Deck 6: Somatic Symptom and Dissociative Disorders

Question 1

You hear two colleagues talking,and one of them states that a friend has just been diagnosed with illness anxiety disorder.What is your colleague's friend's age and gender most likely to be?

A) The friend is likely to be a woman in her early 60s.
B) The friend is likely to be a man in his mid-40s to late 50s.
C) The friend is likely to be a young adolescent girl.
D) The friend is just as likely to be a man or women, at any age in the adult life cycle.

Answer 1

The friend is just as likely to be a man or women, at any age in the adult life cycle.

Question 2

Which of the following is a central feature of illness anxiety disorder?

A) the interpretation of harmful stimuli as nonthreatening
B) the interpretation of almost any physical sensation or symptom as threatening
C) a distrust of medical personnel
D) more acute physical sensations than someone without hypochondriasis

Answer 2

the interpretation of almost any physical sensation or symptom as threatening

Question 3

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

A) somatic symptom disorder
B) body dysmorphic disorder
C) illness phobia
D) illness anxiety disorder

Answer 3

illness anxiety disorder

Question 4

Henry has illness anxiety disorder.What are his symptoms?

A) when he is truly ill he represses the knowledge
B) when he feels normal bodily sensations he interprets them as a sign of a serious illness
C) when he has a real physical illness it is exaggerated to the point where Henry can only focus on the pain
D) Henry has an unrealistic fear of infection and disease

Question 5

What is the essential element of illness anxiety disorder?

A) dissociation
B) anxiety
C) depression
D) physical pain or discomfort

Question 6

Mark has intense anxiety about his health.He focuses on slight changes in his heartbeat and greatly exaggerates minor aches and pains.He frequently visits multiple doctors because he resents doctors telling him that nothing is physically wrong with him.What condition does Mark appear to have?

A) somatic symptom disorder
B) conversion disorder
C) illness anxiety disorder
D) Munchausen syndrome

Question 7

If someone complains of pain when no medical cause can be found,what will their pain be like?

A) The pain can be real even if it goes away with psychological treatment.
B) If psychological treatment eliminates the pain, the pain cannot have been real in the first place.
C) The pain usually goes away when the person is sleeping, which is a key indication that the pain is not real.
D) Unlike true pain, the pain originates from the brain and not the part of the body that feels injured.

Question 8

While patients with panic disorder and patients with illness anxiety disorder both tend to misinterpret bodily sensations,how do the two kinds of patients differ?

A) Those with panic disorder have imagined physical sensations, while those with illness anxiety disorder experience real physical sensations.
B) Those with panic disorder tend to fear immediate catastrophe, while those with illness anxiety disorder tend to fear long-term illness.
C) Those with panic disorder tend to ignore the symptoms of their first attacks, while those with illness anxiety disorder tend to seek immediate medical treatment following the first indication of pain.
D) Those with panic disorder have real physical sensations, while those with illness anxiety disorder experience sensations that are "all in their minds."

Question 9

Mark injured his back at work several years ago.Although he was treated and considered healed by his physicians,he still complains of severe and debilitating back pain.Other than some minor scar tissue,his doctors can't find anything that could be causing more than some minor stiffness.What is Mark's most likely diagnosis?

A) somatic symptom disorder with predominant pain due to a general medical condition
B) somatic symptom disorder due to primarily psychological factors
C) somatic symptom disorder with predominant pain due to psychological factors
D) somatic symptom disorder with predominant pain due to psychological factors and a general medical condition

Question 10

Which two disorders have been historically linked by the term hysteria?

A) conversion disorders with the schizophrenias
B) somatoform disorders with their subtypes
C) dissociative disorders and somatization disorder
D) somatoform disorders and dissociative disorders

Question 11

In 1962,Anna was diagnosed with "hypochondriasis". What disorder would she be diagnosed with today?

A) blood-injection-injury disorder
B) somatic health disorder
C) illness anxiety disorder
D) persistent health delusional disorder

Question 12

What is the common aspect of all somatoform disorders?

A) a pathological belief that one's appearance is ugly
B) a pathological concern with appearance or functioning of the body
C) a pathological concern with the meaning of a physical pain
D) a pathological belief that a serious medical condition will cause death

Question 13

Which of the following is NOT a learning experience of those with illness anxiety disorder?

A) being rewarded by parents when expressing bodily concerns
B) observing parents express concern about bodily symptoms
C) having a relative who is a health care worker
D) being instructed that bodily concerns are dangerous

Question 14

Which of the following predicts the development of illness anxiety disorder?

A) never experiencing true illness as a child
B) having suicidal thoughts or past family history of suicide
C) a major depressive episode
D) realizing the benefits of being the ill person

Question 15

What is another name for somatic symptom disorder?

A) Briquet's syndrome
B) Munchausen syndrome by proxy
C) imagined ugliness
D) koro

Question 16

Gisele has somatic symptom disorder.Which of the following MOST likely describes Gisele?

A) she has schizophrenia
B) she has illness anxiety disorder
C) she is unmarried
D) she is wealthy

Question 17

Illness anxiety disorder is essentially an emotional disturbance.What triggers it?

A) dysfunctional family interactions
B) misinterpretation of mostly normal physical sensations
C) physical pathology
D) misinterpretations of severe or unusual physical sensations

Question 18

What is the meaning of the word "soma"?

A) fantasy
B) demonic
C) illness
D) body

Question 19

Joe just ate six chili-dogs and drank a litre of soda.If Joe had illness anxiety disorder,how would he probably interpret any resulting stomach discomfort?

A) as yet another sign of numerous vague, chronic "infections" that have plagued him for years, which no one seems to be able to properly diagnose
B) as a sign that something is probably seriously wrong with his stomach, and he would calmly phone in "sick" to work
C) as a sign that something is seriously wrong with his stomach and, feeling very anxious, he would immediately call his doctor
D) as a sign that someone is trying to poison him

Question 20

If Jane has illness anxiety disorder,how frequently can we expect her to see her physician and how will she feel as a result of these visits?

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

Question 21

Fred has been having seizures,but tests show no known cause.What is the most likely diagnosis for Fred?

A) conversion disorder
B) malingering
C) illness anxiety disorder
D) dissociative disorder

Question 22

A person who is blind but has no underlying cause for their blindness may be suffering from which of the following?

A) conversion disorder
B) illness anxiety disorder
C) detachment disorder
D) dissociative disorder

Question 23

Susan has a sick daughter who has been in and out of hospital four times in the last six months,but no cause for her illnesses can be found.At first,the doctors suspect that Susan may have Munchausen syndrome by proxy,however,Susan exhibits a behaviour that contradicts that diagnosis.What is that behaviour?

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

Question 24

Jake has somatic symptom disorder,his brother Kyle has a disorder that is often observed in family members of people with somatic symptom disorder.What disorder does Kyle most likely have?

A) body dysmorphic disorder
B) illness anxiety disorder
C) antisocial personality disorder
D) panic disorder

Question 25

Anne feels as though she has a lump in her throat,but the doctors can find no obstructions.What diagnosis is a psychiatrist most likely to give Anne?

A) la belle indifférence
B) globus hystericus
C) echerichia coli
D) malingering

Question 26

Martin wants to help his wife,Joann,with her somatic symptom disorder.So he asks his friend Joe,who is a psychiatrist,for help.Joe tells Martin the best therapy for Joann is:

A) hypnosis
B) Prozac
C) traditional psychotherapy
D) cognitive behavioural therapy

Question 27

Somatic symptom disorder and antisocial personality disorder share several features; for example,they are both associated with lower socioeconomic status.What other feature is common to both disorders?

A) drug and alcohol abuse
B) being male
C) suicide attempts
D) legal problems

Question 28

Vince has been under a lot of stress.One morning he awakens to find he is totally blind.At his physician's office,Vince says he is upset by the loss of his eyesight,but he appears to be totally calm.Which of the following can best explain Vince's lack of emotional reaction?

A) malingering
B) la belle indifférence
C) emotional compensation
D) Munchausen syndrome

Question 29

Frank complained to his doctor that he had weakness in his legs and difficulty keeping his balance,with the result that he fell frequently.Medical examinations revealed no physical problems.What is this type of conversion symptom called?

A) globus hystericus
B) aphasia
C) aphonia
D) astasia-abasia

Question 30

Which of the following is classified as a somatoform disorder?

A) derealization
B) conversion disorder
C) dissociative disorder
D) hysterical disorder

Question 31

Dr.Banks has chosen a treatment for Amy's illness anxiety disorder based on its proven effectiveness. Which treatment did she most likely select?

A) operant conditioning
B) cognitive-behavioural treatment
C) emotional restructuring
D) psychosurgery

Question 32

Kelly shows up at an emergency room demanding immediate treatment for bleeding and abdominal cramps.Later,hospital workers find evidence that Kelly injected herself with a blood thinner to cause the bleeding and then she faked the cramps just to gain admission to the hospital.Kelly denies everything and leaves the hospital to find someone who will "treat me properly!" What condition does?Kelly most likely have?

A) illness anxiety disorder
B) Munchausen syndrome
C) conversion disorder
D) somatization disorder

Question 33

Which of the following characterizes the disorder Munchausen syndrome by proxy (or factitious disorder by proxy)?

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

Question 34

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

A) the ability to identify everything in the visual field even though the patient reports that she is blind
B) great concern with the loss of function and belief that it is a symptom of a potentially fatal disease
C) the ability to avoid walking into things even though he reports being unable to see anything
D) the ability to see some bright objects when calm, but suffering complete loss of sight during a stressful period or emergency

Question 35

Somatization disorder and antisocial personality disorder are often associated with gender.Which of the following best describes this relationship?

A) Somatization disorder is more common among males, and it reflects high dependency.
B) Somatization disorder is more common among females, and it reflects high dependency.
C) Somatization disorder is more common among males, and it reflects high aggression.
D) Somatization disorder is more common among females, and it reflects high aggression.

Question 36

Joel has both somatic symptom disorder and antisocial personality disorder,and his psychiatrist explains that this makes sense because both involve:

A) genetic defects and poor nutrition
B) poor modelling by parents and other authority figures
C) parental psychopathology
D) pleasure seeking and impulsivity

Question 37

Which of the following individuals possesses the most characteristics associated with somatic symptom disorder?

A) Clarissa, a 17-year-old female described as impulsive
B) Nirmala, a 10-year-old female described as impulsive
C) James, a 16-year-old male described as emotionally dependent
D) Marco, a 45-year-old male described as extremely emotionally sensitive

Question 38

When do conversion disorder symptoms generally appear?

A) following a death
B) following a period of depression.
C) shortly after a distressing physical injury
D) following a serious illness

Question 39

Andrew tells Paul that he has been diagnosed with globus hystericus? What symptom did Andrew most likely complain about to his doctor?

A) blurred vision
B) the sensation of a lump in his throat
C) unexplained lumps all over the body
D) generalized numbness

Question 40

Doctors suspect that Allen has somatic symptom disorder.What symptoms is Allen most likely displaying?

A) problems with his sensory-motor systems.
B) problems with his cognitive functioning.
C) problems with his digestive system.
D) problems regulating emotions under stress.

Question 41

How did Freud explain conversion disorder?

A) He argued that people with the disorder had converted unconscious conflicts into defence mechanisms expressed as physical symptoms.
B) He argued that people with the disorder experienced real physical illness as a result of internal conflict.
C) He argued that people with the disorder experienced physical symptoms as a result of the superego.
D) He argued that people with the disorder converted unconscious conflicts into physical symptoms.

Question 42

Darren was in a fugue state for six months.What did he likely do in that six months?

A) travelled, assumes a new identity while remembering who he really was
B) felt compelled to travel but did not experience memory loss
C) experienced memory loss and identity confusion, but did not travel
D) travelled, experienced memory loss, and experienced identity confusion

Question 43

Which of the following disorders is most likely to involve self-injury?

A) malingering
B) factitious illness disorder
C) illness anxiety disorder
D) conversion disorder

Question 44

In their study of individuals suffering from depersonalization,what did Charbonneau and O'Connor (1999)find in the majority of cases?

A) The age of onset was in the 20s.
B) Onset occurred following a traumatic life event, sexual abuse, or giving birth.
C) These individuals eventually developed symptoms of schizophrenia.
D) There were additional dissociative disorders.

Question 45

Rebecca has depersonalization derealization disorder.Which of the following complaints will Rebecca MOST likely report to her doctor?

A) memory loss
B) detachment
C) an inability to compare their own experience to reality
D) hallucinations

Question 46

Ian is experiencing dissociation.Before this problem occurred,Ian was healthy and well-adjusted.What likely happened in Ian's recent past?

A) a minor illness
B) an episode of binge drinking
C) an extremely stressful event
D) a period of major depression

Question 47

What research evidence contradicted Freud's explanation of the cause of conversion disorder?

A) Conversion disorder patients display la belle indifférence.
B) There is great variability in the amount of concern that conversion disorder patients display regarding their symptoms.
C) La belle indifférence is a myth, and few patients show it.
D) Conversion disorder patients actually are quite concerned with their symptoms.

Question 48

While driving alone in her car,Sally suddenly looks around and,for a moment,she can't remember where she is,how she arrived at this point on the road,or even why she is driving her car.What is Sally experiencing?

A) neurotic distortion
B) derealization
C) depersonalization
D) early onset psychosis

Question 49

What is the main difference between a dissociative fugue and dissociative amnesia?

A) Fugue involves travel; dissociative amnesia does not necessarily involve travel.
B) Fugue states are the result of trauma; dissociative amnesia is the result of guilty feelings.
C) Fugue states are associated with anxiety; dissociative amnesia is not.
D) Memories return after a fugue state but not after an occurrence of dissociative amnesia..

Question 50

Which of the following provides evidence for the influence of social and cultural factors in conversion disorder?

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

Question 51

Jenna,a recently married young woman,described episodes of "spacing out." During these episodes,she feels as if she is observing herself from outside of her body.Her experiences seem "dream-like," and she reports feeling completely separated from what is going on around her.What diagnosis best fits Jenna's symptoms?

A) stress associated with being newly married
B) post-traumatic episodes
C) detachment disorder
D) depersonalization disorder

Question 52

Tracey has localized amnesia,what does she likely have no memory of?

A) events prior to a trauma
B) anything, including who she is
C) events following a trauma
D) selective events, particularly those involving trauma

Question 53

When would Paul be most likely to be diagnosed with a somatic symptom disorder with predominant pain?

A) if he is convinced that he has a serious illness because of the pain experienced
B) if he has physical reasons for pain but psychological factors play a major role as well
C) if he has physical reasons for pain, but knowingly exaggerates the pain to gain sympathy, attention, or some other benefit
D) if he has an unrealistic fear of experiencing pain or discomfort

Question 54

Which of the following is important when treating conversion disorder?

A) removing any benefits that patients receive for limitations imposed by the disorder
B) applying a strict behavioural program that includes reinforcement for each display of progress and punishment when necessary
C) conducting an in-depth exploration of psychological conflicts concerning the patient's relationships
D) regressing the patient to the early stages of psychosexual development, where the conflicts originated

Question 55

In dissociative amnesia,memory loss can be partial or total.How long does it generally last?

A) It is permanent.
B) It lasts a fleeting moment.
C) It is brief.
D) It can be temporary or lifelong.

Question 56

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

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

Question 57

Why is it difficult to describe effective treatments for conversion disorder?

A) Extensive research has found drugs work for some patients while cognitive-behavioural therapy works for others.
B) Extensive research has found that there are no effective treatments for the disorder.
C) Research in the 1970s suggested drug treatments worked; however, recent research suggests that drug treatments do not work.
D) There have been very few systematic, controlled studies evaluating treatment.

Question 58

In the absence of any physical trauma to the brain or drug intoxication,what is the most likely cause of sudden loss of ability to recall important personal information?

A) depersonalization disorder
B) dissociative fugue
C) dissociative amnesia
D) retrograde amnesia

Question 59

Gail tells Bill that she has experienced dissociation before and goes on to describe it in detail.What sorts of experiences did Gail likely describe to Bill?

A) numbness in her hands
B) extreme withdrawal from the external world
C) experiencing gross misrepresentations of external reality
D) feeling detached from herself and her surroundings

Question 60

In 2003,Kenneth Mackay was convicted of murdering Crystal Paskemin in Saskatoon.Although he admitted to having run over the victim with his truck,which he claims was an accident,his defence lawyer argued that Mackay had no memory of burning the victim's body because of the trauma of the accident.What did a memory expert testify in court that Mackay might have suffered?

A) a dissociative fugue state
B) dissociative amnesia
C) an episode of extreme depersonalization
D) a dissociative trance state

Question 61

What is the average length of time between an individual's first symptoms of dissociative identity disorder and the identification and diagnosis of the disorder by a professional?

A) less than a month
B) one year
C) seven years
D) 20 years

Question 62

If left untreated,what course does dissociative identity disorder usually take across the life span?

A) Its form does not change substantially, but the frequency of switching increases with age.
B) The natures of the alter personalities change as the person ages, but the number of them stays about the same.
C) The number of alter personalities stays about the same, but the host personality becomes increasingly aggressive.
D) Its form does not change substantially, but the number of alter personalities increases substantially.

Question 63

What happens during interpersonality amnesia?

A) Specific events experienced by one personality are remembered only by that personality and not others.
B) Some alter personalities have total recall of past events, whereas some other personalities have only partial recall of past events.
C) Traumatic events experienced by one personality are remembered only by that personality and not others.
D) Specific events experienced by one personality are not remembered by that personality but are recalled by alter personalities.

Question 64

Dr.Arnold follows the sociocognitive explanation of alter personalities in dissociative identity disorder.Which statement would Dr.Arnold most like make about the development of alters?

A) "The creation of alters is directly influenced by dysfunctional patterns of family communication."
B) "The creation of alters is the result of hypnotically inserted (false) memories."
C) "The creation of alters is the result of social reinforcement by the therapist."
D) "The creation of alters are consciously and voluntarily simulated by suggestible individuals."

Question 65

What do we call the model that suggests that most symptoms of dissociative identity disorder can be accounted for by therapists who inadvertently suggest the existence of alters to suggestible individuals?

A) the observational learning model
B) the psychosocial model
C) the sociocognitive model
D) the therapeutic induction model

Question 66

Sue has dissociative identity disorder.What does she most likely also have?

A) depression
B) at least one other psychological disorder
C) antisocial personality disorder
D) a history of problems with the law

Question 67

Pat has dissociative identity disorder and lives with her parents.Her parents observe her "switch" from one personality to another on a regular basis.How do her parents describe the "switches"?

A) "They are usually instantaneous."
B) "They are subtlety done by the host personality."
C) "They usually occur at the will of the original personality."
D) "They are usually gradual."

Question 68

According to Ross (1997)and others,what is the average number of alter personalities (i.e.,in addition to the original personality)in individuals with dissociative identity disorder?

A) 5
B) 15
C) 25
D) 50

Question 69

What is the nature of an alter personality?

A) It is usually distinct from the person's host personality.
B) It is usually partially similar to the person's host personality.
C) It is usually the opposite of the host personality in every way.
D) In some people it is distinct; in other people it is partially similar to the host personality.

Question 70

Dr.Little has a new patient who has just developed dissociative identity disorder.Which of the following people is most likely Dr.Little's patient?

A) a 13-year-old girl
B) a 9-year-old girl
C) a 3-year-old girl
D) a 17-year-old girl

Question 71

During a dissociative fugue state,which of the following is it NOT uncommon for individuals to do?

A) take on a new identity
B) speak in a different tone of voice and use different physical gestures than they did previously
C) commit suicide
D) brutally assault people

Question 72

Cathy claims to have 16 different personalities,each with its own unique traits and memories,living inside her.If her claims are accurate,what condition is she most likely suffering from?

A) dissociative depersonalization
B) dissociative identity disorder
C) dissociative fugue
D) dissociative trance disorder

Question 73

In dissociative identity disorder,who is usually the first personality to seek treatment?

A) the person's original personality
B) someone other than the person's original personality
C) the most aggressive personality
D) the first alter personality to develop

Question 74

In the "Hillside Strangler" case,what did Kenneth Bianchi claim to be suffering from?

A) dissociative identity disorder
B) dissociative trance disorder
C) dissociative fugue
D) dissociative derealization

Question 75

Angie has dissociative identity disorder (DID).What is most likely part of Angie's history?

A) drugs and alcohol abuse
B) delusions
C) child abuse
D) a family history of DID

Question 76

What is the main reason that dissociative identity disorder (DID)patients tend to have many additional psychological disorders?

A) The more personalities associated with the DID, the more additional disorders will develop.
B) Most DID patients abuse drugs and alcohol, which leads to other disorders.
C) Most have suffered horrible child abuse, which leads to many problems in later life.
D) They appear to have an extreme genetic vulnerability to psychopathology.

Question 77

What sort of sexual behaviour do "alters" exhibit?

A) They rarely have sexual relationships.
B) They usually have sex more frequently than the host.
C) They will have sexual relationships if it is beneficial to the host personality for them to do so.
D) There is no set pattern of sexual activity in alters.

Question 78

With regard to dissociative identity disorder,what does the term "alter" mean?

A) the most complete personality, apart from the original personality
B) the most dominant of the personalities
C) a different personality from the original personality of the individual
D) the ability to switch to other personalities at will

Question 79

In dissociative identity disorder,what is the "host" personality?

A) It is usually the one that "nurtures" the other personalities.
B) It is usually the one that is the most frequently seen of the personalities.
C) It is usually the one that is the most aggressive of the personalities.
D) It is usually the one that asks for treatment and becomes the patient.

Question 80

Mary,who is 40,appears to believe she is a 20-year-old woman.Suddenly,however,she starts to speak and behave very differently,and says she no longer thinks of herself as "Mary." Instead,she claims to be Elise,a 10-year-old child.What has Mary most likely just experienced?

A) an alter trance
B) a switch
C) a conversion reaction
D) a host reaction