Deck 5: Somatic Symptom and Related Disorders and Dissociative Disorders

Question 1

All of the following have been implicated in the development and maintenance of somatic symptom disorders EXCEPT

A)the additional attention one receives when sick.
B)a specific hypochondriac gene.
C)the high incidence of disease in the family during the hypochondriac's childhood.
D)stressful life events.

Answer 1

a specific hypochondriac gene.

Question 2

Which of the following statements is true with regard to the treatment of somatic symptom disorders?

A)Cognitive-behavioral treatment has been demonstrated in several studies to be a very effective treatment.
B)It is relatively easy to treat as long as the patient is willing to participate in therapy.
C)Primary care physicians can usually treat patients by educating and reassuring patients.
D)They are difficult to treat and there are no treatments with proven effectiveness.

Answer 2

Cognitive-behavioral treatment has been demonstrated in several studies to be a very effective treatment.

Question 3

With regard to the treatment of illness anxiety disorder, some research supports the use of

A)classical conditioning and operant conditioning.
B)psychoanalysis.
C)cognitive-behavioral treatment and stress management.
D)humanistic therapy.

Answer 3

cognitive-behavioral treatment and stress management.

Question 4

Illness anxiety disorder is also known as (and previously listed in the DSM as)

A)hypochondriasis.
B)illness psychosis.
C)fictitious disorder.
D)dissociation.

Question 5

Since Jane suffers from illness anxiety disorder, we can expect her to see her physician

A)often and feel completely reassured that there is nothing wrong with her health.
B)rarely but continue to believe that she is quite ill.
C)almost never because she does not trust physicians.
D)often but continue to be anxious about her health anyway.

Question 6

With regard to a diagnosis of illness anxiety disorder, women are

A)as equally likely as men to be diagnosed.
B)less likely than men to be diagnosed.
C)more likely than men to be diagnosed.
D)more likely than men to be diagnosed during middle to late adulthood, but no more likely than men to be diagnosed during teen years and early adulthood.

Question 7

Which of the following are typical characteristics of patients with illness anxiety disorder?

A)Female and from lower socioeconomic groups
B)Female and sexually conservative
C)Male and impulsive
D)Male and aggressive

Question 8

Joe just ate six chilidogs and drank a liter of soda. If Joe suffers from illness anxiety disorder, he would probably interpret any resulting stomach discomfort as

A)his own fault for eating so much.
B)the result of poor quality food.
C)gas pains from overeating.
D)a sign that something is seriously wrong with his stomach.

Question 9

Concerning one recent study of selective serotonin reuptake inhibitor treatments for illness anxiety disorder, the most accurate statement among the following is that

A)they are effective.
B)they are not effective.
C)they appear to be effective, as does CBT, but only CBT was significantly different from a placebo condition.
D)neither the drug treatment nor CBT was found to be significantly more effective than a placebo condition.

Question 10

Shelley experiences persistent feelings of detachment from herself, as if she were observing herself from outside her body. The experience is so intense that she often has trouble remembering who she is and functioning in a coherent manner. Shelley most likely suffers from

A)severe anxiety attacks.
B)a dissociative disorder.
C)persistent depression.
D)illness anxiety disorder.

Question 11

Somatic symptom disorder and illness anxiety disorder have all of the following in common EXCEPT

A)they are both outdated terms that are no longer officially part of the DSM.
B)they are both associated with frequent visits to the doctor.
C)disease conviction is a core feature of both disorders.
D)for both, the essential problem is anxiety.

Question 12

Kyop goeu, or __________________, is an example of a culture-bound somatic concern found in the Khmer people of Cambodia.

A)a feeling of "wind overload"
B)fear losing semen
C)fear of genital retraction
D)a sensation of something crawling in the head

Question 13

Jill is constantly worried that she will get sick. Although she feels fine now and believes that she is healthy, she still worries endlessly about developing a serious illness. Most likely Jill would be diagnosed with

A)generalized anxiety disorder.
B)illness anxiety disorder.
C)a specific phobia of germs.
D)body dysmorphic disorder.

Question 14

The common aspect of all somatic symptom disorders is a set of

A)irrational beliefs about supernatural influences on one's health.
B)irrational judgments of one's own physical attractiveness.
C)excessive or maladaptive responses to physical symptoms or to associated health concerns.
D)excessive or maladaptive responses to pain only.

Question 15

Illness anxiety disorder is present when

A)normal bodily sensations are interpreted by the patient as a sign of a serious illness.
B)real physical illness is exaggerated to the point where the patient can only focus on the pain.
C)the patient has an unrealistic fear of contacting germs.
D)the patient is truly ill but does not trust the medical establishment enough to seek treatment.

Question 16

A main difference between somatic symptom disorder and illness anxiety disorder is

A)somatic symptom disorder has a real medical basis and illness anxiety disorder does not.
B)somatic symptom disorder is heritable and illness anxiety is not.
C)somatic symptom disorder is associated with physical exacerbation of real symptoms, whereas illness anxiety disorder is associated with distorted beliefs about normal bodily function.
D)none; the two terms refer to the same disorder in DSM-5.

Question 17

Psychological factors affecting other medical conditions is considered

A)a somatic symptom disorder.
B)the cause for conversion disorder.
C)the result of conversion disorder.
D)an archaic term for illness anxiety.

Question 18

Which the following is classified as a somatic symptom or related disorder?

A)Obsessive-compulsive disorder
B)Illness anxiety disorder
C)Dissociative identity disorder
D)Body dysmorphic disorder

Question 19

The cause for somatic symptom and related disorders is most likely

A)biological.
B)psychological.
C)stressful life events.
D)all of these are correct.

Question 20

Which of the following is NOT a part of cognitive-behavioral therapy for illness anxiety disorder in Barsky and Ahern's 2005 clinical trial?

A)Reassurance to the patients that their symptoms did not reflect a serious illness
B)Identifying and challenging illness-related misinterpretations of physical sensations
C)Purposely "creating" symptoms by focusing attention on certain body areas
D)Coaching on seeking less reassurance regarding patients' illness concerns

Question 21

Historically, "hysteria" was thought to be the result of a

A)dysfunctional ovary.
B)tense vagina.
C)wandering uterus.
D)flip-flopped fallopian tubes.

Question 22

Globus hystericus, a common conversion disorder symptom, is the sensation of a

A)pain in the neck.
B)swollen kidney.
C)lump in the throat.
D)lump in the breast.

Question 23

Which of the following would be typical for a patient suffering from a conversion disorder?

A)Ability to avoid walking into things even though the patient reports being unable to see anything
B)Ability to see some bright objects when calm but suffering complete loss of sight during a stressful period or emergency
C)Performance far below average when asked to name objects in the visual field when the patient reports blindness
D)Ability to name everything in the visual field even though the patient reports blindness

Question 24

According to your textbook, in some religious groups, seizures, paralysis, and trances are often seen as evidence of

A)an increased power to cause natural disasters.
B)contact with a loved one who has passed away.
C)contact with God.
D)none of these are correct

Question 25

Conversion disorder patients were conceptualized by Freud as

A)converting unconscious conflicts into physical symptoms.
B)converting unconscious conflicts into defense mechanisms.
C)experiencing physical symptoms as a result of the superego.
D)experiencing internal conflicts as a result of physical illness.

Question 26

Which of the following statements is true about factitious disorders?

A)Patients are usually revealed to be harboring a reason for malingering
B)The symptoms are uncontrollable.
C)There is no obvious reason for voluntarily producing symptoms.
D)All of these are correct

Question 27

Loss of physical functioning without any physical cause is most likely a case of

A)conversion disorder.
B)illness anxiety disorder.
C)somatic symptom disorder.
D)none of these are correct.

Question 28

Min has been experiencing repeated seizures, but none of the neurologists he has visited could find any abnormal EEG activity. He is likely exhibiting a case of

A)psychogenic nonepileptic seizures.
B)globus hystericus.
C)aphonia.
D)dissociative disorder.

Question 29

Conversion disorder symptoms generally appear

A)out of the blue.
B)following a physical injury to the affected area.
C)following a traumatic event.
D)in women with repressed sexuality.

Question 30

The modern view of the causes of conversion disorder is

A)completely different from Freud's ideas of the etiology of this disorder.
B)somewhat similar to the causes that Freud described for this disorder.
C)a combination of genetic predisposition and neurobiological trauma.
D)based on social learning theory.

Question 31

Parents suspected of facetious disorder imposed on another (Munchausen syndrome by proxy) show all of the following typical behaviors EXCEPT

A)helping medical staff to discover the true nature of the child's illness.
B)developing a positive relationship with medical staff.
C)appearing extremely concerned and caring toward the child.
D)purposefully making the child sick.

Question 32

Which of the following is NOT an accurate statement regarding conversion disorder symptoms?

A)They uniquely belong to Western culture.
B)They are common aspects of some religious/healing rituals.
C)They do not constitute a disorder unless they persist and interfere with an individual's functioning.
D)Some individuals who exhibit them are held in high esteem because they are sometimes seen as contact with God.

Question 33

"Functional neurological symptom disorder" is associated with which disorder in the DSM-5?

A)Conversion disorder
B)Illness anxiety disorder
C)Somatic symptom disorder
D)None of these are correct

Question 34

In factitious disorders, the patient

A)voluntarily makes up symptoms with no apparent motivation.
B)is unaware that he or she is making up symptoms.
C)truly experiences symptoms with no apparent physical cause.
D)makes up symptoms in an effort to avoid work or to receive some other benefit.

Question 35

An example of factitious disorder imposed on another is

A)deliberate actions directed toward making a child sick.
B)a parent lying to a doctor, for example, saying that the child has had symptoms that never really existed.
C)a parent developing the same symptoms that the child exhibits.
D)convincing a child to lie to a doctor about factitious symptoms.

Question 36

Serena has completely lost the use of her right arm during the past year, but medical experts can find no physical reason for her paralysis. This could be an example of

A)somatic symptoms disorder.
B)illness anxiety
C)conversion disorder.
D)dissociative disorder.

Question 37

Factitious disorders are a set of conditions that

A)fall somewhere between malingering and conversion disorders.
B)are completely under voluntary control like malingering.
C)are a manifestation of physical symptoms mostly due to anxiety.
D)are one form of typical child abuse.

Question 38

With regard to "la belle indifference" (the observation that conversion disorder patients are not concerned about their symptoms), research suggests that

A)conversion disorder patients display uncommonly high levels of concerns about their physical loss.
B)Freud's explanation is essentially correct.
C)conversion disorder patients show no difference in the distress over symptoms than those with organic disease.
D)"la belle indifference" is an accurate description of the lack of concern about their physical loss in conversion disorder patients.

Question 39

Difficulty speaking without any physical or organic pathology is known as

A)hysteria.
B)malingering.
C)aphonia.
D)la belle indifference.

Question 40

Which of the following statements is correct regarding diagnosing a patient's symptoms as a conversion disorder?

A)It is quite apparent when a patient is malingering (faking), but it is difficult to determine whether symptoms are due to real physical disorders or a conversion disorder.
B)It is quite apparent when a symptom is due to a real physical disorder, but it is impossible to determine the difference between a conversion disorder and patient malingering (faking).
C)It is very difficult to determine whether symptoms are due to malingering (faking), real physical disorders, or a conversion disorder.
D)The act of diagnosing a conversion disorder can sometimes immediately alleviate the symptoms.

Question 41

While Alice is under hypnosis, she expresses strong emotions about being in a car accident that caused the death of her oldest son. When not under hypnosis, she expresses no emotion about the death of her oldest son when talking about the accident. This absence of emotion when not under hypnosis is characteristic of

A)general amnesia.
B)selective amnesia.
C)depersonalization.
D)derealization.

Question 42

Derealization is defined as

A)vivid hallucinations.
B)altered perception involving loss of the sense of one's own reality.
C)altered perception involving loss of the sense of reality of the external world.
D)the feeling that one is no longer a person.

Question 43

Many people experience feelings of unreality during an intense panic attack. People undergoing intense stress or experiencing a traumatic event may also experience these symptoms, which characterize the newly defined

A)acute stress disorder.
B)facetious disorder imposed on another.
C)dissociative amnesia.
D)conversion disorder.

Question 44

Your textbook authors describe a treatment plan for conversion disorder involving

A)in-depth exploration of psychological conflicts.
B)regression to the early psychosexual stages of development.
C)application of a strict behavioral program that includes reinforcement for each display of progress and punishment when necessary.
D)removal of any reinforcing or supportive consequences that patients receive for limitations imposed by the disorder.

Question 45

People who do not remember anything, including who they are, are said to suffer from

A)dissociative fugue.
B)poor memory retrieval.
C)general amnesia.
D)dissociative identity disorder.

Question 46

In healthy, well-adjusted individuals, dissociation typically occurs following

A)calm, reflective periods.
B)participation in a group activity.
C)reading or any activity that requires great concentration.
D)stress or a traumatic event.

Question 47

Freud called the reduction in anxiety by converting unconscious conflicts into physical symptoms

A)primary narcissism.
B)secondary narcissism.
C)primary gain.
D)secondary gain.

Question 48

Depersonalization is defined as

A)altered perception including loss of the sense of one's own reality.
B)altered perception involving loss of the sense of reality of the external world.
C)vivid hallucinations.
D)the feeling that one is no longer a person.

Question 49

Brain imaging studies have found that depersonalization is associated with all of the following EXCEPT

A)deficits in perception.
B)deficits in emotion regulation.
C)dysregulation in the HPA axis.
D)dysregulation of the visual cortices.

Question 50

While walking home from work, Jordan suddenly looks around and, for a moment, can't remember where he is, how he arrived at this point on the road, or even why he is walking. Jordan is experiencing

A)derealization.
B)depersonalization.
C)the early stages of what will eventually become a severe psychotic disorder.
D)symptoms of a mood disorder.

Question 51

Anxiety, mood, and personality disorders are commonly found in individuals with

A)depersonalization-derealization disorder.
B)dissociative amnesia.
C)somatic symptom disorder.
D)conversion disorder.

Question 52

In treating conversion disorder, which of the following statements is true?

A)Clients respond well to CBT.
B)Clients respond well to hypnosis.
C)Clients respond well when hypnosis and CBT are combined.
D)Clients do not respond well to any treatment.

Question 53

Jason suddenly notices that the world looks weird to him. Some objects look bigger than normal and others look smaller. Cars passing by seem oddly shaped, and people appear dead or mechanical. Joe is experiencing

A)derealization.
B)depersonalization.
C)classic early psychosis symptoms.
D)mania.

Question 54

The diagnosis of derealization-depersonalization disorder is

A)often co-occurring with other disorders.
B)quite rare and only applicable to those diagnosed with psychosis.
C)fairly common, since many people experience derealization and depersonalization.
D)fairly common and applied to anyone who is frightened by an experience of derealization or depersonalization.

Question 55

Dissociation is likely to happen

A)after an extremely stressful or a traumatic event.
B)when there is potential secondary gain.
C)when there is primary gain.
D)when a patient is malingering.

Question 56

In dissociative fugue, the term fugue relates to

A)confusion.
B)flight or travel.
C)loss of consciousness.
D)hallucination.

Question 57

According to your textbook, which of the following statement is true about the treatment of conversion disorder?

A)The principle treatment strategy for conversion disorder is to identify and attend to the traumatic or stressful life event.
B)The use of medication is generally supported in the treatment of conversion disorder.
C)Social support and attention are the most effective method of treatment for conversion disorder.
D)In treating conversion disorder, Freudian methods to access the unconscious are the most effective.

Question 58

In dissociative amnesia, the individual typically has no memory of

A)any events.
B)events prior to a trauma.
C)selective events or emotional tone attached to them, particularly those involving trauma.
D)events following a trauma.

Question 59

Evidence for the influence of social and cultural factors in conversion disorder includes the fact that conversion disorder

A)is almost exclusively experienced by women.
B)is being diagnosed more frequently in our society.
C)tends to occur in lower socioeconomic groups where there is less medical knowledge.
D)tends to occur in wealthy areas where there is easy access to sophisticated medical tests.

Question 60

The experience of dissociation occurs in

A)psychotic disorders only.
B)individuals with dissociative disorders only.
C)only in those individuals who have experienced great personal trauma.
D)certain psychological disorders but also in nondisordered people at times.

Question 61

African Americans from the South often refer colloquially to trance syndromes as

A)"phii pob."
B)"autohypnosis."
C)"frenzy witchcraft."
D)"falling out."

Question 62

________ is a dissociative disorder that is not found in Western cultures and appears to have some similarities to dissociative fugue.

A)Amok
B)Exorcism
C)Trance
D)Voodoo

Question 63

The causes of dissociative identity disorder appear to be

A)physical abuse.
B)sexual abuse.
C)witness to a traumatic event.
D)all of these are correct

Question 64

In dissociative identity disorder, the "host" personality usually

A)is of a gender opposite to that of the individual.
B)becomes overwhelmed trying to hold all of the personality fragments together.
C)is the "leader" of the multiple identities.
D)is well aware of each personality and everything that happens while each personality is active.

Question 65

Individuals with dissociative identity disorder generally

A)take on only one other distinct personality.
B)suffer a loss of their own identity that lasts several years.
C)maintain complete awareness of all of their personalities.
D)have several distinct personalities.

Question 66

During a dissociative fugue state, it is not uncommon for individuals to

A)commit suicide.
B)see the world as a strange and foreign place.
C)take on a new identity.
D)involuntarily contact friends and family.

Question 67

The defining feature of dissociative identity disorder is that aspects of the individual's personality are

A)fixated.
B)completely suppressed.
C)dissociated.
D)dissociative disorders.

Question 68

Many dissociative identity disorder patients have at least one ________________ alter who handles sexuality and generates income, sometimes by acting as a prostitute.

A)street savvy
B)impulsive
C)criminal
D)sexually aggressive

Question 69

During a fugue state, patients diagnosed with dissociative fugue

A)travel and typically experience memory loss during their trip.
B)travel involuntarily but do not experience memory loss.
C)temporarily lose memory of who they are but are able to recover their sense of identity after the fugue state.
D)permanently lose memory of who they are and seldom recover any sense of their own identity.

Question 70

The existence of a cross-gendered alter in dissociative identity disorder is

A)common.
B)rare.
C)present in every patient.
D)almost never seen in this disorder.

Question 71

Some theorists suggest that dissociative identity disorder is an extreme subtype of

A)dissociative amnesia.
B)obsessive-compulsive disorder.
C)posttraumatic stress disorder.
D)antisocial personality disorder.

Question 72

In non-Western cultures, trance and possession are

A)extremely rare.
B)never considered a disorder.
C)the most common forms of dissociative disorders.
D)the rarest forms of dissociative disorders.

Question 73

One aspect of the DSM-5 criteria for diagnosis of dissociative identity disorder is

A)patient awareness of the distinct personalities.
B)existence of three or more personality fragments.
C)amnesia.
D)history of abuse.

Question 74

With regard to dissociative identity disorder, the term alter refers to ________ within the individual.

A)the "host" personality
B)a dangerous personality
C)the most recent personality to emerge
D)a different personality

Question 75

Dissociative trances commonly occur in Nigeria where they are called

A)amok.
B)phi pob.
C)vinvusa.
D)pivloktoq.

Question 76

Fugue states usually end rather

A)abruptly with recall of most of what happened.
B)slowly over a long period of lingering in and out of a state of fugue.
C)abruptly with no memory of what happened.
D)slowly with no memory of what happened.

Question 77

A switch

A)usually occurs instantaneously.
B)is the transition from one personality to another in dissociative identity disorder.
C)may exhibit physical transformations.
D)all of these are correct

Question 78

Which of the following statements is FALSE about dissociative identity disorder?

A)Once established, the disorder lasts a lifetime without treatment.
B)For prevalence rates, the ratio of females to males is approximately 9 to 1.
C)The frequency of switching increases with age.
D)The form that the disorder takes does not differ substantially over the lifespan.

Question 79

In dissociative identity disorder, the "host" personality is usually the one that

A)is the most aggressive of the personalities.
B)asks for treatment and becomes the patient.
C)earns income for the individual.
D)is sexually provocative.

Question 80

Vanessa, who is 40, apparently believes that she is a 20-year-old woman. Suddenly, however, she starts to speak and behave very differently, and says she no longer thinks of herself as "Vanessa." Instead, she claims to be Elise, a 10-year-old child. It is likely that Vanessa has just experienced a

A)switch.
B)dissociative fugue.
C)conversion reaction.
D)manic episode.