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Abnormal
Chapters 7 & 13 - Somatoform & Dissociative Disorders
93
Psychology
Undergraduate 2
05/10/2006

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Term
Dissociative disorders
Definition
persistent, maladptive disruptions in the integration of memory, consciousness, or identity. Verge on the unbelievable. Person may be unable to remember many seemingly familiar details about the past; he or she may wander far from home or perhaps assume a new identity, or even 2 personalities may coexist in the same person
Term
explicit memory
Definition
conscious recollection of a past event
Term
implicit memory
Definition
changes in behavior apparently based on a memory of prior event, but with no conscious remembering of the event
Term
Why are recovered memories controversial?
Definition
They are dramatic recollections of long-ago traumatic experiences supposedly blocked from the conscious mind by dissociation
Term
Characteristics of dissociative disorders
Definition
persistent, maladptive disruptions in integration of memory, consciousness, or identity that occur outside of conscious awarness
Term
Dissociative fugue
Definition
a rare & unusual disorder characterized by sudden, unplanned travel, the inability to remember details about the past, and confusion about identity or assumption of a new identity. It typically follows a traumatic event. Travel is purposeful as well
Term
depersonalization disorder
Definition
a less dramatic form of dissociation whein people feel detached from themselves and their social or physical environment. Sensations as feeling as though you were in a dream or floating about your body and observing yourself act. They are persistent or recurrent, and they cause distress
Term
Dissociative amnesia
Definition
partial or complete loss of recall for particular events or for a period of time. a sudden inability to recall extensive an impt personal info that exceeds normal forgetfulness.
Term
psychogenic amnesia
Definition
results from traumatic stress or emotional distress
Term
dissociative identity disorder
Definition
2 or mor personalities coexist within a single ind, and one or both of the personalities may be unaware of the existence of the other. also known as multiple personality disorder
Term
Why has there been an increase of DID since 1980?
Definition
It has occurred in conjunction with growing public concern about child sexual abuse, a traumatic experience that has been hypothesized to play a role in the etiology of many dissociative disorders
Term
% of population thought to have dissociative disorders?
Definition
over 10% of adult population
Term
wrong misdiagnoses of dissociative disorders
Definition
many ppl diagnosed with schizophrenia, BPD, depression, panic disorder, or substance abuse
Term
existence of DIs outside the US
Definition
rarely diagnosed outside of US & Canada
Term
"Bianchi" condition
Definition
Findings raise caution that the "symptoms" of DID can be induced through role playing and hypnosis
Term
Etiology of DIs
Definition
theory and speculation dominate because little systematic research has been done
Term
psychological factors
Definition
multiple personalities develop in response to trauma, particularly trauma of child abuse
Term
State depedent learning
Definition
a process documented in lab reasearch wherein learning that takes place in one state of affect or consciousness is best recalled within the same state of consciousness
Term
biological factors for DIs
Definition
very little evidence and not much more speculation has been offered. no genetic contribution to dissociative symptoms
Term
most important contributing cause of DIs
Definition
shared family environment
Term
Social factors and "iatrogenesis"
Definition
DIs are often produced by iatrogenesis, whcih is the manufacture of the DDs by their treatment. Many 'cases' were created by the expectations of the therapists
Term
abreaction
Definition
emotional reliving of a past traumatic event
Term
What might be an iatrogenic effect of abreaction?
Definition
many skeptics are concerned that hypnosis can exacerbate or even create dissociative symptoms, or false memories of past abuse
Term
primary therapeutic goal in treating DID
Definition
reinforce the different personalities as a whole; not to have only one personality triumph over the others
Term
Overreaching goal of prescribing medications for DID
Definition
to reduce distress, not to cure the disorder
Term
Somatoform Disorders characteristics
Definition
Problems characterized by unusual symptoms that occur in absence of a known physical illness; only in the physical form; there is really nothing physicall wrong with the person (no underlying organic impairment); substantial impairment, particularly a sensory or muscular system; often multiple physical symptoms; preoccupation with a particular body part w/ fears
Term
conversion disorder
Definition
symptoms mimic those found in neurological diseases; hysterical blindness or paralysis; they have no anatomic sense; accurately conveys central assumption of diagnosis- the idea that psychological conflicts are converted into physical symptoms
Term
somatization disorder
Definition
a history of multiple, somatic complaints in the absence of organic impairments; patient must complain of at least 8 physical symptoms: pain, gastrointestinal, sexual, double vision, numbness, seizures; histrionic manner (vague, but dramatic, self centered, and seductive); la belle indifference (flippant lack of concern for physical symptoms
Term
hypochondriasis
Definition
a fear or belief that one is suffering from a physical illness; preoccupation with fears of disease extends over long periods of time (at least 6 months); not delusional
Term
pain disorder
Definition
preoccupation with pain
Term
body dysmorphic disorder
Definition
preoccupied with some imagined defect in appearance; typically a facial preoccupation that may lead to repeated visits to a plastic surgeon; cause significant distress and interfere with work or relationships
Term
malingering disorder
Definition
pretending to have a somatoform disorder in order to achieve some external gain, such as a disability payment; more dramatic symptoms
Term
factitious disorder
Definition
motivated primarly by a desire to assume the sick role rather than by a desire for external gain; pretend to be ill or make themselves appear to be ill. ex: taking drugs that produce a rapid heart rate
Term
prevalence rates among somatoform disorders
Definition
Rare, hypochondrias are rare, somatization is rare, all disorders besides hypochondrais are more common among women (10x more common), occur in lower socioeconomic gropus, 4x more common among African A.
Term
What are the most prominent disorders that co-occur with Somatoform Disorders? What are possible explanations for the comorbidity?
Definition
Depression & anxiety. Either condition may cause the other, or both could be caused by a 3rd variable, such as life stress
Term
Why is somatization disorder frequently linked with ASPD?
Definition
ASPD may be the male expression of high negative emotion & absence of inhibition, where as somatization disorder is the female expression of the same characteristics
Term
Psychological Factors of somatoform disorders
Definition
Onset of somatization is triggered by traumatic stress; exposure to dead bodies
Term
Secondary gain
Definition
avoiding work or responsibility to gain attention and sympathy
Term
biological factors for somatoform disorders
Definition
no organic cause of symptom can be identified; identifcation of somatoform disorders involves a process called diagnosis by exclusion
Term
social factors of SDs
Definition
limited insight into their emotional distress and/or lack of social tolerance of psychological complaints
Term
How is pain disorder treated?
Definition
cognitive behavior therapy (CBT)
Term
Why is there such limited research investigating treatment of Somatoform Disorders
Definition
because most of disorders are treated by a physician and they receive physical treatment, and never seek help from a mental health professional
Term
schizophrenia
Definition
changes in the way a person thinks, feels, and relates to other people outside encironment; various combos of psychotic symptoms in the absence of other forms of disturbance, such as mood disorders; disrupts many aspects of a person's life; it is 2nd leading cause of disease burden
Term
typical onset of schizophrenia
Definition
during adolescence or early adulthood; between ages 15-35
Term
Prodromal stage of schizo
Definition
precedes active phase and is marked by an obvious deterioration in role functioning as a student, employee, or homemaker; peculiar behaviors, unusual percpetions, outburst of anger, increased tension, restlessness; social withdrawal, indeciveness, lack of willpower
Term
active phase of schizo
Definition
hallucinations, delusions, disorganized speech
Term
residual phase of schizo
Definition
follows active stage; defined by symptoms similar to those of prodromal stage; positive symptoms have improved, but person still continues to be impaired in various ways; negative symptoms, such as impoverished expression of emotions
Term
Hallucinations in schizo
Definition
a positive symptom; sensory experiences that aren't caused by actual external stimuli; most often auditory- they hear voices that can be comforting or pleasing to the patient
Term
delusions during schizo
Definition
beliefs that are rigidly held in spite of their preposterous nature; patients express and defend their beliefs with utmost conviction; preoccupation; not typically shared with others; many focus on grandiose or paranoid content
Term
negative symptoms
Definition
something that appears to be missing from the person's behavior
Term
blunted affect
Definition
lack of outward expression; flattening or restriction of the person's nonverbal display of emotional responses; affective flattening; neither happy or sad; apathetic and expressionless
Term
anhedonia
Definition
inability to experience pleasure; lack of positive subjective feelings
Term
avoltion
Definition
lack of will or volition; indeciveness, ambivalence, or loss of willpower; apathetic and ceases to work toward personal goals or to function independently
Term
alogia
Definition
poverty of speech, thought blocking; "speechless"; remarkable reductions in speech; patients train of speech is interrupted before a though or idea has been completed
Term
disorganized speech
Definition
involves tendency of some patients to say things that don't make sense; make irrelavent responses to questions, expressing disconnected ideas, and using words in peculiar ways
Term
thought disorder
Definition
part of disorganized speehc because the failur to communicate successfully reflects a disturbance in the though patterns that govern verbal discourse
Term
catatonia
Definition
immobility and marked muscular rigidy; also can refer to excitment and overactivity; ex: purposeless or repetetious movments; may assume unusual postures or remain rigid standing or sitting for longs periods of time
Term
stuporous state
Definition
catatonic posturing; reduced responsiveness; unaware of surroundings
Term
inappropriate affect
Definition
incongruity and lack of adaptability in emotional expression; content of speech is inconsistent with facial expressions
Term
dementia praecox
Definition
splitting of mental associations
Term
Criteria A for schizo
Definition
2 or more of following symptoms that last for a significant period of time during a 1 month period: delusions, hallucinations, disorg speech, grossly disorg or catatonic behavior, negative symptoms (such as affective flattening, alogia, or avolition)
Term
criteria b for schizo
Definition
social/occupational dysfunction: one or more major areas of functioning such as work, interpersonal relations is markedly below level of achieved prior to onset
Term
criteria c for schizo
Definition
duration: continuous signs of disturbance persist for at least 6 months and 1 month must meet for criteria a
Term
Catatonic Type
Definition
symptoms of motor immobility or excessive and purposeless motor activity
Term
Disorganized type
Definition
Disorganized speech, disorganized behavior, and flat or inappropriate affect; all 3 symptoms must be present
Term
Paranoid Type
Definition
systematic delusions with persecutory or grandiose content; preoccupation with frequent auditory hallucinations
Term
Undiffereniated type
Definition
patients who display prominent psychotic symptoms and either meet criteria for several subtypes or otherwise don't meet criteria for catatonic, paranoid, or disorganized types
Term
residual type
Definition
patients no longer meet the criteria for active phase, but still express signs of negative symptoms; "partial remission"
Term
Schizoaffective Disorder
Definition
Patients who fall on the boundary between schizophrenia and mood disorder with psychotic features; symptoms overlap with a MDE or manic episode; presence of delusions or hallucinations for at least 2 weeks in absence of prominent mood symptoms; if delusions or hallucinations are present during a depressive episode, then it's MDE with psychotic features
Term
Delusional Disorder
Definition
Doesn't meet full symptomatic criteria for schizophrenia, but are preoccupied for at least 1 month with non-bizarre delusions; no hallucinations, disorganized speech, catatonic behavior, or negative symptoms
Term
Brief Psychotic Disorder
Definition
People who exhibit psychotic symptoms- delusions, hallucinations, disorganized speech, or disorganized or catatonic behavior for at least one day, but no more than one month
Term
What factors should be taken into consideration when thinking about outcome of schizo?
Definition
Severe, progressive disorder that most often begins in adolescence and typically has a poor outcome. Best predictor of social adjustment is previous social adjustment
Term
Life time morbidity risk for schizo
Definition
Proportion of a specific population will be affected by the disorder at some time during their lives; 1%
Term
ECA data for schizo
Definition
Begins earlier in men than in wome; men 18-25 and women 25-35; men have more negative symptoms and women have more positive symptoms; women better response to treatment
Term
Gender differences in schizo
Definition
Biological difs involving certain hormones
Term
Cross-Cultural Comparisons (WHO, IPSS) for schizo
Definition
Incidence in schizo is relatively constant across dif cultural settings; better follow up results in developed countries; schizo occurs with similar freq and presents similar symptoms in different cultures
Term
Findings from behavioral genetics in schizo
Definition
Some type of genetic influence; much higher prevalence among 1st degree relatives; MZ twins have higher concordance; polygenic characteristic
Term
Why are birth complications harmful?
Definition
children have increased risk for schizo; chidren from famine also at higher reisk for birth defects
Term
Bad time of year for schizo
Definition
winter months with viral infections
Term
What are the findings from Structural Brain Imaging (MRI)? What part of the brain are implicated
Definition
Most have a decrease in total volume of brain tissue; mildly to moderately enlarged lateral ventricles
Term
What are the findings from Functional Brain Imaging (PET, fMRI) for schizo?
Definition
Dysfunctions in various neural networks, including some regions of prefrontal cortex and several regions of temporal lobes; structural and functional irregularities in frontal cortex and limbic areas of temporal lobes
Term
Dopamine Hypothesis for schizo
Definition
function of specific dopamine pathways in the limbic area of the brain; excessive levels of dopaminergic activty
Term
What is relationship between social class and Schizophrenia?
Definition
Highest prevalence among low SES
Term
Social causation hypothesis
Definition
stress & social isolation, poor nutrition, low social class play a causal role in development of schizo
Term
social selection hypothesis
Definition
cognitive/social impairments associated with the illness lead individuals to drift to a lower SES
Term
Expressed Emotion
Definition
family environment does have a significant impact on course of schizo; ex: high EE family
Term
schizotaxia
Definition
inds who are predisposed to schizophrenia inherit a subtle neurological defect of unknown form
Term
Threshold model
Definition
liability is viewed as lying along a continuum, but the probability that certain symptoms will be present changes dramatically as the person crosses a threshold
Term
antipsychotic medication
Definition
treat positive symptoms; target dopamine receptors; older version of medicine
Term
atypical antipsychotics
Definition
newer version; target negative symptoms (not positive)
Term
what's the most cost effective treatment for schizo?
Definition
assertive community treatment
Term
What's most effective in high EE families?
Definition
Family-Oriented Aftercare
Term
Institutional programs
Definition
token economies to help increase freq of desired behavior and decrease undesirable behavior
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