Deck 7: Disorders of Bodily Preoccupation

Question 1

Somatization, conversion disorder, pain disorder, and hypochondriasis are all classified by DSM-IV-TR as

A) anxiety disorders.
B) factitious disorders.
C) somatoform disorders.
D) psychophysiological disorders.

Answer 1

C

Question 2

Which term describes physical symptoms and disability in the absence of physical disease?

A) factitious
B) somatoform
C) psychosomatic
D) gastrointestinal

Answer 2

B

Question 3

Clients with medically unexplained symptoms account for what percent of problems confronted daily?

A) 15% to 45%
B) 35% to 70%
C) 40% to 605
D) 25% to 50%

Answer 3

D

Question 4

All of the following are symptoms of pain disorder except:

A) some form of bodily injury must be present
B) client can present with or without organic symptoms
C) severe, prolonged pain
D) complaints can be used for attention

Question 5

What are the two categories of pain disorder listed in DSM-IV-TR?

A) acute and chronic
B) primary and secondary
C) generalized and specific
D) autonomic and voluntary

Question 6

Which of the following is one of the criteria for the diagnosis of pain disorder?

A) The pain must be described as piercing and unbearable.
B) Reported pain symptoms must occur in at least four parts of the body.
C) The pain and deficits related to it are not intentionally produced or feigned.
D) There must be a clear precipitating incident that led to the reported pain symptoms.

Question 7

What analogy did Descartes use in order to help in conceptualizing pain?

A) a herd of animals walking slowly over a person
B) the slow dripping of water from a leaky bucket
C) blades of grass in a lawn that move with every breeze
D) an individual pulling the rope at the bottom of a tower causing the bell in the belfry to ring

Question 8

For several years, Ted has had back pain that is sufficiently severe that he has not been able to work. Nevertheless, physicians do not believe that the pain is as severe as one would believe from Ted's reaction. They have come to believe that Ted's presentation of his pain symptoms is related to his family's response. What term do physicians use for this phenomenon?

A) secondary gain
B) family somatization
C) dysfunctional family
D) unconscious manifestation

Question 9

Tomas has been given a diagnosis of pain disorder. His therapist wants to focus on pain behaviors and that conditions have a positive or negative effect on the behaviors. What approach will the therapist implement?

A) behavioral therapy
B) operant conditioning
C) biofeedback
D) psychotherapy

Question 10

Frank has learned from his father that if he displays pain-like symptoms, he will receive attention. Frank has recently married and wants his wife to help manage his pain. She has refused to accept this responsibility. What approach could help Frank?

A) psychodrama
B) cognitive therapy
C) biofeedback
D) cognitive-behavior therapy

Question 11

What have studies of the Yogi practitioner, Swami Rama, revealed concerning his claimed abilities to control bodily functions?

A) His claims of controlling bodily functions were false.
B) There are limits to the effectiveness of biofeedback.
C) "Involuntary" physical processes can be consciously controlled.
D) Yoga produces the same body control as other forms of exercise.

Question 12

While reading an interview with Swami Rama, you are struck by some of his claims. You tell a friend about the Swami and when asked for an example of one of the claims, what will you say?

A) He can slow up and speed up his heart beat.
B) He can change his brain waves on command.
C) He can walk over hot coals for a distance greater than a football field.
D) He can support the weight of a fully loaded truck on his chest with no injury.

Question 13

Your friend tells you about a news report on a form of therapy in which people are given information about their physiological state in the form of electronic signals. What is the likely topic of this report?

A) biofeedback
B) behavior modification
C) pharmacological therapy
D) systematic desensitization

Question 14

What is one of the limitations of biofeedback?

A) high cost
B) alters brain electrical activity
C) takes years of training to be effective
D) effectiveness tends to drop after training stops

Question 15

Phil would like to learn to control his heart rate and blood pressure. After carefully reading the literature, what has he determined he will need to accomplish his goal?

A) electrical or chemical stimulation
B) external reinforcement such as food
C) years of discipline, as in the practice of yoga
D) information about the state of the target system

Question 16

Michael is always complaining of a long list of aches, pains, and other symptoms. He focuses on slight changes in his heartbeat, is convinced he always has a fever, and frequently sees a physician. What is Michael's most likely diagnosis?

A) fugue
B) conversion disorder
C) somatization disorder
D) Munchausen syndrome

Question 17

What is another name for Briquet's syndrome?

A) hypochondriasis
B) conversion disorder
C) somatization disorder
D) depersonalization disorder

Question 18

Which disorder is often associated with unnecessary surgeries?

A) fugue
B) bipolar disorder
C) conversion disorder
D) somatization disorder

Question 19

Jessica constantly complains of a long list of physical symptoms that do not center around one particular ailment. After finding no medical explanation for her symptoms, a physician suspects Jessica suffers from

A) depersonalization.
B) dissociative fugue.
C) conversion disorder.
D) somatization disorder.

Question 20

Multiple somatic symptoms that are chronic and presented in a very dramatic and vague fashion are found in

A) conversion disorder.
B) somatization disorder.
C) depersonalization disorder.
D) psychophysiological disorder.

Question 21

Alice has the diagnosis of somatization disorder; Mary has the diagnosis of hypochondriasis. What is the major difference in the symptoms of their disorders?

A) Mary's symptoms have lasted longer than Alice's.
B) Mary's symptoms involve a break with reality; Alice maintains good contact with reality.
C) Alice has multiple symptoms; Mary's symptoms focus on her fear of a specific disease.
D) Alice has some real impairment from her disorder; Mary is actually malingering to increase attention.

Question 22

Patients with somatization disorder exhibit many of the same personality characteristics as patients with

A) schizoid personality disorder.
B) avoidant personality disorder.
C) histrionic personality disorder.
D) obsessive-compulsive personality disorder.

Question 23

How many people in a sample of 10,000 are likely to meet the criteria for somatization disorder?

A) 50
B) 100
C) 250
D) 500

Question 24

Glove anesthesia is an example of what disorder?

A) factitious disorder
B) conversion disorder
C) somatization disorder
D) histrionic personality disorder

Question 25

After witnessing a car accident that killed his wife, Dan says he cannot see. However, medical specialists found nothing wrong with the structure or function of his eyes, and brain scans reveal no evidence of any structural damage to the brain. After holding a case conference, a team of professionals suggests that Dan should be evaluated for the possible diagnosis of

A) hypochondriasis.
B) conversion disorder.
C) somatization disorder.
D) psychophysiological disorder.

Question 26

La belle indifference, a nonchalant attitude that communicates little concern about seemingly serious symptoms, tends to occur with which disorder?

A) hypochondriasis
B) conversion disorder
C) somatization disorder
D) Munchausen syndrome

Question 27

A psychologist has just finished analyzing a client who is believed to have a conversion disorder. The psychologist asks the family to meet with him as part of the process of planning treatment. The psychologist is especially concerned about what he calls secondary gain. When one of the family members asks for an explanation, what will the psychologist say?

A) "Clients with this disorder tend to develop a second disorder after the first is treated. "
B) "The client is attempting to control the family's interaction patterns by producing the symptoms."
C) "The family's attention and affection can actually have the effect of reinforcing the symptoms."
D) "The symptoms exhibited by the client are actually related to a second and previously undiagnosed disorder."

Question 28

Paul has been under a lot of stress at work. One morning he wakes up and finds himself blind. Although his physician can find nothing physically wrong, Paul is not faking. Which disorder is most consistent with Paul's symptoms?

A) hypochondriasis
B) conversion disorder
C) somatization disorder
D) Munchausen syndrome

Question 29

What is the origin of the concept of conversion disorder?

A) Its roots are in psychotic disorders such as schizophrenia.
B) Ancient philosophers developed the concept to show how mind and body were separate.
C) The origin is traced the category of hysteria, which was thought to be a disorder of the uterus.
D) Ancient physicians used the concept to describe disorders that began with one set of symptoms and evolved into a different set of symptoms.

Question 30

Robert is unable to hear. A thorough physical examination reveals no medical findings that could account for this reported inability to hear. Which of the following diagnoses is a clinician likely to consider at this point?

A) hypochondriasis
B) depersonalization
C) conversion disorder
D) psychophysiological disorder

Question 31

Jessica constantly complains of a large number of physical complaints that do not center around one particular ailment. After finding no medical explanation for her symptoms, a physician suspects she sufferers from conversion disorder. If Jessica lived several hundred years ago, what diagnosis would be made?

A) hysteria
B) depersonalization
C) dementia praecox
D) manic-depressive psychosis

Question 32

How long must a person have the persistent belief that he or she has a serious illness despite medical reassurance in order to meet the criteria for hypochondriasis?

A) two months
B) six months
C) one year
D) two years

Question 33

Tammy is convinced that a pain in her leg is the first sign of bone cancer. During a physical examination, her family physician finds no evidence of cancer. To be sure the physician orders X-rays that confirm the original findings. Nevertheless, Tammy sought the opinions of other physicians who agreed
that there was no evidence of cancer. Tammy's behavior is most consistent
with which disorder?

A) bipolar disorder
B) hypochondriasis
C) dissociative fugue
D) conversion disorder

Question 34

Omar's statement that "I immediately get upset if something is wrong with me", and he drives to the doctor's office is associated with:

A) hypocondriasis
B) somatization disorder
C) conversion disorder
D) malingering

Question 35

Someone with body dysmorphic disorder is likely to be concerned about

A) cancer.
B) vague pains.
C) excessive facial hair.
D) sudden loss of sight.

Question 36

Which of the following individuals exhibits behavior that is consistent with the diagnosis of body dysmorphic disorder?

A) Al who believes his intestines have turned to dust
B) Linda who reports difficulty with her sense of vision
C) Iris who thinks her eyebrows are too large for her face
D) George who thinks his dental fillings can receive radio waves

Question 37

Which of the following would not be especially helpful in treating hypocondriasis?

A) cognitive-behavior therapy
B) support therapy
C) existential therapy
D) reassurance

Question 38

Alice believes that she has excessive facial hair and wrinkles on her face, despite the fact that no one sees these "defects." After thinking about this for months, she finally decides to see a mental health professional. What is likely to happen in the first few sessions?

A) She will seek reassurance that she is not psychotic.
B) Alice will talk about her depression and not mention her bodily preoccupation.
C) Alice will complain that other people will not "level" with her about her "true" appearance.
D) She will insist that the therapist keep the lights down so her features will not be noticed during the sessions.

Question 39

Which part of the body is the usual focus of preoccupation in body dysmorphic disorder?

A) head
B) hands
C) feet
D) genitals

Question 40

What is the primary basis for distinguishing between malingering and factitious disorder?

A) symptom severity
B) goal of the behavior
C) specific disease chosen
D) presence of actual physical damage

Question 41

Amy has been diagnosed with factitious disorder; Sally has been diagnosed with somatization disorder. What is the major difference between these two individuals?

A) Amy is seeking attention from medical personnel; Sally really believes she is ill.
B) Amy is more likely to have experienced child abuse; Sally is more likely to have brain damage.
C) Amy is capable of altering her bodily functions at will; Sally feels that she no control over her bodily functions.
D) Amy is actually suffering from delusions; Sally probably has a genetically caused disorder.

Question 42

At the local hospital a patient with a long and complicated case was observed putting some of his own blood into his urine sample. At the staff conference, there is a great deal of discussion concerning this case, and much of the discussion revolves around two likely diagnoses. When the group
leader summarizes the discussion, which two diagnoses will be under active consideration?

A) factitious and malingering
B) bipolar disorder and schizophrenia
C) depersonalization and Munchausen
D) hypochondriasis and somatization disorder

Question 43

Amber craves attention and has a high need to be cared for. Amber has ______. Annette seeks SSI disability and seeks medical care and hospitalization. Annette's diagnosis is _____________.

A) malingering; somatization disorder
B) facticious disorder; malingering
C) malingerling; facticious disorder
D) malingering; hypocondriasis

Question 44

Ann often goes to the Emergency Room describing a number of bizarre symptoms. Sometimes she actually makes herself sick so she can be seen by a physician. Her behavior appears to be solely for the purpose of getting the attention of health care providers. What diagnosis is she likely to receive?

A) hypochondriasis
B) conversion disorder
C) somatization disorder
D) Munchausen syndrome

Question 45

What term is used for repeated, conscious simulation of disease for the sole purpose of assuming the role of a patient?

A) malingering
B) dissociation
C) hypochondriasis
D) Munchausen syndrome

Question 46

Munchausen syndrome derives its name from Baron Von Munchausen. What characteristic of this man was a reason for using his name for this disorder?

A) He told elaborate lies.
B) He frequently drank to excess.
C) He would create physical symptoms to avoid having to fight.
D) He was capable altering his heart rate by simply willing that it occur.

Question 47

A patient at the local hospital was discovered exhibiting Munchausen syndrome. When the hospital staff collects the patient's records over the last 5 years, what are they likely to discover?

A) a history of felony arrests
B) prior, unnecessary surgeries
C) a past history of childhood abuse
D) a difficult birth resulting in brain damage

Question 48

You are given an assignment to search the web for a case of factitious disorder by proxy. Which of the following cases is likely to fit this description?

A) a husband and wife mimic each other's symptoms in order to confuse a therapist
B) a mother causes physical symptoms in her child for the purpose of seeking treatment
C) the more time they spend in group therapy, the more clients tend to exhibit each other's symptoms
D) a client reports the symptoms that he sees exhibited on television shows because he "lives through the lives of others"

Question 49

Martin is wanted by the police as a suspected bank robber. In order to avoid legal charges, he goes to an Emergency Room and says he cannot remember who he is or anything about his life. Martin may have amnesia, but clinicians will also have to rule out

A) malingering.
B) factitious disorder.
C) conversion disorder.
D) somatization disorder.

Question 50

When a mother produces symptoms of diseases in her child and presents the child for treatment, this is called:

A) malingering by proxy
B) facticious disorder
C) malingering
D) facticious disorder by proxy

Question 51

What are some of the major coping strategies people use to deal with pain?

Question 52

What are some reasons that people tend to engage in somatization?

Question 53

What are the three major characteristics found in hypochondriacal patients and what are the consequences of the characteristics?

Question 54

What are the key points to keep in mind when trying to distinguish factitious disorder from malingering?

Question 55

When considering disorders of bodily preoccupation, if the clinician finds no organic disease this does not mean the client's suffering is not real.

Question 56

Participation in regular activities is an important consideration in recovery from pain disorder.

Question 57

A biopsychological model is the approved and accepted approach in examining pain other than in the context of examining physical etiology of pain.

Question 58

A barrier to pain treatment is finding objective indicators.

Question 59

Since pain disorders are a biobehavioral phenomena, the focus of attention should be on how the patient is responding to physical trauma and the social environment.

Question 60

Several somatic complaints that are recurrent and/or chronic describe somatization disorders.

Question 61

A conversion disorder is a disturbance that does not appear to be under the client's voluntary control.

Question 62

The term "hypochondriac" is associated with a conversion disorder.

Question 63

Cognitive-behavioral therapy is a promising approach for treating body dysmorphic disorder.

Question 64

Factitious disorders are more common in men than women.