Deck 8: Somatic Symptom and Dissociative Disorders

Question 1

All of the following were diagnosed as somatic symptom disorders in the DSM-IV except ________

A) hypochondriasis
B) somatization disorder
C) pain disorder
D) fugue disorder

Answer 1

fugue disorder

Question 2

Dan's various medical complaints and hospital stays finally led him to see a psychiatrist. After a thorough medical and psychological evaluation, the 28-year-old teacher and father of two was diagnosed with both depression and somatic symptom disorder. What is atypical about this case summary?

A) Such diagnoses are usually made in adolescence.
B) Somatic symptom disorder is seen much more commonly in women.
C) Somatization disorder and depression are rarely comorbid disorders.
D) It is rare for an individual with somatization disorder to marry and have children.

Answer 2

Somatic symptom disorder is seen much more commonly in women.

Question 3

John and Ira eat dinner together after work. Several hours later, each starts to feel nausea and stomach pains. John has a somatic symptom disorder, Ira does not. Most likely ________

A) both men will think that the food they ate made them sick.
B) John will think that he has stomach cancer and Ira will think the food he ate made him sick.
C) John will think the food he ate made him sick and Ira will not think anything at all.
D) Ira will think he has stomach cancer and John will think the food he ate made him sick.

Answer 3

John will think that he has stomach cancer and Ira will think the food he ate made him sick.

Question 4

Ryan has diabetes but has no trouble functioning. One day, his wife informs him that she is leaving him. Ryan suddenly develops terrible pain in his back, to the point he is unable to get out of bed. His wife agrees to stay for "a while" to take care of him. Ryan probably has ________

A) somatization disorder.
B) somatic symptom disorder .
C) pain disorder associated with both psychological factors and a general medical condition.
D) body dysmorphic disorder.

Question 5

Evan is terrified because he is convinced that he has a terminal heart condition. He has consulted with several physicians who have found no evidence of any heart disease. Evan continues to feel terrified even when the doctors find no physical problem. His diagnosis is probably ________

A) somatization disorder.
B) pain disorder.
C) somatic symptom disorder.
D) malingering.

Question 6

The most effective treatment to date for somatic symptom disorder ________

A) increases psychological distress.
B) results in only temporary changes in psychological symptoms.
C) decreases healthcare expenditures.
D) has not been shown to effect physical functioning.

Question 7

According to the revisions made for DSM-5, most people previously diagnosed with __________ will be diagnosed with somatic symptom disorder.

A) hypochondriasis
B) factitious disorder
C) somatization disorder
D) body dysmorphic disorder

Question 8

Which of the following is in the DSM-5?

A) Hypochondriasis
B) Somatization disorder
C) Pain disorder
D) Somatic symptom disorder

Question 9

Dysfunctional assumptions about symptoms and diseases are a component of a cognitive-behavioral explanation of ________

A) somatic symptom disorder.
B) dissociative fugue.
C) somatization disorder.
D) depersonalization disorder.

Question 10

Consciously faking symptoms is characteristic of ________

A) malingering.
B) hypochondriasis.
C) somatization disorder.
D) somatic symptom disorder.

Question 11

Which of the following statements would be an example of those thoughts associated with a person suffering from somatic symptom disorder?

A) A sore throat is nothing to worry about unless there is a temperature along with it, then it is a big problem.
B) A sore throat is serious and requires a trip to the doctor. If the doctor tests and finds nothing, it is okay.
C) A sore throat is a major problem. It could be cancer or some other deadly disease no matter what the doctor says.
D) A sore throat could be a serious sign of cancer, but it would be important to wait until the doctor says one way or the other before panicking.

Question 12

Response prevention has been used in the treatment of ________

A) dissociative identity disorder.
B) factitious disorder.
C) malingering.
D) somatic symptom disorder.

Question 13

Individuals with somatic symptom disorders ________

A) intentionally fake their illnesses in order to obtain some special treatment.
B) generally have a physical cause for their illness.
C) believe that their symptoms are real and serious.
D) usually have little concern over their state of health.

Question 14

Somatization disorder, as defined in DSM-5, ________

A) has been subsumed into somatic symptom disorder
B) involves multiple symptoms involving one body part or function.
C) involves the fear of having multiple different diseases.
D) involves having pain in at least four different areas of the body.

Question 15

Conditions involving physical complaints or disabilities occurring in the absence of any physical pathology that could account for them are ________

A) hypochondriacal disorders.
B) anxiety disorders.
C) dissociative disorders.
D) somatic symptom disorders.

Question 16

Catastrophizing about minor bodily sensations is characteristic of individuals with ________

A) somatic symptom disorder.
B) hypochondriasis and conversion disorder.
C) dissociative fugue and somatization disorder.
D) dissociative fugue and conversion disorder.

Question 17

Somatization disorder and hypochondriasis are similar in DSM-5 in that ________

A) both involve patients thinking they have a physical disease.
B) both involve patients thinking that they can easily cope with their symptoms.
C) both disorders have been subsumed into somatic symptom disorder
D) both involve patients reacting to physical symptoms by becoming more physically active.

Question 18

Sara notices a lump on her side. She goes to her physician because she is worried that it is cancer. The physician sends her for a biopsy. During the three weeks between first noticing the lump and getting her results that it is not cancer, Sara was almost unable to function. She felt constant anxiety and thought constantly about having cancer. After she found out that she did not have cancer, Sara felt much better. Sara ________

A) has hypochondriasis.
B) has conversion disorder.
C) has somatization disorder.
D) has no mental disorder.

Question 19

If Ronald is typical of people with somatic symptom disorder, he may ________

A) avoid accepting a psychological explanation for his problems.
B) avoid visiting a physician.
C) have bizarre delusions about his body rotting out.
D) feel relieved when his doctor tells him he is healthy.

Question 20

Research on somatic symptom disorder has shown that people with the disorder tend to ________

A) ignore information about illness.
B) overestimate the dangerousness of diseases.
C) underestimate the dangerousness of diseases.
D) overestimate their ability to handle being ill.

Question 21

The most common kind of speech-related conversion reaction is ________

A) alexia
B) aphonia
C) apraxia
D) alogia

Question 22

What would be most helpful to a person with somatic symptom disorder?

A) Staying physically active despite the pain.
B) Restricting physical activity as much as possible.
C) Getting a great deal of sympathy and attention.
D) Being allowed to avoid unpleasant tasks while he or she is in pain.

Question 23

Which of the following was once viewed as form of "hysteria"?

A) Conversion disorder
B) Dissociative identity disorder
C) Dissociative fugue
D) Hypochondriasis

Question 24

Which of the following best explains why conversion disorder is a less common diagnosis today than it was historically?

A) Advances in the psychiatric profession have decreased the prevalence of all disorders linked to traumatic events.
B) Those once diagnosed with conversion disorder are now more likely to be diagnosed with PTSD.
C) Today's psychiatrists tend to view this diagnosis as one that lacks reliability and validity, thus they are hesitant to even consider it as a diagnostic option.
D) Advances in the medical field have made patients more sophisticated about medical and psychological disorders.

Question 25

Alan fell off a ladder at work and claims his back is in intense pain, even though medical tests find nothing wrong. He does not like to talk about it and keeps quiet other than his report to his attorney. Caleb fell off a ladder at work and claims he hurt his back, too, even though medical tests find nothing wrong. He talks about it all of the time in great detail. Which diagnosis would seem to fit each man?

A) Malingering in Alan and conversion disorder in Caleb
B) Malingering in Alan, factitious disorder in Caleb
C) Factitious disorder in Alan, malingering in Caleb
D) Conversion disorder in Alan, malingering in Caleb

Question 26

Which of the following disorders was once the most frequently diagnosed disorder among soldiers in World War I?

A) Acute anxiety disorder
B) Conversion disorder
C) Dissociative identity disorder
D) Hypochondriasis

Question 27

Munchausen's syndrome by proxy is a variant of which of the following disorders?

A) Conversion disorder
B) Body dysmorphic disorder
C) Hypochondriasis
D) Factitious disorder

Question 28

How is a conversion seizure different from an epileptic seizure?

A) A conversion seizure does not resemble an epileptic seizure on an EEG.
B) Patients show more confusion after a conversion seizure.
C) Patients have no loss of memory after an epileptic seizure.
D) Patients do not lose bowel or bladder control after an epileptic seizure.

Question 29

Which disorder would include intentionally taking drugs in order to stimulate various real illnesses?

A) Factitious disorder
B) Malingering
C) Dissociative identity disorder
D) Somatization disorder

Question 30

Earl falls at work. The initial medical tests showed no major physical problems. However, Earl calls the next day and tells his boss that he is unable to use his right leg because it is paralyzed. He also informs his boss that he plans to sue the company. Earl most likely ________

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

Question 31

In what way was Freud's view of conversion disorder consistent with learning theories?

A) Freud proposed that faulty thinking underlies the symptoms of conversion disorder.
B) He advocated treating conversion disorder by punishing the problem behaviors.
C) He believed that the symptoms of conversion disorder were maintained by the relief from anxiety they provided.
D) Freud believed that those with conversion disorder were suffering bodily symptoms due to a conflict between their inner desires and the demands placed on them by society (the environment).

Question 32

The diagnosis of somatic symptom disorder is ________ and contains no assumptions about _________.

A) descriptive, cause
B) definitive, treatment
C) superceded by a diagnosis of hypochondria, treatment
D) superceded by a diagnosis of malingering, consequences

Question 33

The current prevalence of conversion disorder is ________

A) decreasing as sophistication about disorders decreases.
B) increasing as sophistication about disorders increases.
C) decreasing as sophistication about disorders increases.
D) consistent with previous eras.

Question 34

Which of the following is characterized by a reluctance to discuss symptoms?

A) Conversion
B) Hypochondriasis
C) Somatic symptom
D) Malingering

Question 35

Which of the following is a way to distinguish between someone with conversion disorder and someone who is malingering?

A) People with conversion disorder are very willing to talk about their symptoms; malingerers will be more cautious.
B) People with conversion disorder will be very cautious about talking about their symptoms; malingerers are very willing to talk about them.
C) People with conversion disorder are usually very defensive; malingerers will try to seem very open and trusting.
D) If their symptoms are shown to be inconsistent, people with conversion disorder become very defensive while malingerers do not.

Question 36

A nurse in an emergency room sees many illnesses and reported illnesses. A group of psychology students are listening to her speak and one asks her what might be one way to tell the difference between a conversion disorder and a true organic disturbance. Which of the following would be a valid answer?

A) The patient will show some signs of an illness but not enough signs.
B) The patient will not be able to use muscles that are "damaged."
C) The patient shows no signs of atrophy in damaged areas.
D) The patient shows the signs of illness under hypnosis.

Question 37

Following the rejection of his latest novel, Jim 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 Jim's case of conversion disorder?

A) Jim had some ability to move his hand.
B) Jim is male, and most people with this disorder are women.
C) Jim's symptoms subsided after only two weeks.
D) Jim only lost the ability to move his right hand.

Question 38

A new disorder in DSM-5 is ________

A) conversion disorder.
B) hypochondriasis.
C) illness anxiety disorder.
D) somatization disorder.

Question 39

About 25 percent of people with illness anxiety disorder would have been diagnosed as having ________, according to the DSM-IV.

A) conversion disorder
B) hypochondriasis
C) illness anxiety disorder
D) somatization disorder

Question 40

A person with illness anxiety disorder has a preoccupation with ________

A) making other people sick.
B) having an anxiety attack.
C) having or acquiring a serious illness.
D) small objects that appear at night on the horizon.

Question 41

The DSM-5 recognizes how many types of pathological dissociation?

A) 1.
B) 2.
C) 3.
D) 8.

Question 42

Gerard became amnesic, wandered away from home and assumed a completely new identity as a shoe salesman. He suffers from ________

A) dissociative fugue.
B) dissociative identity disorder.
C) malingering identity disorder.
D) depersonalization.

Question 43

Assuming a new identity in a new place is characteristic of ________

A) depersonalization disorder.
B) all forms of dissociative amnesia.
C) dissociative fugue.
D) dissociative identity disorder.

Question 44

The inability to learn new information is known as ________

A) anterograde amnesia.
B) retrograde amnesia.
C) continuous amnesia.
D) generalized amnesia.

Question 45

Jill did not remember the accident happening or her graduation a couple of months before. What form of memory loss is this characteristic of?

A) Episodic
B) Semantic
C) Retrograde
D) Short term

Question 46

The disorder involving the experience of sudden loss of the sense of self is ________

A) depersonalization disorder.
B) psychogenic amnesia.
C) disidentity disorder.
D) derealization disorder.

Question 47

Dissociative identity disorder was formerly known as ________

A) psychogenic amnesia.
B) multiple personality disorder.
C) conversion hysteria.
D) neurasthenia.

Question 48

Once a dissociative fugue ends, people ________

A) can remember everything that has happened to them.
B) remember who they are but cannot remember their past.
C) can remember their past but cannot remember what happened during the fugue.
D) can remember their past but keep their new identity.

Question 49

Jeremy suffers from dissociative amnesia. He probably ________

A) remembers only events from the past and does not remember skills he learned more recently.
B) can perform only simple tasks, regardless of the complex work that he was able to do previously.
C) is able to recognize close friends and relatives but not acquaintances.
D) had trouble remembering information stored before a traumatic incident.

Question 50

In the study mentioned in the text, the German man who had dissociative fugue denied that he could speak German. However, he learned German-English word pairs much faster than control words. This supports that ________

A) mainly episodic memory is lost; implicit memory stays intact.
B) mainly implicit memory is lost; episodic memory stays intact.
C) both episodic and implicit memory are affected.
D) most people with dissociative fugue are faking.

Question 51

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?

A) Her response is not typical and suggests that she is suffering from acute stress disorder.
B) She experienced an instance of derealization.
C) She had a psychotic break.
D) She experienced an instance of depersonalization.

Question 52

In soap operas, characters often forget their past experience following some trauma. They don't merely forget the traumatic event, they forget who they are, where they came from-they lose almost all memory of their lives. They then move to a new place and start a new identity. This would best be described as an instance of ________

A) anterograde amnesia.
B) dissociative fugue.
C) continuous amnesia.
D) generalized amnesia.

Question 53

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?

A) Experiments using medication
B) Checking reports from doctors' offices
C) Testing personality traits of individuals who have experienced these issues
D) Use of different brain imaging methods to determine where loss of function occurs

Question 54

In the DSM-IV, depersonalization and derealization used to be treated as ________

A) two separate disorders.
B) both associated with psychogenic amnesia.
C) forms of malingering.
D) conversion disorders.

Question 55

Which of the following has been demonstrated about the effects of dissociative amnesias on memory?

A) Implicit memory is generally intact.
B) Explicit memory is rarely affected.
C) Episodic memory is not compromised.
D) Semantic memory is most dramatically affected.

Question 56

Which of the following is most suggestive of dissociative identity disorder?

A) Grace's feelings about James switched from positive to negative instantly.
B) Peter could not explain why he didn't complete the project.
C) Delilah was never able to make up her mind.
D) Kyla could not recall where she had been or what she had done all day.

Question 57

Although Charlie remembered most of the main issues of the meeting, he had no recollection of the decision to eliminate the department that he headed. Which disorder would be in effect?

A) Dissociative disorder
B) Conversion disorder
C) Factitious disorder
D) Somatic symptom disorder

Question 58

When a person experiences dissociative amnesia, one main type of memory is usually affected. Which?

A) Semantic memory (pertaining to language and concepts)
B) Procedural memory (how to do things)
C) Perceptual memory (the representation of things in images)
D) Episodic memory (the events we have experienced)

Question 59

Dissociation ________

A) only occurs in people with a dissociative disorder.
B) is a sign that something is seriously wrong.
C) is extremely common and not necessarily pathological.
D) is extremely rare and not necessarily pathological.

Question 60

What do somatic symptom disorder and the dissociative disorders have in common?

A) Both are characterized by physical complaints.
B) Both are more common in men.
C) Both appear to be ways of avoiding anxiety.
D) Both have onset during early childhood.

Question 61

An in-depth study by Lewis and colleagues of 12 convicted murderers diagnosed with dissociative identity disorder looked into their backgrounds. The study found strong evidence that each was severely abused, both physically and sexually. Why does the text refer to this study as "flawed."

A) Malingerers were studied separately from the larger group of DID sufferers.
B) Malingerers were excluded from the study.
C) There was no control group of murderers without DID.
D) There was no control group of DID sufferers who were not murderers.

Question 62

According to sociocognitive theory, ________

A) the mind separates due to some traumatic experience and is never fully integrated, resulting in the multiple identities observed in DID.
B) the alters in DID develop as a means of escaping from some form of trauma.
C) DID has a factitious origin.
D) DID may develop when a suggestive patient is treated by an overzealous clinician.

Question 63

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?

A) It is unusual for a person with DID to have seventeen alters.
B) It is unusual for a person with DID to have alters that are very different from the host personality.
C) It is unusual for a person with DID to have fragmentary alters.
D) No aspect of this case is unusual.

Question 64

Which of the following statements is most typical of individuals with DID?

A) Periods of "lost time."
B) Socially inept as a child.
C) Aware of separate personalities prior to beginning treatment.
D) Tends to express emotional distress in complaints about her body.

Question 65

In an individual with DID, "switches" between identities ________

A) usually take several days.
B) produce gaps in memory.
C) occur symmetrically, such that all identities share equal control.
D) are controlled by the host identity.

Question 66

Studies of individuals with DID compared to those trained to simulate the disorder ________

A) support the trauma model more than the sociocognitive model.
B) support the sociocognitive model more than the trauma model.
C) definitively demonstrate that DID is faked, whether intentionally or unintentionally.
D) suggest that DID is faked, but only unconsciously.

Question 67

An example of dissociative trance disorder is ________

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

Question 68

Why has the term "multiple personality disorder" been replaced with "dissociative identity disorder"?

A) The old term was often used to refer to both schizophrenia and DID, thus a new term was needed to end this confusion.
B) The word "multiple" suggested the presence of more identities than were commonly observed.
C) Fully developed personalities are not present in DID, just varying expressions of different aspects of the patient's personality.
D) A new diagnostic term was wanted to remove some of the stigma associated with the old term and its presentation in the media.

Question 69

Sociocognitive theory ________

A) explains why symptoms of DID are often not seen until after treatment is initiated.
B) explains why the number of alters is usually constant.
C) can't account for the role that trauma appears to play in DID.
D) does not explain the phenomenon of "lost time."

Question 70

Which of the following is an explanation for the increased prevalence of DID?

A) Increased public awareness of DID.
B) The increased incidence of verbal abuse.
C) Changes in the diagnostic criteria for PTSD.
D) Therapists can seek greater insurance reimbursement for DID patients.

Question 71

Which of the following is true of opposite sex alters in DID?

A) They are rare.
B) They are quite common.
C) When they do occur, they usually assume the role of host.
D) They occur most commonly when sexual abuse has occurred.

Question 72

Which of the following summarizes the posttraumatic theory for the origin of DID?

A) Therapists unwittingly reinforce role-playing of alter identities.
B) Genetically programmed tendencies to dissociate are triggered by stress.
C) Children deal with severe abuse by creating alters who provide an "escape."
D) The rewards of avoiding punishment from the legal system induces people to fake symptoms.

Question 73

There is debate as to the relationship between DID and abuse because ________

A) few of those who develop DID have a history of abuse.
B) there is little evidence of a link between trauma and psychopathology.
C) other factors correlated with abuse may be the true causal factors in DID.
D) most reports of abuse are faked.

Question 74

DID is a condition in which aspects of memory such as identity and consciousness are _________

A) overly integrated.
B) no longer integrated.
C) implicitly segregated.
D) shared by separate people.

Question 75

What is one reason why the prevalence of DID has been increasing?

A) Children in today's society are far more likely to experience severe trauma than they were in the past.
B) DID has only recently received full acceptance from the psychiatric community and thus professionals are now using this diagnosis.
C) As of 1980 most insurance companies had to accept DID as a billable diagnosis.
D) It may be that the prevalence of DID has not changed at all, but that clinicians may unknowingly encourage the emergence of new identities.

Question 76

All of the following are associated with DID except ________

A) depression.
B) hallucinations.
C) psychosis.
D) substance abuse.

Question 77

Which of the following is most commonly true of the host identity in DID?

A) It does not answer to the person's actual name.
B) It is always the most well-adjusted of the identities.
C) It is the second or third alter to develop.
D) It is not the original identity.

Question 78

A person with two or more well-developed identities has the disorder called ________

A) fugue state.
B) depersonalization disorder.
C) dissociative identity disorder.
D) localized psychogenic amnesia.

Question 79

Brigid has been diagnosed with dissociative identity disorder. Brigid is the host personality. We can expect that the alter identities ________

A) are very much like Brigid.
B) are strikingly different from Brigid.
C) only "come out" when there is no stress in the environment.
D) are very much like one another.

Question 80

Recent estimates suggest that about 50 percent of those with DID have ________

A) only two identities.
B) two alters, in addition to the host identity.
C) more than 10 identities.
D) as many as 200 identities.