or produce symptoms- Factitious disorders sound logical and correctLecture 24 (March 20): Disorders Featuring Somatic SymptomsSomatic Symptom DisorderSignificant distress and concern over bodily symptoms – 2 patterns1. Somatization pattern (Briquet’s syndrome): widespread long-lasting ailment that often includes pain, GI, sexual, and neurological symptoms- women < men in the US- Symptoms presented in dramatic, exaggerated way- May wax and wane over time many years, but rarely completely disappears without treatment2. Predominant pain pattern: pain is key feature- Hard to estimate prevalence, but is fairly common- Often develops after accident or illness that caused true pain- Can begin at any age and more common in womenConversation & Somatic Symptom (Sx) DisorderCausal explanations:- Old explanation: hysteria (strong emotions  body symptoms)- Other models have also been used, but not a lot of empirical support and disorders are not well understoodo Psychodynamic Model: Electra stage (love dad, must compete with mom), when parents overreact to these feelings, the “complex” remains unresolved and converts sexual feelings into physical Sxso Behavioral Model: Sick behaviors  rewards (R+ and R-)o Cognitive Model: Symptoms are a form of communicationo Multicultural Model: More common to express somatic symptoms in non-western culturesTreatment:- Psychotherapy is often last resort and only after having exhausted medical optionsTargeting causes:- Psychodynamic – develop insight into “true” struggles- Behavioral –exposure to trauma/events that triggered the symptoms- Biological – antianxiety or antidepressant drugsTargeting physical symptoms:- Suggestion through hypnosis- Contingency management: reinforce non-sick behavior and extinguish sick behavior- Confrontation: present with the medical info ( telling them that their symptoms are without medical basis)Illness Anxiety DisorderChronic anxiety about health and concern that they are developing a serious illness despite no physical symptoms- a.k.a. hypochondriasis- OCD-like: Check bodies constantly for symptoms- Panic Disorder-like: Misinterpret bodily signs- Often appears in early adulthoodo Men and women have equivalent ratesCausal explanations- Behavioral: operant or classical conditioning; modeling- Cognitive: oversensitivity to bodily cuesTreatment:- Antidepressants- ERP- Cognitive restructuring (similar to OCD)Psychophysiological DisordersA group of illnesses that seem to result from biopsychosocial factors (psychosomatic)- DSM-5 calls them “psychological factors affecting medical condition”- There is actual physical change in these disorders, separating them from those discussedearlier- Ex: ulcers, asthma, insomnia, headaches/migraines, high BP, CHD, plus more and more are considered every dayBroad psychological factors:- Needs, attitudes, emotions, or coping styles may cause people to recurrently overreact to stress/stressorso Over time, this can develop into these disorderso Ex: Repressive coping style, Type A personality (time urgency and hostility)Sociocultural factors:- Social conditions like poverty may set stage for these disorders- Ethnic minorities are more at risk for these disorders (in US/abroad)o Though the relationship is complicated (see “Hispanic Health Paradox”)PsychoneuroimmunologyExamines the link between stress and infection- Lymphocytes are the most important cells in the immune system (white cells that attack invaders)- Stress interferes with lymphocyte activity (generally slows it down), increasing risk for infectiono Socially isolation  poorer immune functioningIntervention (behavioral medicine):- Relaxation training (class activity)o Progressive muscle relaxationo Deep breathing- Biofeedback- Meditation- Hypnosis- Cognitive restructuring- Support groups- Awareness and acceptance- OthersLecture 25 (March 23): Eating DisordersWestern society generally equates thinness with health & beauty to the point of “national obsession” Startling rise in the past 30 years with a core issue of intense fear of weight gain Three diagnoses in the DSM-5:1. Anorexia nervosa2. Bulimia nervosa3. Binge eating disorder (new in