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Chapter 8: Somatic Symptom and Dissociative Disorders Multiple-Choice Questions 1. 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. Answer: d. somatic symptom disorders. 2. 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. Answer: c. believe that their symptoms are real and serious. 3. Consciously faking symptoms is characteristic of a. malingering. b. hypochondriasis. c. somatization disorder. d. somatic symptom disorder. Answer: a. malingering. 4. All of the following are diagnosed as somatic symptom disorders EXCEPT a. hypochondriasis b. somatization disorder c. pain disorder d. fugue disorder Answer: d. fugue disorder 5. Evan is terrified because he is convinced that he has a terminal heart condition. He has consulted with several physicians about it who have found no evidence of any heart disease. Interestingly, Evan continues to feel terrified even when the doctors find no physical problem. His diagnosis is probably a. somatization disorder. b. pain disorder. c. hypochondriasis. d. malingering. Answer: c. hypochondriasis. 6. John and Ira eat dinner together after work. Several hours later, each starts to feel nausea and stomach pains. John is a hypochondriac, Ira is 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: b. John will think that he has stomach cancer and Ira will think the food he ate made him sick. 7. If Ronald is typical of people with hypochondriasis, he will 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. Answer: a. avoid accepting a psychological explanation for his problems. 8. 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. Answer: d. has no mental disorder. 9. People with hypochondriasis tend to rely on maladaptive thoughts that increase their vulnerability to this somatic symptom issue. Which of the following statements would be an example of those thoughts? 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. Answer: c. A sore throat is a major problem. It could be cancer or some other deadly disease no matter what the doctor says. 10. According to the revisions made for the 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 Answer: a. hypochondriasis 11. Dysfunctional assumptions about symptoms and diseases are a component of a cognitive-behavioral explanation of a. hypochondriasis. b. dissociative fugue. c. somatization disorder. d. depersonalization disorder. Answer: a. hypochondriasis. 12. Research on hypochondriasis 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. Answer: b. overestimate the dangerousness of diseases. 13. Response prevention has been used in the treatment of a. dissociative identity disorder. b. factitious disorder. c. malingering. d. hypochondriasis. Answer: d. hypochondriasis 14. Catastrophizing about minor bodily sensations is characteristic of individuals with both a. hypochondriasis and somatization disorder. b. hypochondriasis and conversion disorder. c. dissociative fugue and somatization disorder. d. dissociative fugue and conversion disorder. Answer: a. hypochondriasis and somatization disorder. 15. Somatization disorder, as defined in DSM-IV, 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. Answer: a. has been subsumed into somatic symptom disorder 16. Somatization disorder and hypochondriasis are similar in that a. both think they have a physical disease. b. both think that they can easily cope with their symptoms. c. both pay more attention to bodily sensations and see them as symptoms. d. both react to physical symptoms by becoming more physically active. Answer: c. both pay more attention to bodily sensations and see them as symptoms. 17. Somatization disorder and hypochondriasis differ because a. in somatization disorder, people have physical symptoms involving one body part or function, in hypochondriasis, people are concerned about having an organic disease. b. in somatization disorder, people are concerned about having an organic disease, in hypochondriasis, people have physical symptoms involving one body part or function. c. in somatization disorder, people are concerned about having an organic disease, in hypochondriasis, people are concerned about multiple different physical symptoms. d. in somatization disorder, people are concerned about multiple different physical symptoms, in hypochondriasis, people are concerned about having an organic disease. Answer: d. in somatization disorder, people are concerned about multiple different physical symptoms, in hypochondriasis, people are concerned about having an organic disease. 18. Dan's various medical complaints and hospital stays finally led him to psychiatrist. After a thorough medical and psychological evaluation, the twenty-eight-year-old teacher and father of two was diagnosed with both depression and somatization disorder. What is atypical about this case summary? a. Such diagnoses are usually made in adolescence. b. Somatization 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: b. Somatization disorder is seen much more commonly in women. 19. The most effective treatment to date for somatization 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. Answer: c. decreases healthcare expenditures. 20. 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. pain disorder associated with psychological factors. c. pain disorder associated with both psychological factors and a general medical condition. d. body dysmorphic disorder. Answer: b. pain disorder associated with psychological factors. 21. Why is the timeframe of 6 months important in diagnosing pain disorder? a. It determines whether the symptoms are acute or chronic b. It determines whether the pain is real or imagined c. It determines whether the pain is localized or generalized d. It determines whether there is a psychological condition present that plays a causal role Answer: a. It determines whether the symptoms are acute or chronic 22. What would be most helpful to a person with pain 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. Answer: a. Staying physically active despite the pain. 23. People with pain disorder tend to a. seem indifferent to their symptoms. b. have fewer somatic symptoms. c. report more pain than people whose somatic symptom pain disorder is related to a medical condition. d. be consistent in their report of pain, regardless of the stress they feel. Answer: b. have fewer somatic symptoms. 24. A new disorder in DSM-5 is: a. conversion disorder. b. hypochondriasis. c. illness anxiety disorder. d. somatization disorder. Answer: a. conversion disorder. 25. Which of the following was once viewed as form of "hysteria"? a. conversion disorder b. dissociative identity disorder c. dissociative fugue d. hypochondriasis Answer: a. conversion disorder 26. In what way was Freud's view of conversion disorder consistent with behavioral 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). Answer: c. He believed that the symptoms of conversion disorder were maintained by the relief from anxiety they provided. 27. 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. not changing. Answer: c. decreasing as sophistication about disorders increases. 28. The most common kind of speech-related conversion reaction is a. alexia b. aphonia c. apraxia d. alogia Answer: b. aphonia 29. What is a pseudoseizure? a. A seizure that looks exactly like a seizure on EEG but cannot be explained. b. A seizure that resembles an epileptic seizure but is different. c. A faking seizure with little thrashing. d. Any seizure that cannot be explained. Answer: b. A seizure that resembles an epileptic seizure but is different. 30. 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 Answer: b. conversion disorder 31. 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. Answer: d. Advances in the medical field have made patients more sophisticated about medical and psychological disorders. 32. 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. Answer: b. Jim is male, and most people with this disorder are women. 33. 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. Answer: a. People with conversion disorder are very willing to talk about their symptoms, malingerers will be more cautious. 34. 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. Answer: d. is malingering. 35. 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. Answer: c. The patient shows no signs of atrophy in damaged areas. 36. 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 Answer: d. factitious disorder. 37. Alan fell off a ladder at work and claims he is in intense back 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 Answer: a. malingering in Alan and conversion disorder in Caleb 38. Which of the following disorders is characterized by a reluctance to discuss symptoms? a. conversion b. hypochondriasis c. somatic symptom d. malingering Answer: d. malingering 39. Which disorder would include intentionally taking drugs in order to stimulate various real illnesses? a. Munchausen’s syndrome b. malingering c. dissociative identity disorder d. somatization disorder Answer: a. Munchausen’s syndrome 40. What do the somatic symptom and 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 alleviating anxiety. d. Both have onset during early childhood. Answer: c. Both appear to be ways of alleviating anxiety. 41. 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. Answer: c. is extremely common and not necessarily pathological. 42. 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. Answer: b. She experienced an instance of derealization. 43. 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. Answer: a. depersonalization disorder. 44. The inability to learn new information is known as a. anterograde amnesia. b. retrograde amnesia. c. continuous amnesia. d. generalized amnesia. Answer: a. anterograde amnesia. 45. 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. Answer: b. dissociative fugue. 46. 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 Answer: a. dissociative disorder 47. 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. Answer: d. had trouble remembering information stored before a traumatic incident. 48. Jill did not remember the accident happening or her graduation a couple of months ago. What form of memory loss is this characteristic of? a. episodic b. semantic c. retrograde d. short term Answer: a. episodic 49. 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. Answer: a. dissociative fugue. 50. 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. Answer: c. dissociative fugue. 51. Once a dissociative fugue ends, people a. can remember everything that has happened to them. b. remembers 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. Answer: c. can remember their past but cannot remember what happened during the fugue. 52. 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) Answer: d. Episodic memory (the events we have experienced) 53. 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. Answer: a. mainly episodic memory is lost, implicit memory stays intact. 54. 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. Answer: a. Implicit memory is generally intact. 55. There has been little systematic research conducted on dissociative amnesia and fugue, yet some studies have revealed new information. Which of the following would be a 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 Answer: d. use of different brain imaging methods to determine where loss of function occurs 56. Dissociative identity disorder was formerly known as a. psychogenic amnesia. b. multiple personality disorder. c. conversion hysteria. d. neurasthenia. Answer: b. multiple personality disorder. 57. Which of the following is most suggestive of dissociative identity disorder? a. Grace's feelings about James switch 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. Answer: d. Kyla could not recall where she had been or what she had done all day. 58. 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. Answer: c. dissociative identity disorder. 59. 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. Answer: d. It is not the original identity. 60. 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. Answer: b. They are quite common. 61. 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. Answer: b. are strikingly different from Brigid. 62. Octavia has been diagnosed with dissociative identity disorder (DID). She has seventeen 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. Answer: d. No aspect of this case is unusual. 63. In the 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. Answer: b. produce gaps in memory. 64. The text presented the case of Mary Kendall, who suffered from dissociative identity disorder. She is typical of individuals with this disorder in that a. she has periods of "lost time." b. she was socially inept as a child. c. she was aware of her separate personalities prior to beginning treatment. d. she tended to express her emotional distress in complaints about her body. Answer: a. she has periods of "lost time." 65. All of the following are associated with DID except a. depression. b. hallucinations. c. psychosis. d. substance abuse. Answer: c. psychosis. 66. 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. Answer: c. Fully developed personalities are not present in DID, just varying expressions of different aspects of the patient's personality. 67. 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. over ten identities. d. as many as two hundred identities. Answer: c. over ten identities. 68. 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. Answer: 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. 69. 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. Answer: a. Increased public awareness of DID. 70. Experimental studies of DID find that inter personality amnesia exists for a. all types of memories. b. explicit memories. c. implicit memories. d. conditioned responses. Answer: b. explicit memories. 71. Studies of the brains of individuals with DID a. find no differences in brain activity associated with different identities. b. support the assertion that DID is a real disorder. c. do not indicate any explanation for interpersonal amnesia. d. have provided no consistent findings. Answer: b. support the assertion that DID is a real disorder. 72. 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. Answer: c. other factors correlated with abuse may be the true causal factors in DID. 73. According to socio cognitive 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. Answer: d. DID may develop when a suggestive patient is treated by an overzealous clinician. 74. 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. Answer: c. Children deal with severe abuse by creating alters who provide an "escape." 75. Socio cognitive 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." Answer: a. explains why symptoms of DID are often not seen until after treatment is initiated. 76. A recent 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 a. each was a pathological liar long before showing signs of dissociative disorder. b. disordered thinking was associated with abnormal brain functioning. c. each was severely abused, both physically and sexually. d. each had vivid memories of being tortured and neglected by strangers. Answer: c. each was severely abused, both physically and sexually. 77. 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 enjoy 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. Answer: d. a person who believes he or she is at times possessed by a spirit and is extremely upset because of this. 78. When it comes to the effectiveness of treatment for dissociative disorders, we know a. very little. b. that medications are worthless, but that psychotherapy is quite effective. c. that depersonalization is much more effectively treated than amnesia. d. that antidepressant medications are most effective in treating dissociative identity disorder. Answer: a. very little. 79. The treatment goal for most therapists who treat dissociative identity disorder is a. acceptance of the alter personalities. b. reduction in the impact of distress and impairment. c. integration of the alter personalities. d. self-understanding of the causes for the alter personalities. Answer: c. integration of the alter personalities. 80. Your textbook authors report that rigorously designed and controlled studies on the treatment of dissociative identity disorder a. have only examined psychodynamic forms of treatment. b. are widespread. c. demonstrate the effectiveness of cognitive-behavior therapy. d. are non-existent. Answer: d. are non-existent. Fill-in-the-Blank Questions 1. When a person intentionally produces symptoms and is motivated by incentives, this is known as __________. Answer: malingering 2. ______________ is the disorder in the DSM-5 used to replace hypochondriasis without somatic symptoms. Answer: Illness anxiety disorder 3. _____________ is the disorder in which a person has many different physical symptoms from different areas of the body and the symptoms cannot be explained by medical findings. Answer: Somatic symptom disorder 4. ____________ is the diagnosis given when a person has persistent and severe pain in one or more areas of the body, and it is not feigned or does not have medical causes. Answer: Pain disorder 5. Pain disorder is easier to treat than somatization disorder because it is less ______. Answer: complex 6. ______ involves a pattern in which symptoms or deficits affecting the senses or motor behavior strongly suggest that the patient has a medical or neurological condition. Answer: Conversion disorder Short Answer Questions 1. Explain the difference between somatic symptom and dissociative disorders. Why are these disorders commonly considered at the same time? Answer: Somatic symptom disorders are characterized by physical complaints, thought to be manifestations of some psychological problem. In contrast, dissociative disorders involve some separation of the functioning of consciousness, memory, identity, or perception. Again, the underlying cause for the observed distortions is some psychological abnormality. Both were once classified as neuroses and are thought to have anxiety as their underlying cause. 2. How do people with hypochondriasis typically relate to physicians? Answer: They repeatedly visit physicians seeking medical advice, but their concerns that they have a dread illness are not reduced when the doctors find nothing wrong. In fact, they often are disappointed that no physical problem has been found. 3. Discuss two of the causal factors of hypochondriasis. Answer: 1. Misinterpretations of bodily sensations - overfocus on symptoms, perceiving them as more dangerous than they are, look for confirming evidence and discount disconfirming evidence. 2. Dysfunctional beliefs about themselves - believe will be unable to cope with illness, see self as weak and unable to tolerate exercise. 3. Secondary reinforcements - current and past history - special comfort, relieved of responsibilities. 4. Briefly describe somatization disorder. Answer: Somatization characterized by multiple complaints of physical ailments over a long period of time, with onset before the age of thirty. These physical symptoms cannot be adequately explained by organic causes and result in either medical treatment or significant life impairment. The patient must report pain symptoms at different sites or involving different functions, two gastrointestinal symptoms, one sexual symptom, and one pseudoneurological symptom such as memory problems or loss of sensation. 5. Explain the difference between somatization disorder and hypochondriasis. Answer: Only people with hypochondria believe they have an organic disease. People with hypochondria usually have only a few symptoms, people with somatization disorder have multiple symptoms. 6. Can a person who has an actual medical condition be diagnosed with pain disorder? Why or why not? Answer: In pain disorders, pain reports that are out of proportion to an established medical condition that might cause some pain. Another type is when there is no medical condition or its existence is of minimal causal significance in the pain complaint. But psychological factors must be important. 7. Distinguish between the primary and secondary gains experienced by those with conversion disorder. Answer: Primary gains refer to the alleviation of anxiety or avoidance of stressful situations that results from the conversion symptoms. External "rewards" for the physical complaints experienced are those external factors that maintain the behaviors, such as sympathy and extra attention. 8. What factors tend to be associated with the onset of conversion disorder? Answer: An individual typically experiences an intolerable stressor. Conversion symptoms then develop and provide an escape from the unwanted situation, although the individual sees no connection between the situation and the symptoms. Guilt, self-punishment, and the opportunity for financial compensation following injury are also associated with the origin of conversion disorder. 9. What are some ways to distinguish between conversion disorder and a true physical problem? Answer: Symptoms don't conform to the normal symptoms of the disorder, the selective nature of the dysfunction and symptoms can be changed under hypnosis. 10. What is the difference between malingering and factitious disorder? Answer: Both disorders involve the conscious faking of physical symptoms. The malingerer, however, has a clear reason for the faked symptoms, while the individual with factitious disorder apparently is making complaints for no apparent external cause. The child who feigns illness to miss school is malingering, while the teen who adopts the "sick role" for the attention he gains may meet the diagnostic criteria for factitious disorder. 11. What is the main goal of treatment for DID? Answer: The goal of treatment in DID is usually the reintegration of the alters. As DID develops due to a dissociation of aspects of the self, a true remission would involve a complete integration of the various identities into a cohesive whole. Hypnosis is commonly used in an attempt to achieve this goal. Essay Questions 1. Explain the similarities and the difference between conversion disorder, factitious disorder, and malingering. Answer: Similarities - all involve physical symptoms with no physical cause. All involve some gain. Differences - only in conversion disorder are the symptoms involuntary, in factitious and malingering the person is consciously faking. While all can involve gain, the main type of gain is different. In conversion disorder the main gain is avoiding or escaping a stressful situation without taking responsibility for doing so. In factitious disorder, the person enjoys the sick role. In malingering, the gain is typically monetary, e.g. a law suit. 2. Describe the three diagnostic criteria for excessive thoughts, feelings, or behavior related to somatic symptoms that the DSM-5 identifies for a diagnosis of Somatic Symptom Answer: The focus in DSM-5 is on there being at least one of the following three features: (1) disproportionate and persistent thoughts about the seriousness of one’s symptoms; (2) persistently high level of anxiety about health or symptoms; and/or (3) excessive time and energy devoted to these symptoms or health concerns 3. What is dissociative fugue? Under what circumstances is this disorder likely to develop? Answer: Dissociative fugue has been described as a walking amnesia. In this form of amnesia, an individual not only forgets his or her history, but he or she also leaves. The individual with dissociative fugue may actually leave his or her home and begin a new life elsewhere with a new identity. Such an extreme means of dealing with anxiety is most commonly seen when faced with a situation that both intolerable and inescapable. 4. Discuss the various controversies surrounding the role of abuse in the development of DID. What evidence is there to suggest that abuse does play a causal role in DID? Answer: While a history of abuse is often reported by those diagnosed with DID, it can only be said that abuse may play a nonspecific causal role on the development of DID. While abuse is common in those with DID, there are many other environmental factors that may accompany an abusive situation that may play a more significant role in DID. Furthermore, if abuse were the true "cause" of DID, it would be expected that DID would be even more common than it is. There is also the possibility that many of the reported cases of abuse by those with DID may not have actually occurred. Thus, while abuse is often frequently reported by those with DID, the conclusion that abuse plays a causal role is not warranted. Test Bank for Abnormal Psychology: DSM 5 James N. Butcher, Jill M. Hooley, Susan M. Mineka 9780205965090, 9780205944286

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