2011 PSYB32 Midterm 2 Study Guide

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5 Jul 2011

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Midterm 2
Lecture 5:
Chapter 7: Somatoform and dissociative disorders
Inter-rater reliability is poor, culture plays a moderating roles
Only pain disorder with both psychological factors and a general medical condition will be diagnosis
because pain is a subjective experience and have no test thus we can never know whether it is a
psychological or physical.
Pain disorders are often co-morbid with substance abuse e.g. pain killers, anxiety, and depression
These patients are reinforced and develop into iatrogenic disability; reinforcement of being disabled
Typically women suffer from body dysmorphic disorders than men, and will be more specific
It is important to know that patients, who suffer from body dysmorphic disorders (BDD), often have
obsessive compulsive personality disorder characteristics. They are obsessed with looking at their defective
reflection in mirror. Usually begins in late adolescence or adulthood
Depression, social phobia co-morbit because imagine defect and not want to be in public, or sad about
They usually meet the criteria of a delusional
5% of the population might have hypochondriacs, and is chronic. Depression and anxiety is highly co-morbit
Hypochondriacs have shifting complaints, believe they have a specific disorder
Somatization disorder patients have symptom complaints, more often in women and runs in families (20%)
Depression and anxiety is highly co-morbit along with substance abuse and histrionic personality disorder,
and conversion disorder
Conversion disorder, may have Phonia(lost of voice), Anosmia (lost of smell), symptoms appear suddenly as
a result of a stressor
Malingering is when the person is consciously faining/faking impairment in the context of external
incentive such as insurance check or getting out of military
Factitious disorder is when the patient intentionally faining/faking impairment without external incentive
Conversion disorder is when the impairment is unconscious
Munchausen Biproxy: When a person causes a family member illness in order to care for; conscious
Dissociative disorders are rare and do not know the cause
Dissociative amnesia is usually time locked which means it lasts for a period of time and goes away
suddenly like the onset usually after a stressful event
Sodium amatol: truth serum, relaxes unconscious guard
Dissociative fugue, even more uncommon, 0.2% prevalence in population
Fugue is brief in duration, occurs after severe stressor, rare that it will recur again after recovery
Dissociative disorders usually have acute onsets
1.3% prevalence of D.I.D. but commonly misdiagnosis of being borderline or schizophrenia (vice versa).
Begins in childhood or adulthood
There are gaps in between memories of separate egos
DID is chronic and severe causing disability
Chapter 6: Anxiety Disorder
Anxiety disorders are the most common, 31% lifetime prevalence
Co-morbidity amongst the different anxiety disorders are high because symptoms are not disorder specific
e.g. elevated heart rate may be a symptom for OCD and GAD, causes/etiology may be applicable to more
than one disorder
Claustrophobia: fear of enclosed spaces
Agoraphobia: fear of open spaces with a lot of people
Xenophobia: fear of strangers
Phobia: comes from Greek work of being afraid
Specific phobia is more prevalent in women
Categories of specific phobia: objects, situation, animals, natural environment
Social phobia is more disabling than specific phobia
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Generalized or specific qualifier of social phobia. Women have a higher probability (11 vs. 15% lifetime
Panic attacks can occur to any one of the anxiety disorders
Systematic desensitization- Joseph Walt
Flooding: forcing the patient into the phobia
GAD is always there
GAD: 5% prevalence, underestimate
OCD, compulsions are not pleasant
Guest Speaker: Chris Rodregious; Gestalt Psychologist
Integrated therapist, using variety of approaches
Excitement and anxiety have the same physiologic reactions, the difference is how you interpret it
View from a holistic approach, addresses what is happening in the moment not the past or future
Brings into awareness discrepancies in the persons presentation (e.g. someone who is crying but says she
feels great
Gestalt is bringing someone into congruent with the presentation and acceptance of self awareness
It includes the neurosis, as a necessary element in the change process
How the individual resist contact in the here and now or how they resist change is the rich resource from
which the therapist draws interventions.
Perls’ basic premise was that life happens in the present not in the past or the future and that when we are
dwelling on the past or fantasizing about the future we are not living fully. Through living in the present
we are able to take responsibility for our responses and actions. To be fully present in the here and now
offers us more excitement, energy and courage to live life directly
It is based on a need cycle, sensation, awareness, mobilization of energy, excitement, action, contact,
withdrawal(only when satisfied)
Neurosis interrupts the cycle and results in unfinished business
Anxiety is an essential expression of being alive and anxiety is the beginning of feeling (of whats going to
If the excitement is blocked because of beliefs or interruptions, excitement becomes anxiety and build up
and become chronic
The holding or stuck of the cycle is a mechanism to protection against emotion
Anxiety holds in emotion
Sensory sensation, learn to be highly aware of yourself
Paradoxical theory of change: the more you try to become something, the less of it you become
Lecture 6: Chapter 10 Mood Disorders
Cognitive biases:
Arbitrary inference: where the individual will draw conclusions without evidence. For example, associate
feelings with reality and thoughts to your relationship to the external world
Selective abstraction: conclusion drawn from only one of the elements from a situation, an element you
choose to focus on. For example, focus on less positive aspects of a situation and create negative conclusions
from that.
Overgeneralization: overall sweeping conclusion based on a single trivia event. Everyone over generalizes
but it is what the person feels after that differs from the depressed. For example, you receive a bad grade in
history and all of a sudden you make the conclusion that you are simply bad in history
Magnification and minimization: when we exaggerate our evaluation of performance in either direction.
Panic attack (more common in women with mood disorders), substance abuse (males have higher rates),
sexual dysfunction (males with mood disorders have high rates of comorbitity and personality disorders
(females more prevalent) are highly co-morbit with mood disorders
Symptoms of depression vary within the life time
More somatic complaints with younger patients such as headaches
Elderly with depression tend to not only report depression symptoms but also cognitive impairments
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