Chapter 5 281 Exam 2 Study Guide Somatic Symptom and related Disorders Somatic Symptom Disorder condition in which physical symptoms or concerns about an illness cannot be explained by medical or specific psychological disorder o Common symptoms are back chest pains stomachaches headaches o They have high anxiety about their health thoughts must be excessive and disproportionate to the symptoms Conversion disorder symptoms of altered motor or sensory dysfunction o The things they are experiencing don t make sense Ex glove anesthesia only hand is numb which doesn t agree o Symptoms can include the extremes of blindness or paralysis without o They re not intentionally producing these symptoms MUST RULE with science medical explanation OUT MEDICAL CAUSES Illness Anxiety Disorder people with this disorder have a high level or worry about health and easily becomes alarmed about the possibility of having an illness o There are mild to no somatic symptoms o They cannot be reassured that they are well o High comorbidity rates with depression and anxiety Emotional Stress physical symptoms Hypervigilance pay more attention to things in body Somatic amplification more sensitive to physical symptoms Etiology Treatments Must have person realize it is not a medical issue SSRIs don t know if this helps a comorbid issue or the other CBT Cognitive Behavioral Therapy Factitious Disorders Factitious disorder physical or psychological signs or symptoms of illness are intentionally produced in what appears to be a desire to assume a sick role o Deceptive practices used to produce signs of illness Ex red candy in urine samples to appear as blood Mouthwash in wounds so they won t heal Faking a temperature o NOT the same thing as malingering which is when a person intentionally produces symptoms because they want something to happen or want to avoid something Factitious disorder imposed on others physical or psychological symptoms intentionally produced in someone else o Most commonly seen in mother and child considered form of child abuse Gain mastery or control the only thing they control is their body Etiology Masochism takes pleasure in physical pain Positive reinforcement the attention Treatments We don t have 1 medication that works to treat this Usually treat by symptoms Dissociative Disorders a personal nature 1 8 Dissociative amnesia an inability to recall important information usually or o Psychological not medical cause o The symptoms cause clinically significant distress or impairment in social occupational or other important areas of functioning o Localized amnesia can t remember events during certain period of o Generalized amnesia can t remember any aspect of one s life o Selective amnesia can t remember some elements of traumatic time experience o Dissociative fugue apparently purposeful travel wandering associated with the amnesia Depersonalization derealization disorder described as feelings of being detached from one s body or mind or unreality or detachment with respect to one s surroundings 0 8 o Typically onset 16 23 years old o Patients will explain this as observer of their own behavior o You see this often as a feature of another disorder high comorbidity o The symptoms cause clinically significant distress or impairment in social occupational or other important areas of functioning Dissociative Identity disorder within one person two or more distinct identities that make the person who they are was previously called multiple personality disorder 1 5 o Common symptoms include the inability to recall large amounts of personal information everyday events or traumatic events o The symptoms cause clinically significant distress or impairment in social occupational or other important areas of functioning o Described in some cultures as possession o Must be careful of Iatrogenesis therapist creates disorder from leading questions Etiology DID Failure of normal personal integration Early traumatic experiences ex Sexual assault Dysfunctional parent child interactions Dissociation a way to block painful memories Treatments Dissociative amnesia usually resolves w o treatment DID and Depersonalization disorder have no controlled pharmacological trials but antidepressants help CBT may be helpful for cognitive restructuring Terms and Concepts 5 types of dissociative experiences o Depersonalization Almost like looking at self from across room o 2 Derealization Like your environment isn t real o 3 Amnesia Can t remember o 4 Identity Confusion Unclear who you are o 5 Identity Alteration worst very end of spectrum Behaviors show someone ahs assumed another identity The difference between amnesia and dissociative amnesia is that amnesia shows a medical cause for the loss of memory dissociative amnesia is a psychological cause Iatrogenic disorders develop from therapist asking cued or leading questions that in turn actually develop a disorder like DID The difference between Factitious disorders and malingering is that people with factitious disorders just want people to see them as sick they aren t trying to get out of doing something like they are in malingering Malingering is when people make up disorders to get something or get out of something o Ex Faking illness for lawsuit Trauma plays a huge role in the development in dissociative disorders and earlier trauma usually brings an earlier onset on the disorder Chapter 6 Major Depressive Disorder persistent sad or low mood Symptoms can include change in sleep and eating patterns Anhedonia and Dysphoria Anhedonia loss of interest in enjoyable activities Dysphoria low mood MDD is different from Bipolar disorder because it does not have the manic stage or elevated mood It s an episodic illness and must last at least 2 weeks There are emotional sadness cognitive feeling worthless and physical symptoms feeling fatigued Specifiers for MDD o Peripartum onset formerly known as post partum depression 6 13 of new mothers Onset within 6 months of delivery May negatively impact the child o Single episode person only suffers from one episode in his or her o Recurrent episodes multiple episodes separated by periods of lifetime normal mood Dysthymia a persistent depressive disorder that can best be described as a chronic state of depression The difference between dysthymia and depression is that dysthymia must last at least 2 years never without symptoms for more than 2 months o High risk for suicide b c of social isolation Mislabeled as moody or difficult