PSY 3604 Exam 2 Ch 8

Alan Frances, who served as the chair of the task force that developed DSM-IV, has called the new DSM-5 somatic symptom disorder a __________. "much needed revision that focuses on real psychological symptoms" that should be a useful category for practicing clinicians "cumbersome product that relies too heavily on identifiable physical conditions for diagnosis" "loosely defined and fatally flawed" diagnosis and recommended that clinicians not use it "significant improvement over the separate, narrowly defined categories used in the DSM-IV"

"loosely defined and fatally flawed" diagnosis and recommended that clinicians not use it

Upwards of 80 percent of the population reports experiencing some somatic (physical) symptoms in the past week. Of these cases that drive people to visit doctors' offices, approximately what percentage are medically unexplained? 5 to 10 percent less than 5 percent 20 to 50 percent 10 to 15 percent

20 to 50 percent

Conversion disorders are found in approximately __________ of people referred for treatment at neurology clinics. 1 percent 10 percent 20 percent 5 percent

5 percent

For how long must the preoccupation with a real or imagined illness persist before a diagnosis of illness anxiety disorder can be made? 3 months 6 months 1 month 1 year

6 months

Which of the following statements accurately describes changes between DSM-IV and DSM-V relative to how somatic symptom disorder is diagnosed? According to DSM-V, individuals must be experiencing chronic somatic symptoms but not dysfunctional thoughts, feelings, and/or behaviors. According to DSM-IV, individuals must be experiencing dysfunctional thoughts, feelings, and/or behaviors, along with chronic somatic symptoms. According to DSM-IV, individuals must be experiencing dysfunctional thoughts, feelings, and/or behaviors, but not chronic somatic symptoms. According to DSM-V, individuals must be experiencing dysfunctional thoughts, feelings, and/or behaviors, along with chronic somatic symptoms.

According to DSM-V, individuals must be experiencing dysfunctional thoughts, feelings, and/or behaviors, along with chronic somatic symptoms.

Which of the following disorders was once the most frequently diagnosed disorder among soldiers in World War I and very common during World War II? Dissociative identity disorder Acute anxiety disorder Hypochondriasis Conversion disorder

Conversion disorder

__________ disorders are a group of conditions that involve disruptions in a person's normally integrated functions of consciousness, memory, identity, or perception. Somatic symptom Dissociative Obsessive-compulsive Psychotic

Dissociative

__________ memory refers to stored information that people cannot consciously recall. Eidetic Flashbulb Explicit Implicit

Implicit

Which of the following statements correctly identifies the difference between factitious disorder and malingering? Malingering represents unconscious desires that the patient is unaware of. Factitious disorder describes a conscious, deliberate act on the part of the patient to obtain gain. In the case of factitious disorder, the person is motivated by external incentives, such as avoiding situations perceived as stressful or personal responsibilities. With malingering, the person receives no tangible external rewards. In the case of factitious disorder, the person receives no tangible external rewards. With malingering, the person is motivated by external incentives, such as avoiding situations perceived as stressful or personal responsibilities. Neuroimaging reveals that factitious disorder engages activity in the cingulate gyrus of the brain. Malingering engages activity in the left temporal lobe.

In the case of factitious disorder, the person receives no tangible external rewards. With malingering, the person is motivated by external incentives, such as avoiding situations perceived as stressful or personal responsibilities.

Which of the following describes a critique of the decision to group factitious disorders within the somatic symptom and related disorders category in the DSM-5? It is not possible to differentiate factitious disorder from malingering. Factitious disorder is not a real diagnosis, so it will make others believe that somatic disorders are fake diagnoses, too. Factitious disorder is much more common than other somatic disorders, affecting upward of 10 percent of the population. Including a disorder where someone intentionally feigns illness may increase stigma and lack of regard for the seriousness of somatic disorders.

Including a disorder where someone intentionally feigns illness may increase stigma and lack of regard for the seriousness of somatic disorders.

Following the rejection of his latest novel, Jahir experienced an inability to make some movements with his right hand. While he was unable to write, he could scratch and make other simple motions with his affected hand. Two weeks later, he was able to write again. What is unique about Jahir's case of conversion disorder? Jahir only lost the ability to move his right hand. Jahir is male, and most people with this disorder are women. Jahir's symptoms subsided after only two weeks. Jahir had some ability to move his hand.

Jahir is male, and most people with this disorder are women.

Octavia has been diagnosed with dissociative identity disorder (DID). She has 17 different "alters," which are strikingly different from her host personality. Some of her alters are not full personalities, but fragments and memories. Some of the alters are children. What aspect of this case is unusual? It is unusual for a person with DID to have fragmentary alters. No aspect of this case is unusual. It is unusual for a person with DID to have seventeen alters. It is unusual for a person with DID to have alters that are very different from the host personality.

No aspect of this case is unusual.

What major change has been made to the category of somatic symptom and related disorders in DSM-5? The duration for which the symptoms must be present before a diagnosis is made has been extended to 12 years. An exclusion criterion has been added, removing this diagnosis for anyone who is currently using and/or abusing psychoactive drugs. No distinction has been made between medically explained and medically unexplained symptoms. The clinical specifics of "with normal premorbid functioning" and "without normal premorbid functioning" have been added.

No distinction has been made between medically explained and medically unexplained symptoms.

Which of the following best describes the symptoms associated with amok? Persons afflicted with this syndrome experience visual and auditory hallucinations or paranoia. Persons afflicted exhibit violent, aggressive, or homicidal behavior which is directed at other people and objects. Afflicted persons fear that their genitals are retracting into their body. Afflicted persons feel they have been given a curse believed to be cast by a malevolent glare from another person.

Persons afflicted exhibit violent, aggressive, or homicidal behavior which is directed at other people and objects.

After learning of her father's death, Sophia felt dazed and confused but still retained her sense of self. When speaking of her response to the news, she said she felt like she was in a movie watching the events happening to her. Despite this strange feeling, she understood what was happening and did the things that she needed to do. What can be said of Sophia's response to her father's death? Her response is not typical and suggests that she is suffering from acute stress disorder. She experienced an instance of derealization. She had a psychotic break. She experienced an instance of depersonalization.

She experienced an instance of derealization.

Which of the following is true for both illness anxiety disorder and somatic symptom disorder? The average age of onset is 20 years. Physical symptoms are absent. Patients are often faking their symptoms. Medical conditions cause many of the observed symptoms.

The average age of onset is 20 years.

In DSM-5, the diagnostic criteria for DID have been modified to include pathological possession. Which of the following statements can be attributed to this modification? The change distinguishes between observed behaviors associated with schizophrenia and those associated with DID. The change makes the diagnosis of DID more inclusive and applicable to a broader range of cultural groups. The change enables the clinician to distinguish between spiritual and religious occurrences. The inclusion of pathological possession has led some developers of the DSM-5 to be concerned about the validity of this concept.

The change makes the diagnosis of DID more inclusive and applicable to a broader range of cultural groups.

Which of the following most accurately describes research on the prevalence of depersonalization/derealization disorder? Depersonalization/derealization disorder occurs more commonly in men than in women. Depersonalization/derealization disorder tends to onset after the age of 65. The lifetime prevalence of depersonalization/derealization disorder is around 1 to 2 percent of the population. Depersonalization/derealization disorder occurs more commonly in women than in men.

The lifetime prevalence of depersonalization/derealization disorder is around 1 to 2 percent of the population.

Which of the following best summarizes current understanding about the causes of somatic symptom disorders? These symptoms are caused by a defense mechanism against unresolved or unacceptable unconscious conflicts. These symptoms are caused by extreme negative affect that gets focused on the body. These symptoms are caused by medical illnesses. These symptoms are caused by a hypervigilant focus on bodily sensations and changes, where these sensations are attributed to illness and thus lead to excessive worry and catastrophizing.

These symptoms are caused by a hypervigilant focus on bodily sensations and changes, where these sensations are attributed to illness and thus lead to excessive worry and catastrophizing.

Which of the following responses is more common among people who are malingering compared with people experiencing somatic symptom disorders? They believe themselves to be "victims of their symptoms." They talk a lot more about their symptoms to try to convince others that they are real. They are unlikely to be phased by inconsistencies pointed out in their symptoms. They become evasive and defensive when asked about their symptoms in detail.

They become evasive and defensive when asked about their symptoms in detail.

How are spiritual possessions unique from DID or pathological trances? They tend to be volitional, transient, and part of religious or spiritual practices. They occur spontaneously and cause distress. They are always elicited by indigenous healers. The other identity is experienced as an external spirit, power, or deity.

They tend to be volitional, transient, and part of religious or spiritual practices.

There has been little systematic research conducted on dissociative amnesia and fugue, yet some studies have revealed new information. Which of the following is the source of this information? Experiments using medication Testing personality traits of individuals who have experienced these issues Use of different brain imaging methods to determine where loss of function occurs Checking reports from doctors' offices

Use of different brain imaging methods to determine where loss of function occurs

For individuals with DID, "alters" are not in any meaningful sense personalities but rather reflect __________. a failure to integrate various aspects of a person's identity, consciousness, and memory difficulties that the patient has with distinguishing reality from fantasy negative introjects established in the patient during childhood characteristics of individuals that may have befriended the patient during childhood

a failure to integrate various aspects of a person's identity, consciousness, and memory

An example of dissociative trance disorder is ________ a person who believes that he or she can voluntarily be possessed by a spirit and enjoys allowing this to happen. a person who enters into a trance state more than once. a person who often feels as though the world around him or her isn't real, although he or she knows it is. a person who believes he or she is at times possessed by a spirit and is extremely upset because of this.

a person who believes he or she is at times possessed by a spirit and is extremely upset because of this.

Most current forms of psychotherapy for DID are based on the assumption that the disorder was caused by __________. early separation from the mother a tendency for the patient to engage in an overly active fantasy life abuse poor treatment techniques administered by therapists lacking in appropriate training

abuse

Amnesia caused by organic brain pathology is more likely to be classified as __________ amnesia, whereas amnesia that occurs following intolerably stressful circumstances is more likely to be __________ amnesia. anterograde; retrograde posttraumatic; retrograde retrograde; anterograde anterograde; posttraumatic

anterograde; retrograde

Connor is able to talk only in a whisper, although he can usually cough in a normal manner. This type of vocal symptom pattern, found with cases of conversion disorder, is referred to as __________. dysarthria aphonia alexia spasmodic dysphonia

aphonia

What is the major commonality of the different somatic symptom disorders? a loss of contact with reality and a tendency to respond to an internally generated fantasy world bodily symptoms that cause significant psychological distress and impairment a lack of control over physical functions, such as eating, sleeping, and sexual behaviors the presence of two or more fully formed identities within the same individual

bodily symptoms that cause significant psychological distress and impairment

The term "somatic disorder" can be understood in terms of its linguistic roots. "Soma" means __________. body medical psychological physical

body

Jessa wakes up one morning unable to see anything. Concerned, he goes to the doctor who is unable to find any medical or neurological condition that would be causing his sudden blindness, despite conducting a thorough medical and neurological assessment battery. After talking with Jessa more, his doctor learns that he recently got fired from his job after undergoing a divorce. Which of the following is most likely causing Jessa's symptoms? hypochondriasis conversion disorder factitious disorder an underlying medical condition that the doctor missed

conversion disorder

In __________, one's sense of the reality of the outside world is lost. dissociation personalization derealization a fugue

derealization

Matthew has been under significant stress at his job. He is concerned about his well-being because he has episodes at work and home where friends, family, and places seem as though they are unreal or dreamlike. Matthew's reality testing, however, is intact. What DSM symptom best fits with Matthew's experiences? dissociative amnesia conversion reaction personalization derealization

derealization

Andrew often cannot remember what went on during his history class. He finds the class boring and daydreams during the lecture. He is so involved in his daydreaming that, frequently, he is unaware when the class has ended and is surprised when he hears classmates leaving the room. Andrew's behavior is an example of __________. dissociation a conversion reaction explicit memory abreaction

dissociation

Angela's uncle Leo, an accountant, disappeared from his home in Dover, Delaware, after his wife died from a lengthy illness. He was later found working in a casino in Las Vegas, Nevada. When located, Leo had no memory of who he was or how he got to Las Vegas. He had assumed a name, rented an apartment, and managed his daily affairs in Las Vegas without any problems. What diagnosis best fits with Leo's behaviors? dissociative identity disorder dissociative fugue derealization depersonalization

dissociative fugue

Which of the following types of memory is typically the only type of memory affected by dissociative amnesic reactions? semantic memory episodic and/or autobiographical memory short-term memory procedural and/or implicit memory

episodic and/or autobiographical memory

Maya, age 32, is irritated that her sister is getting so much attention around her upcoming wedding. In order to get more attention for herself, Maya begins feigning the symptoms of a major illness. She even has herself hospitalized for this phantom sickness. These are symptoms of what psychological disorder? somatic symptom disorder illness anxiety disorder factitious disorder patient faking disorder

factitious disorder

Individuals with illness anxiety disorder __________. have high anxiety about developing or having an illness; however, if somatic symptoms are present, they are mild in intensity may become suspicious or delusional in their beliefs about the treatment they are receiving develop the disorder after having been treated for a serious or life-threatening illness often come from families where a family member has a long-term debilitating illness

have high anxiety about developing or having an illness; however, if somatic symptoms are present, they are mild in intensity

Important to understanding somatic symptom disorders is the fact that the affected patients __________. have control over their symptoms but are using symptoms as a way of meeting a strong desire to be cared for by others have no control over their symptoms and are trying to intentionally deceive others are overwhelmed by anxiety and are trying to deceive others have no control over their symptoms and are not trying to intentionally deceive others

have no control over their symptoms and are not trying to intentionally deceive others

In cases of dissociative identity disorder, the identity that is most frequently encountered and carries the person's real name is called the __________. host factitious identity alter substitute

host

According to the revisions made for DSM-5, most people previously diagnosed with __________ will now be diagnosed with somatic symptom disorder. hypochondriasis factitious disorder body dysmorphic disorder dissociative disorder

hypochondriasis

When hypochondriasis occurs with no or only very mild physical symptoms, what would be the correct DSM-5 diagnosis? conversion disorder body dysmorphic disorder somatic symptom disorder illness anxiety disorder

illness anxiety disorder

An important goal of psychotherapy for persons with DID is to __________. assist the patient in acknowledging and accepting past childhood trauma integrate the patient's personalities into one identity that is better able to cope with current stressors enable the patient to release alters and mourn their passing help the patient eliminate sources of secondary gain that may develop as a result of having alters

integrate the patient's personalities into one identity that is better able to cope with current stressors

Dissociation ________ is extremely rare and not necessarily pathological. only occurs in people with a dissociative disorder. is extremely common and not necessarily pathological. is a sign that something is seriously wrong.

is extremely common and not necessarily pathological.

One of the major criticisms of the diagnostic criteria of somatic symptom disorder __________. focuses on the extensive criteria that must be met in order to be diagnosed concerns the possibility that immigrants and members of non-dominant cultural groups will be overdiagnosed is that the new diagnostic criteria appear far too loose and could lead to many people being mislabeled as having a mental health issue points out that younger adults will be disproportionately labeled because this population often experiences a range of physical symptoms

is that the new diagnostic criteria appear far too loose and could lead to many people being mislabeled as having a mental health issue

When a person intentionally creates his own physical symptoms in order to get some sort of external gain—disability benefits, avoidance of military service, or extended time off from his job—he is demonstrating the symptoms of __________. somatic symptom disorder Munchausen's syndrome by proxy malingering factitious disorder

malingering

Research finds that people with depersonalization/derealization disorder have an elevated risk of developing one of several other different disorders, including which of the following? dissociative amnesia mood and anxiety disorders ADHD anorexia nervosa

mood and anxiety disorders

Which of the following personality traits are considered risk factors for developing somatic symptom disorder? extraversion, stoicism, and narcissism negative affect, absorption, and alexithymia openness, affect lability, and high fear of death conscientiousness, narcissism, and affect lability

negative affect, absorption, and alexithymia

Implicit perception can be defined as __________. perceiving while being fully aware of previous experiences of that which is being perceived occurring in the absence of awareness recall of information with a direct awareness of how the information was learned remembering things one cannot consciously recall

occurring in the absence of awareness

About 20 percent of persons diagnosed with conversion disorder present the symptom of la belle indifference. This term refers to the fact that __________. patients are distressed by the symptoms, so much so that they are unable to talk many patients presenting with conversion disorder maximize the inconvenience of the symptoms they are experiencing patients exhibit very little anxiety and fear, behaviors that would normally be expected in people with symptoms such as paralysis or blindness secondary gain plays a big role

patients exhibit very little anxiety and fear, behaviors that would normally be expected in people with symptoms such as paralysis or blindness

According to cognitive-behavioral formulations, somatic symptom disorder can be viewed as a disorder of both __________. insufficient dopamine availability in the brain and cognitive processes perception and cognition emotional expression and physical state mind and spirit

perception and cognition

Recent studies have compared the behavior of people diagnosed with DID with the behavior of people who are asked (after appropriate training) to simulate DID. Individuals diagnosed with DID differed from simulators in that __________. persons with DID reported fewer pathological symptoms persons with DID showed more cognitive processing problems persons with DID were less sensitive to external stimulation such as noises or temperature the simulators typically presented with more elaborate personalities

persons with DID showed more cognitive processing problems

Zack, diagnosed with somatic symptom disorder, is participating in a form of behavioral therapy where his therapist has instructed him to not engage in checking his body as he routinely does and to not seek constant reassurance from others. Zack's therapist is using the technique of __________. response prevention thought stopping imagery-based prevention behavioral experiment

response prevention

With the general public, the diagnosis of dissociative identity disorder (DID) is often confused with the diagnosis of __________ as a result of the use of the phrase "__________." schizophrenia; split personality paranoid personality disorder; deranged personality borderline personality disorder; split personality psychopathy; cracked personality

schizophrenia; split personality

Burke et al. (2014) conducted a study involving 10 women with conversion disorder. The findings revealed that when the anesthetic body part was stimulated, there was decreased activation in somatosensory cortex but increased activation in areas such as the anterior cingulate cortex and the insula. These results support the notion that __________. limbic structures are more involved in sensation and physical movement than previously thought motor areas of the brain are less important as survival mechanisms than are the emotion-related regions of the brain sensory areas of the brain may be inhibited by overactive emotion-based processing areas of the brain biochemical processes associated with conversion disorders may reroute neural messages to other areas of the brain such as emotional processing centers

sensory areas of the brain may be inhibited by overactive emotion-based processing areas of the brain

Lenny's wife, Morgan, has been diagnosed with DID. According to Morgan, she has discovered in therapy that she was abused by her father. Lenny feels Morgan's memories are false memories, and have resulted from leading questions and suggestive techniques used by her psychotherapist. Theoretically, what perspective reflects Lenny's concerns? psychodynamic theory neodissociation theory posttraumatic theory sociocognitive theory

sociocognitive theory

When hypochondriasis is accompanied by significant physical symptoms, the DSM-5 diagnosis will be __________. reaction formation disorder anxiety disorder somatic symptom disorder conversion disorder

somatic symptom disorder

Brain-imaging data were evaluated for nine individuals diagnosed with dissociative amnesia. Although the sample size was small, the imaging suggested that, for these diagnosed individuals, there was a __________. reduced functioning in the temporal region significant functional change in the brain stem subtle loss of function in the right anterior hemisphere loss in total brain volume with a slight increase in volume of the amygdala

subtle loss of function in the right anterior hemisphere

With conversion disorders, Freud thought that the reduction in anxiety and intrapsychic conflict was __________, but noted that patients often also experienced __________ as well. the result of the conversion holding libidinal forces at bay; undefined psychic energy "primary gain" that returned the repressed thought to an unconscious level; "tertiary gain" such as having unconscious needs met in new, indirect ways under the direction of the superego; energy and influence from the id the "primary gain" that maintained the condition; "secondary gain" such as receiving sympathy and attention from loved ones

the "primary gain" that maintained the condition; "secondary gain" such as receiving sympathy and attention from loved ones

A promising treatment of dissociative disorders involves administering rTMS (repetitive transcranial magnetic stimulation) to the temporoparietal junction, an area of the brain involved in __________. executive functions and planning behavior the experience of a unified self and body regulation of choice behavior and emotion regulation of emotions associated with pleasure

the experience of a unified self and body

The historical roots of somatoform disorders date back to __________. the humanist perspective championed by Rogers and Maslow which suggests that somatoform disorders develop in response to blocking self-actualization medical models that looked at abnormalities in limbic system structures the psychoanalytic concept of hysteria and the work of Freud, Breuer, and Janet early classical conditioning theorizing by Watson and the belief that behaviors associated with somatoform disorders were a product of faulty learning

the psychoanalytic concept of hysteria and the work of Freud, Breuer, and Janet

It has been suggested that some of the increase in the prevalence of DID is artifactual and has occurred because __________. popular movies and books have generated a large interest in the subject of borderline personality disorder beginning with the DSM-III in 1980, the diagnostic criteria became more inclusive of symptoms normally attributed to other diagnoses therapists looking for evidence of DID in patients may implicitly propose the existence of alternate identities neuroimaging techniques are able to verify different brain responses when comparing the host to alter personalities

therapists looking for evidence of DID in patients may implicitly propose the existence of alternate identities

The sensory symptoms or deficits found with persons with conversion disorder are most often found in which of the following sensory systems? olfactory visual vestibular gustatory

visual