Essentials of Abnormal Psychology 7th Edition By V. Mark Durand - Test Bank

Sample Answer: Somatic symptom disorder shares some features with illness anxiety disorder, including a history of family illness or injury during childhood. But this history is a minor factor at best because countless families experience chronic illness or injuries without passing on severe anxiety of being ill or the sick role to children. Something else contributes strongly to somatic symptom disorder.

In illness anxiety disorder, as we know it today, severe anxiety is focused on the possibility of having a serious disease. The threat seems so real that reassurance from physicians does not seem to help. In illness anxiety disorder, the individual is preoccupied with bodily symptoms, misinterpreting them as indicative of illness or disease. Almost any physical sensation may become the basis for concern for individuals with illness anxiety disorder.

In somatic symptom disorder, patients go to the doctor with seemingly endless lists of somatic complaints for which he could find no medical basis. Despite the doctor’s negative findings, patients return shortly with either the same complaints or new lists containing slight variations.

Individuals with illness anxiety disorder most often take immediate action on noticing a symptom by calling the doctor or taking medication. People with somatic symptom, on the other hand, do not feel the urgency to take action but continually feel weak and ill, and they avoid exercising, thinking it will make them worse.

Sample Answer: Clinical reports indicate that reassurance and education seems to be effective in some cases—“surprisingly” because, by definition, patients with hypochondriasis are not supposed to benefit from reassurance about their health. However, reassurance is usually given only briefly by family doctors who have little time to provide the ongoing support and reassurance that might be necessary. Mental health professionals may well be able to offer reassurance in a more effective and sensitive manner, devote sufficient time to all concerns the patient may have, and attend to the “meaning” of the symptoms.

Evaluations of more robust treatments have now appeared. CBT focused on identifying and challenging illness-related misinterpretations of physical sensations and on showing patients how to create “symptoms” by focusing attention on certain body areas. Bringing on their own symptoms persuaded many patients that such events were under their control. Patients were also coached to seek less reassurance regarding their concerns. CBT was more effective after treatment and at each follow-up point for both symptoms of hypochondriasis and overall changes in functioning and quality of life. But results were still “modest,” and many eligible patients refused to enter treatment because they were convinced their problems were medical rather than psychological.

A few recent reports suggest that drugs may help some people with hypochondriasis. Not surprisingly, these same types of drugs (antidepressants) are useful for anxiety and depression. In one study, CBT and the drug paroxetine (Paxil), a serotonin-specific reuptake inhibitor (SSRI), were both effective, but only CBT was significantly different from a placebo condition.

Sample Answer: Conversion disorders

generally have to do with physical malfunctioning, such as paralysis, blindness, or difficulty speaking (aphonia), without any physical or organic pathology to account for the malfunction. Most conversion symptoms suggest that some kind of neurological disease is affecting sensory–motor systems, although conversion symptoms can mimic the full range of physical malfunctioning. For this reason, and because the term conversion implies a specific etiology for which there is limited evidence, the name changed to “functional neurological disorder” (with “functional” referring to a symptom without organic cause) in the DSM-5..

Conversion disorders provide some of the most intriguing, sometimes astounding, examples of psychopathology. What could possibly account for somebody going blind when all visual processes are normal, or experiencing paralysis of the arms or legs when there is no neurological damage? Conversion symptoms are often precipitated by marked stress. C.V. Ford (1985) noted that the incidence of marked stress preceding a conversion symptom occurred in 52 to 93 percent of the studied patients. Often, this stress takes the form of a physical injury. In one large survey, 324 out of 869 patients (37 percent) reported prior physical injury. Thus, if the clinician cannot identify a stressful event preceding the onset of the conversion symptom, the clinician might more carefully consider the presence of a true physical condition.

In addition, although people with conversion symptoms can usually function normally, they seem truly unaware either of this ability or of sensory input. For example, individuals with the conversion symptom of blindness can usually avoid objects in their visual field, but they will tell you they can’t see the objects. Similarly, individuals with conversion symptoms of paralysis of the legs might suddenly get up and run in an emergency and then be astounded they were able to do this. It is possible that at least some people who experience miraculous cures during religious ceremonies may have been suffering from conversion reactions. These factors may help in distinguishing between conversion and organically based physical disorders, but clinicians sometimes make mistakes, although it is not common with modern diagnostic techniques. In any case, ruling out medical causes for the symptoms is crucial to making a diagnosis of conversion.