Deck 6: Dissociative Disorder and Somatic Symptom and Related Disorders

Question 1

Wendy feels as though she is outside of her body, observing her own behaviour. This experience is a symptom of

A) dissociative amnesia with fugue.
B) dissociative identity disorder.
C) dissociative amnesia.
D) repressed memory.
E) derealization/depersonalization.

Answer 1

derealization/depersonalization.

Question 2

At present, dissociative disorders are characterized by

A) flat affect.
B) severe brain damage.
C) delusions and hallucinations.
D) maladaptive alterations of identity, memory, and consciousness.
E) poor concentration.

Answer 2

maladaptive alterations of identity, memory, and consciousness.

Question 3

Two forms of amnesia are ___________ amnesia, in which an individual forgets his or her entire life history, and ___________ amnesia, in which a person can remember nothing following a certain point in time.

A) localized; continuous
B) localized; generalized
C) systematized; selective
D) generalized; localized
E) generalized; continuous

Answer 3

generalized; continuous

Question 4

Leanne experiences the sudden feeling of being detached from herself. The term best suited to describe her experience is

A) depersonalization/derealization disorder.
B) dissociative identity disorder.
C) dissociative amnesia with fugue.
D) dissociative amnesia.
E) repression.

Question 5

With regard to brain correlates of depersonalization/derealization, the textbook cites research that suggests ____ play(s) a role.

A) perceptual pathways
B) temporal lobe epilepsy
C) circuits involved in awareness and working memory
D) processing functions
E) circuits responsible for adaptive integration of emotional learning with decision- making

Question 6

Dissociative amnesia with fugue is a loss of memory with the added dimension of

A) mania.
B) substance abuse.
C) psychosis.
D) physical flight.
E) depression.

Question 7

The dissociative disorders have a high degree of comorbidity

A) with physical complaints that clearly don't have a medical cause.
B) with types of delirium, dementias and amnestic disorders.
C) with anxiety, mood and personality disorders.
D) in terms of severe maladaptive disruptions or alternations of identity, memory and consciousness that are experienced as being beyond one's control.
E) in terms of physical symptoms suggestive of medical illness, but no organic basis can be found to account for them.

Question 8

Dissociative disorders and some of the somatic symptom disorders were once viewed as expressions of ___ , which denoted a symptom pattern of emotional excitability and physical symptoms without medical cause, and which was felt to be caused by a ____.

A) neurosis; suppression of psychic stress
B) neurosis; repression of traumatic memories
C) brain degeneration; an over-excitable brain and nervous system
D) hysteria; repression of traumatic memories
E) hysteria; wandering uterus

Question 9

Which of the following matches is incorrect?

A) dissociative amnesia: inability to recall important personal information
B) depersonalization/derealization disorder: presence of two or more personalities
C) dissociative identity disorder: presence of two or more personalities
D) dissociative amnesia with fugue: sudden, unexpected flight from home
E) depersonalization/derealization disorder: feeling of being detached from oneself

Question 10

Which of the following matches is incorrect?

A) continuous amnesia: failure to recall information from a specific date until the present
B) selective amnesia: failure to recall only certain categories of information
C) localized amnesia: failure to recall information from a specific time period
D) generalized amnesia: failure to recall anything in one's lifetime
E) systematized amnesia: failure to recall certain categories of information

Question 11

Approximately _______ of the general population have some type of dissociative disorder whereas _______ of psychiatric patients do.

A) 0.5%; 1.5 to 3%
B) 1.5%; 3 to 6%
C) 3%; 5 to 11%
D) 6%; 10 to 16%
E) 9.1%; 15 to 21 %

Question 12

Which of the following is NOT true of depersonalization disorder?

A) People with this disorder often describe themselves as feeling like a robot that is able to respond to those nearby but without feeling connected to their actions.
B) It is characterized by a feeling of detachment from oneself or one's surroundings.
C) It typically is not associated with depression or anxiety; indeed, patients often display an indifference to their symptoms (la belle indifference).
D) It is highly related to a history of trauma, particularly emotional abuse.
E) A diagnosis of this disorder is usually made in adolescence and tends to be chronic in course.

Question 13

Depersonalization/derealization disorder differs from the other dissociative disorders, in that

A) there are no symptoms of memory impairment or identity confusion.
B) there does not appear to be any sort of dissociative process going on.
C) only with this disorder is there a loss of awareness of one's central and knowing self.
D) there are reduced symptoms or no symptoms of a feeling of depersonalization/ derealization.
E) it alone is associated with history of trauma, particularly emotional abuse.

Question 14

In earlier editions of the DSM, dissociative and somatic symptom and related disorders were categorized as

A) psychoses.
B) depressive disorders.
C) somatic symptom disorder.
D) neuroses.
E) physical disorders.

Question 15

The different unique personalities in an individual diagnosed with dissociative identity disorder are often referred to as

A) alternates.
B) others.
C) egos.
D) splits.
E) alters.

Question 16

A disorder in which people are induced by therapists to remember events that have never occurred is referred to as

A) iatrogenic memory syndrome.
B) trauma-repression syndrome.
C) creative recall syndrome.
D) false memory syndrome.
E) distorted memory syndrome.

Question 17

Heather has suddenly left home and has lost all memory of herself and her past life. She is most likely suffering from

A) repression.
B) depersonalization/derealization disorder.
C) dissociative amnesia.
D) dissociative amnesia with fugue.
E) dissociative identity disorder.

Question 18

Which of the following is NOT among the five patterns of memory loss described in the DSM-5?

A) localized
B) regressive
C) generalized
D) selective
E) continuous

Question 19

__________ is the DSM-5 label for the disorder in which certain aspects of a person's identity become detached or dissociated; it was formerly known as ______.

A) Multiple personality disorder; dissociative identity disorder
B) Dissociative identity disorder; split personality disorder
C) Dissociative identity disorder; multiple personality disorder
D) Split personality disorder; multiple personality disorder
E) Multiple personality disorder; split personality disorder

Question 20

Feelings of depersonalization/derealization are quite common in young adults, and they are only considered pathological when

A) they occur at least 5 times a week.
B) they occur in conjunction with substance use.
C) they occur in conjunction with depersonalization/derealization disorder.
D) they occur in conjunction with feelings of anxiety or depression.
E) they are persistent and personally distressing.

Question 21

Which of the following is true of the transition from one alter to another?

A) It is often called the "transfer".
B) It cannot be artificially precipitated, such as through hypnotic suggestion.
C) It is often precipitated by stress or other identifiable cues in the environment.
D) It happens gradually, with the dominant alter fading and the new one growing stronger.
E) It is always obvious when a transition between alters has occurred.

Question 22

Merskey asserted that dissociative identity disorder is an iatrogenic condition. What does this mean?

A) That the condition emerges very early in infancy.
B) That the condition emerges from psychodynamic defenses against early childhood trauma.
C) That the condition is self-generated.
D) That the condition is caused by treatment.
E) That the condition spreads in families.

Question 23

The term la belle indifference refers to

A) the lack of worry patients with conversion disorder display about their symptoms.
B) the lack of awareness of each other displayed by each of the alters in patients suffering from dissociative identity disorder.
C) the attitude displayed by people accused of malingering.
D) the lack of awareness of their condition displayed by patients suffering from dissociative amnesia with fugue.
E) the lack of concern doctors show patients suffering from conversion disorder.

Question 24

Which of the following medications is sometimes used in the treatment of dissociative identity disorder and associated comorbid disorders?

A) a variety of SSRIs
B) antipsychotics, such as Haldol
C) sodium amytal
D) antianxiety drugs, such as Valium
E) antidepressants, such as Prozac

Question 25

"Glove anesthesia" refers to

A) loss of sensation in the hands when wearing gloves.
B) loss of sensation in the extremities.
C) loss of sensation in the part of the hands which would be covered by gloves.
D) an inability to remember where one has left one's gloves and keys.
E) an extreme fear of wearing gloves.

Question 26

Which of the following is TRUE of dissociative identity disorder?

A) Alters may have different eyeglass prescriptions and allergies.
B) For a diagnosis there must be at least 4 alters that control the person's behaviour.
C) Alters typically share the same memories and have similar histories and mannerisms.
D) The various personalities always claim to be of the same gender.
E) The host is never aware of the various alters.

Question 27

In somatic symptom disorder, patients usually attribute their symptoms to

A) feelings of depersonalization/derealization.
B) psychological problems.
C) an insecure attachment with their parents as children.
D) depression.
E) medical problems.

Question 28

Heather is deliberately faking symptoms of illness in order to gain the attention of doctors. This behaviour is best described as:

A) conversion disorder.
B) factitious disorder.
C) malingering.
D) somatizing.
E) faking.

Question 29

Sandra is experiencing a loss of vision for which her doctor can find no physical cause. The term best suited to describing her condition is

A) factitious disorder.
B) illness anxiety disorder.
C) somatic symptom disorder.
D) conversion disorder.
E) major depressive disorder

Question 30

There is some similarity between illness anxiety disorder and ___________.

A) panic disorder
B) conversion disorder
C) depression
D) psychogenic pain
E) dissociative amnesia

Question 31

Relative to previous editions of the DSM, the diagnostic criteria for DSM-5 dissociative identity disorder are:

A) are far more restrictive.
B) are far more wordy.
C) more strongly grounded in psychodynamic theory.
D) more strongly grounded in attachment theory.
E) more flexible and emphasize less dramatic presentations of the disorder.

Question 32

According to Merskey, cases of dissociative identity disorder

A) represent a legitimate psychiatric disorder.
B) are most frequently found in individuals with criminal inclinations.
C) may be iatrogenic conditions unintentionally caused by practitioners.
D) are frequently cases of individuals faking or malingering their illnesses.
E) are more common outside of North America.

Question 33

Nick Spanos was a leading proponent of the ___________ model of DID.

A) iatrogenic
B) trauma
C) medical
D) socio-cognitive
E) repressed memory

Question 34

Which of the following is true regarding the trauma model of dissociative disorders?

A) This model was very popular but is no longer accepted.
B) According to the model, dissociative disorders develop secondary to severe trauma in adulthood.
C) The model posits that people are most likely to develop dissociative disorders after a motor vehicle accident.
D) The model proposes that people who are high in agreeableness are susceptible to dissociation.
E) According to the model, high hypnotizability is a risk factor for dissociative disorders.

Question 35

Which of the following is NOT one of the steps that is usually followed in the treatment of dissociative identity disorder?

A) discussing emotionally charges memories of past trauma
B) helping patients develop new coping skills
C) integrating the various personalities
D) using hypnosis to assist the patient in role playing the various alters
E) the establishment of trust through a careful discussion of the risks and benefits of therapy

Question 36

Deliberately adopting the sick role and complaining of symptoms to achieve some specific gain like receiving insurance money or avoiding duties is characteristic of

A) la belle indifference.
B) factitious disorders.
C) somatic symptom disorder.
D) malingering.
E) illness anxiety disorder.

Question 37

In conversion disorder

A) there is excessive preoccupation with an imagined or exaggerated body disfigurement.
B) people have long-standing fears, suspicions, or convictions about having a serious disease.
C) a pattern of multiple, recurring, somatic complaints that have no diagnosable basis are observed, leading the individual to seek medical treatment.
D) psychological factors are important in the onset, exacerbation, severity, or maintenance of the patient's pain complaints.
E) symptoms are observed in voluntary motor or sensory functions that suggest neurological causes, but these cannot be confirmed.

Question 38

Recently, experts have suggested that conversion disorder might best be viewed as a form of

A) somatic symptom disorder.
B) dissociative amnesia.
C) factitious disorder.
D) dissociative disorder.
E) anxiety disorder.

Question 39

Which of the following is true of the treatment and prognosis of DID?

A) There have been few attempts to evaluate the success of the treatments.
B) There is considerable evidence that individuals get better without professional help.
C) There is general consensus among experts regarding a specific series of stages that are followed.
D) In general, the prognosis is optimistic.
E) Medication has been found to be useful in treating the disorder.

Question 40

Which of the following is true regarding patterns of DID diagnosis over time?

A) Prior to 1980, DID was second only to depression in terms of prevalence.
B) Prior to 1980, only about 200 cases were documented in the entire world.
C) Prior to 1980, DID was the 5th most diagnosed disorder.
D) Since DSM-5, there has been a dramatic, unexplained increase in DID diagnoses.
E) The prevalence of DID diagnoses has not changed over the last 50 years.

Question 41

The defining symptom of the dissociative disorders is the disruption of mental processes involved in memory or consciousness that are normally integrated.

Question 42

Dissociation was emphasized in early Christianity as a function of God's will.

Question 43

In the middle ages, supernatural beliefs of Plato were soon replaced by more scientific accounts of mental disorders, including the syndromes we recognize as dissociative and somatic symptom and related disorders.

Question 44

The transition from one alter to another is called a "jump."

Question 45

Dissociative symptoms are common among psychiatry patients and often co-occur with depression, anxiety and personality disorders.

Question 46

Somatic symptom and related disorders were at one time viewed as masked

A) aggression.
B) anxiety.
C) depression.
D) psychological conflict.
E) obsessions.

Question 47

With the rise of Christianity, biomedical theories of hysteria were replaced by supernatural explanations.

Question 48

Current thought about dissociative disorders and somatic symptom and related disorders suggests that both are characterized by physical symptoms or behaviours that are caused or exacerbated by elevated serotonin levels.

Question 49

Proponents of false memory syndrome argue that therapists may inadvertently lead patients to uncover repressed memories that have been distorted.

Question 50

Dysfunction in which physiological system is proposed to be implicated in the development of somatic symptom and related disorders?

A) the parasympathetic nervous system.
B) the prefrontal cortex-basal ganglia system.
C) the hypothalamic-pituitary-adrenal axis.
D) the reproductive system.
E) the sensory-perceptual system.

Question 51

According to theories of health anxiety, the development of dysfunctional beliefs about illness leads an individual to:

A) doubt themselves.
B) lose confidence in the healthcare system.
C) develop attentional and interpretive biases.
D) develop traumatic memories.
E) develop healthy eating and fitness habits.

Question 52

Current treatments for somatic symptom and related disorders focus on

A) integrating the various personalities into a single personality.
B) finding the most appropriate pharmacological intervention for the particular individual.
C) helping individuals acquire insight into the origins of their difficulties.
D) the use of hypnosis to help individuals uncover forgotten memories of traumatic events that may be at the root of many of these disorders.
E) affective, cognitive, or social processes that maintain these disorders.

Question 53

The separate personalities in a person suffering from dissociative identity disorder are often referred to as "alters."

Question 54

There is no evidence that people with dissociative disorders score higher on measures of hypnotizability.

Question 55

Canadian psychologist Nick Spanos was an articulate supporter of the diagnosis of dissociative identity disorder.

Question 56

Social learning theory proposes that individuals who report unexplained symptoms:

A) learn how to adopt the sick role from their family physician.
B) learn to adopt the sick role to please their parents.
C) develop a fear of illness via classical conditioning.
D) develop a fear of illness via operant conditioning.
E) observe and internalize the health-related opinions and behaviours of close others.

Question 57

Hippocrates believed that the dissociative and somatic symptom disorders were caused by a wandering uterus.

Question 58

Which of the following represents an overconcern about serious disease?

A) malingering
B) illness anxiety disorder
C) conversion disorder
D) factitious disorder
E) dissociative identity disorder

Question 59

Merskey has argued that dissociative identity disorder is created by the power of suggestion.

Question 60

Recent research suggests that conversion symptoms in people with conversion disorder result from

A) spontaneous self-hypnosis.
B) psychogenic pain.
C) malingering.
D) therapeutic suggestion.
E) valid medical problems.

Question 61

In malingering, individuals deliberately fake or generate the symptoms of illness in order to gain their doctor's attention.

Question 62

What are the various personalities in a person with dissociative identity disorder called? How many of these personalities must there be for a diagnosis of dissociative identity disorder?

Question 63

Describe five patterns of memory loss characteristic of dissociative amnesia.

Question 64

List and BRIEFLY discuss the defining features of 3 somatic symptom and related disorders from the DSM-5.

Question 65

Medication is generally not useful in the direct treatment of DID.

Question 66

DSM-5 criteria for conversion disorder requires determination of whether a genuine medical condition is present.

Question 67

What is the defining symptom of dissociative disorders? What were dissociative disorders categorized as in early editions of the DSM? What specific dissociative disorder has changed names recently?

Question 68

The average number of personalities in dissociative identity disorder is five.

Question 69

Conversion disorder is characterized by voluntary motor or sensory symptoms that reflect underlying neurological, although not anatomical, dysfunction.

Question 70

What is false memory syndrome and how is this distinguished from the trauma-repression hypothesis?

Question 71

Identify and describe the major characteristics of three types of dissociative disorders.

Question 72

Patients with conversion disorder tend to be quite anxious about their symptoms.

Question 73

Dissociative identity disorder is characterized by the presence of two or more personalities.

Question 74

Explain the cognitive-behavioural conceptualization of health anxiety.

Question 75

List the somatic symptom and related disorders and summarize your impression of the current status of this diagnostic category. What are the scientific reasons for keeping this category and the disorders within?.

Question 76

Somatic symptom disorder shares similarities with panic disorder.