Understanding Dissociative Identity Disorder: Key Facts

MULTIPLE CHOICE 1 : Which the following is classified as a somatic symptom or related disorder? A : Obsessivecompulsive disorder B : Illness anxiety disorder C : Dissociative identity disorder D : Body dysmorphic disorder Correct Answer : B 2 : The common aspect of all somatic symptom disorders is a set of A : irrational beliefs about supernatural influences on ones health. B : irrational judgments of ones own physical attractiveness. C : excessive or maladaptive responses to physical symptoms or to associated health concerns. D : excessive or maladaptive responses to pain only. Correct Answer : C 3 : Illness anxiety disorder is present when A : normal bodily sensations are interpreted by the patient as a sign of a serious illness. B : real physical illness is exaggerated to the point where the patient can only focus on the pain. C : the patient has an unrealistic fear of contacting germs. D : the patient is truly ill but does not trust the medical establishment enough to seek treatment. Correct Answer : A 4 : Shelley experiences persistent feelings of detachment from herself, as if she were observing herself from outside her body. The experience is so intense that she often has trouble remembering who she is and functioning in a coherent manner. Shelley most likely suffers from A : severe anxiety attacks. B : a dissociative disorder. C : persistent depression. D : illness anxiety disorder. Correct Answer : B 5 : Joe just ate six chilidogs and drank a liter of soda. If Joe suffers from illness anxiety disorder, he would probably interpret any resulting stomach discomfort as A : his own fault for eating so much. B : the result of poor quality food. C : gas pains from overeating. D : a sign that something is seriously wrong with his stomach. Correct Answer : D 6 : Since Jane suffers from illness anxiety disorder, we can expect her to see her physician A : often and feel completely reassured that there is nothing wrong with her health. B : rarely but continue to believe that she is quite ill. C : almost never because she does not trust physicians. D : often but continue to be anxious about her health anyway. Correct Answer : D 1 / 20 7 : 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. Most likely Jill would be diagnosed with A : generalized anxiety disorder. B : illness anxiety disorder. C : a specific phobia of germs. D : body dysmorphic disorder. Correct Answer : B 8 : With regard to a diagnosis of illness anxiety disorder, women are A : as equally likely as men to be diagnosed. B : less likely than men to be diagnosed. C : more likely than men to be diagnosed. D : more likely than men to be diagnosed during middle to late adulthood, but no more likely than men to be diagnosed during teen years and early adulthood. Correct Answer : A 9 : Illness anxiety disorder is also known as (and previously listed in the DSM as) A : hypochondriasis. B : illness psychosis. C : fictitious disorder. D : dissociation. Correct Answer : A 10 : All of the following have been implicated in the development and maintenance of somatic symptom disorders EXCEPT A : the additional attention one receives when sick. B : a specific hypochondriac gene. C : the high incidence of disease in the family during the hypochondriacs childhood. D : stressful life events. Correct Answer : B 11 : A main difference between somatic symptom disorder and illness anxiety disorder is A : somatic symptom disorder has a real medical basis and illness anxiety disorder does not. B : somatic symptom disorder is heritable and illness anxiety is not. C : somatic symptom disorder is associated with physical exacerbation of real symptoms, whereas illness anxiety disorder is associated with distorted beliefs about normal bodily function. D : none; the two terms refer to the same disorder in DSM-5. Correct Answer : C 12 : Somatic symptom disorder and illness anxiety disorder have all of the following in common EXCEPT A : they are both outdated terms that are no longer officially part of the DSM. B : they are both associated with frequent visits to the doctor. C : disease conviction is a core feature of both disorders. D : for both, the essential problem is anxiety. 2 / 20 Correct Answer : A 13 : With regard to the treatment of illness anxiety disorder, some research supports the use of A : classical conditioning and operant conditioning. B : psychoanalysis. C : cognitive-behavioral treatment and stress management. D : humanistic therapy. Correct Answer : C 14 : Concerning one recent study of selective serotonin reuptake inhibitor treatments for illness anxiety disorder, the most accurate statement among the following is that A : they are effective. B : they are not effective. C : they appear to be effective, as does CBT, but only CBT was significantly different from a placebo condition. D : neither the drug treatment nor CBT was found to be significantly more effective than a placebo condition. Correct Answer : C 15 : Which of the following is NOT a part of cognitive-behavioral therapy for illness anxiety disorder in Barsky and Aherns 2005 clinical trial? A : Reassurance to the patients that their symptoms did not reflect a serious illness B : Identifying and challenging illness-related misinterpretations of physical sensations C : Purposely creating symptoms by focusing attention on certain body areas D : Coaching on seeking less reassurance regarding patients illness concerns Correct Answer : A 16 : The cause for somatic symptom and related disorders is most likely A : biological. B : psychological. C : stressful life events. D : all of these are correct. Correct Answer : D 17 : Which of the following are typical characteristics of patients with illness anxiety disorder? A : Female and from lower socioeconomic groups B : Female and sexually conservative C : Male and impulsive D : Male and aggressive Correct Answer : A 18 : Which of the following statements is true with regard to the treatment of somatic symptom disorders? A : Cognitive-behavioral treatment has been demonstrated in several studies to be a very effective treatment. B : It is relatively easy to treat as long as the patient is willing to participate in therapy. C : Primary care physicians can usually treat patients by educating and reassuring patients. 3 / 20 D : They are difficult to treat and there are no treatments with proven effectiveness. Correct Answer : A 19 : Psychological factors affecting other medical conditions is considered A : a somatic symptom disorder. B : the cause for conversion disorder. C : the result of conversion disorder. D : an archaic term for illness anxiety. Correct Answer : A 20 : Kyop goeu, or __________________, is an example of a culture-bound somatic concern found in the Khmer people of Cambodia. A : a feeling of wind overload B : fear losing semen C : fear of genital retraction D : a sensation of something crawling in the head Correct Answer : A 21 : Functional neurological symptom disorder is associated with which disorder in the DSM-5? A : Conversion disorder B : Illness anxiety disorder C : Somatic symptom disorder D : None of these are correct Correct Answer : A 22 : Loss of physical functioning without any physical cause is most likely a case of A : conversion disorder. B : illness anxiety disorder. C : somatic symptom disorder. D : none of these are correct. Correct Answer : A 23 : Serena has completely lost the use of her right arm during the past year, but medical experts can find no physical reason for her paralysis. This could be an example of A : somatic symptoms disorder. B : illness anxiety C : conversion disorder. D : dissociative disorder. Correct Answer : C 24 : Min has been experiencing repeated seizures, but none of the neurologists he has visited could find any abnormal EEG activity. He is likely exhibiting a case of A : psychogenic nonepileptic seizures. B : globus hystericus. C : aphonia. D : dissociative disorder. 4 / 20 Correct Answer : A 25 : Historically, hysteria was thought to be the result of a A : dysfunctional ovary. B : tense vagina. C : wandering uterus. D : flip-flopped fallopian tubes. Correct Answer : C 26 : Conversion disorder patients were conceptualized by Freud as A : converting unconscious conflicts into physical symptoms. B : converting unconscious conflicts into defense mechanisms. C : experiencing physical symptoms as a result of the superego. D : experiencing internal conflicts as a result of physical illness. Correct Answer : A 27 : Conversion disorder symptoms generally appear A : out of the blue. B : following a physical injury to the affected area. C : following a traumatic event. D : in women with repressed sexuality. Correct Answer : C 28 : Which of the following would be typical for a patient suffering from a conversion disorder? A : Ability to avoid walking into things even though the patient reports being unable to see anything B : Ability to see some bright objects when calm but suffering complete loss of sight during a stressful period or emergency C : Performance far below average when asked to name objects in the visual field when the patient reports blindness D : Ability to name everything in the visual field even though the patient reports blindness Correct Answer : A 29 : Difficulty speaking without any physical or organic pathology is known as A : hysteria. B : malingering. C : aphonia. D : la belle indifference. Correct Answer : C 30 : Which of the following statements is correct regarding diagnosing a patients symptoms as a conversion disorder? A : It is quite apparent when a patient is malingering (faking), but it is difficult to determine whether symptoms are due to real physical disorders or a conversion disorder. B : It is quite apparent when a symptom is due to a real physical disorder, but it is impossible to determine the difference between a conversion disorder and patient malingering (faking). C : It is very difficult to determine whether symptoms are due to malingering (faking), real physical disorders, or a conversion disorder. 5 / 20 D : The act of diagnosing a conversion disorder can sometimes immediately alleviate the symptoms. Correct Answer : C 31 : Globus hystericus, a common conversion disorder symptom, is the sensation of a A : pain in the neck. B : swollen kidney. C : lump in the throat. D : lump in the breast. Correct Answer : C 32 : Which of the following statements is true about factitious disorders? A : Patients are usually revealed to be harboring a reason for malingering B : The symptoms are uncontrollable. C : There is no obvious reason for voluntarily producing symptoms. D : All of these are correct Correct Answer : C 33 : An example of factitious disorder imposed on another is A : deliberate actions directed toward making a child sick. B : a parent lying to a doctor, for example, saying that the child has had symptoms that never really existed. C : a parent developing the same symptoms that the child exhibits. D : convincing a child to lie to a doctor about factitious symptoms. Correct Answer : A 34 : Factitious disorders are a set of conditions that A : fall somewhere between malingering and conversion disorders. B : are completely under voluntary control like malingering. C : are a manifestation of physical symptoms mostly due to anxiety. D : are one form of typical child abuse. Correct Answer : A 35 : Parents suspected of facetious disorder imposed on another (Munchausen syndrome by proxy) show all of the following typical behaviors EXCEPT A : helping medical staff to discover the true nature of the childs illness. B : developing a positive relationship with medical staff. C : appearing extremely concerned and caring toward the child. D : purposefully making the child sick. Correct Answer : A 36 : In factitious disorders, the patient A : voluntarily makes up symptoms with no apparent motivation. B : is unaware that he or she is making up symptoms. C : truly experiences symptoms with no apparent physical cause. D : makes up symptoms in an effort to avoid work or to receive some other benefit. 6 / 20 Correct Answer : A 37 : According to your textbook, in some religious groups, seizures, paralysis, and trances are often seen as evidence of A : an increased power to cause natural disasters. B : contact with a loved one who has passed away. C : contact with God. D : none of these are correct Correct Answer : C 38 : The modern view of the causes of conversion disorder is A : completely different from Freuds ideas of the etiology of this disorder. B : somewhat similar to the causes that Freud described for this disorder. C : a combination of genetic predisposition and neurobiological trauma. D : based on social learning theory. Correct Answer : B 39 : Which of the following is NOT an accurate statement regarding conversion disorder symptoms? A : They uniquely belong to Western culture. B : They are common aspects of some religious/healing rituals. C : They do not constitute a disorder unless they persist and interfere with an individuals functioning. D : Some individuals who exhibit them are held in high esteem because they are sometimes seen as contact with God. Correct Answer : A 40 : With regard to la belle indifference (the observation that conversion disorder patients are not concerned about their symptoms), research suggests that A : conversion disorder patients display uncommonly high levels of concerns about their physical loss. B : Freuds explanation is essentially correct. C : conversion disorder patients show no difference in the distress over symptoms than those with organic disease. D : la belle indifference is an accurate description of the lack of concern about their physical loss in conversion disorder patients. Correct Answer : C 41 : Evidence for the influence of social and cultural factors in conversion disorder includes the fact that conversion disorder A : is almost exclusively experienced by women. B : is being diagnosed more frequently in our society. C : tends to occur in lower socioeconomic groups where there is less medical knowledge. D : tends to occur in wealthy areas where there is easy access to sophisticated medical tests. Correct Answer : C 42 : Freud called the reduction in anxiety by converting unconscious conflicts into physical symptoms 7 / 20 A : primary narcissism. B : secondary narcissism. C : primary gain. D : secondary gain. Correct Answer : C 43 : In treating conversion disorder, which of the following statements is true? A : Clients respond well to CBT. B : Clients respond well to hypnosis. C : Clients respond well when hypnosis and CBT are combined. D : Clients do not respond well to any treatment. Correct Answer : A 44 : According to your textbook, which of the following statement is true about the treatment of conversion disorder? A : The principle treatment strategy for conversion disorder is to identify and attend to the traumatic or stressful life event. B : The use of medication is generally supported in the treatment of conversion disorder. C : Social support and attention are the most effective method of treatment for conversion disorder. D : In treating conversion disorder, Freudian methods to access the unconscious are the most effective. Correct Answer : A 45 : Your textbook authors describe a treatment plan for conversion disorder involving A : in-depth exploration of psychological conflicts. B : regression to the early psychosexual stages of development. C : application of a strict behavioral program that includes reinforcement for each display of progress and punishment when necessary. D : removal of any reinforcing or supportive consequences that patients receive for limitations imposed by the disorder. Correct Answer : D 46 : Dissociation is likely to happen A : after an extremely stressful or a traumatic event. B : when there is potential secondary gain. C : when there is primary gain. D : when a patient is malingering. Correct Answer : A 47 : The experience of dissociation occurs in A : psychotic disorders only. B : individuals with dissociative disorders only. C : only in those individuals who have experienced great personal trauma. D : certain psychological disorders but also in nondisordered people at times. Correct Answer : D 8 / 20 48 : In healthy, well-adjusted individuals, dissociation typically occurs following A : calm, reflective periods. B : participation in a group activity. C : reading or any activity that requires great concentration. D : stress or a traumatic event. Correct Answer : D 49 : Depersonalization is defined as A : altered perception including loss of the sense of ones own reality. B : altered perception involving loss of the sense of reality of the external world. C : vivid hallucinations. D : the feeling that one is no longer a person. Correct Answer : A 50 : Derealization is defined as A : vivid hallucinations. B : altered perception involving loss of the sense of ones own reality. C : altered perception involving loss of the sense of reality of the external world. D : the feeling that one is no longer a person. Correct Answer : C 51 : Brain imaging studies have found that depersonalization is associated with all of the following EXCEPT A : deficits in perception. B : deficits in emotion regulation. C : dysregulation in the HPA axis. D : dysregulation of the visual cortices. Correct Answer : D 52 : Jason 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. Joe is experiencing A : derealization. B : depersonalization. C : classic early psychosis symptoms. D : mania. Correct Answer : A 53 : While walking home from work, Jordan suddenly looks around and, for a moment, cant remember where he is, how he arrived at this point on the road, or even why he is walking. Jordan is experiencing A : derealization. B : depersonalization. C : the early stages of what will eventually become a severe psychotic disorder. D : symptoms of a mood disorder. Correct Answer : B 9 / 20 54 : The diagnosis of derealization-depersonalization disorder is A : often co-occurring with other disorders. B : quite rare and only applicable to those diagnosed with psychosis. C : fairly common, since many people experience derealization and depersonalization. D : fairly common and applied to anyone who is frightened by an experience of derealization or depersonalization. Correct Answer : A 55 : Anxiety, mood, and personality disorders are commonly found in individuals with A : depersonalization-derealization disorder. B : dissociative amnesia. C : somatic symptom disorder. D : conversion disorder. Correct Answer : A 56 : Many people experience feelings of unreality during an intense panic attack. People undergoing intense stress or experiencing a traumatic event may also experience these symptoms, which characterize the newly defined A : acute stress disorder. B : facetious disorder imposed on another. C : dissociative amnesia. D : conversion disorder. Correct Answer : A 57 : In dissociative amnesia, the individual typically has no memory of A : any events. B : events prior to a trauma. C : selective events or emotional tone attached to them, particularly those involving trauma. D : events following a trauma. Correct Answer : C 58 : People who do not remember anything, including who they are, are said to suffer from A : dissociative fugue. B : poor memory retrieval. C : general amnesia. D : dissociative identity disorder. Correct Answer : C 59 : While Alice is under hypnosis, she expresses strong emotions about being in a car accident that caused the death of her oldest son. When not under hypnosis, she expresses no emotion about the death of her oldest son when talking about the accident. This absence of emotion when not under hypnosis is characteristic of A : general amnesia. B : selective amnesia. C : depersonalization. D : derealization. Correct Answer : B 10 / 20 60 : In dissociative fugue, the term fugue relates to A : confusion. B : flight or travel. C : loss of consciousness. D : hallucination. Correct Answer : B 61 : During a fugue state, patients diagnosed with dissociative fugue A : travel and typically experience memory loss during their trip. B : travel involuntarily but do not experience memory loss. C : temporarily lose memory of who they are but are able to recover their sense of identity after the fugue state. D : permanently lose memory of who they are and seldom recover any sense of their own identity. Correct Answer : A 62 : During a dissociative fugue state, it is not uncommon for individuals to A : commit suicide. B : see the world as a strange and foreign place. C : take on a new identity. D : involuntarily contact friends and family. Correct Answer : C 63 : Fugue states usually end rather A : abruptly with recall of most of what happened. B : slowly over a long period of lingering in and out of a state of fugue. C : abruptly with no memory of what happened. D : slowly with no memory of what happened. Correct Answer : A 64 : ________ is a dissociative disorder that is not found in Western cultures and appears to have some similarities to dissociative fugue. A : Amok B : Exorcism C : Trance D : Voodoo Correct Answer : A 65 : In non-Western cultures, trance and possession are A : extremely rare. B : never considered a disorder. C : the most common forms of dissociative disorders. D : the rarest forms of dissociative disorders. Correct Answer : C 66 : Dissociative trances commonly occur in Nigeria where they are called 11 / 20 A : amok. B : phi pob. C : vinvusa. D : pivloktoq. Correct Answer : C 67 : African Americans from the South often refer colloquially to trance syndromes as A : phii pob. B : autohypnosis. C : frenzy witchcraft. D : falling out. Correct Answer : D 68 : Individuals with dissociative identity disorder generally A : take on only one other distinct personality. B : suffer a loss of their own identity that lasts several years. C : maintain complete awareness of all of their personalities. D : have several distinct personalities. Correct Answer : D 69 : The defining feature of dissociative identity disorder is that aspects of the individuals personality are A : fixated. B : completely suppressed. C : dissociated. D : dissociative disorders. Correct Answer : C 70 : With regard to dissociative identity disorder, the term alter refers to ________ within the individual. A : the host personality B : a dangerous personality C : the most recent personality to emerge D : a different personality Correct Answer : D 71 : In dissociative identity disorder, the host personality is usually the one that A : is the most aggressive of the personalities. B : asks for treatment and becomes the patient. C : earns income for the individual. D : is sexually provocative. Correct Answer : B 72 : Many dissociative identity disorder patients have at least one ________________ alter who handles sexuality and generates income, sometimes by acting as a prostitute. A : street savvy B : impulsive 12 / 20 C : criminal D : sexually aggressive Correct Answer : B 73 : In dissociative identity disorder, the host personality usually A : is of a gender opposite to that of the individual. B : becomes overwhelmed trying to hold all of the personality fragments together. C : is the leader of the multiple identities. D : is well aware of each personality and everything that happens while each personality is active. Correct Answer : B 74 : The existence of a cross-gendered alter in dissociative identity disorder is A : common. B : rare. C : present in every patient. D : almost never seen in this disorder. Correct Answer : A 75 : One aspect of the DSM-5 criteria for diagnosis of dissociative identity disorder is A : patient awareness of the distinct personalities. B : existence of three or more personality fragments. C : amnesia. D : history of abuse. Correct Answer : C 76 : Vanessa, who is 40, apparently believes that 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 Vanessa. Instead, she claims to be Elise, a 10-year-old child. It is likely that Vanessa has just experienced a A : switch. B : dissociative fugue. C : conversion reaction. D : manic episode. Correct Answer : A 77 : A switch A : usually occurs instantaneously. B : is the transition from one personality to another in dissociative identity disorder. C : may exhibit physical transformations. D : all of these are correct Correct Answer : D 78 : Which of the following statements is FALSE about dissociative identity disorder? A : Once established, the disorder lasts a lifetime without treatment. B : For prevalence rates, the ratio of females to males is approximately 9 to 1. C : The frequency of switching increases with age. 13 / 20 D : The form that the disorder takes does not differ substantially over the lifespan. Correct Answer : C 79 : The causes of dissociative identity disorder appear to be A : physical abuse. B : sexual abuse. C : witness to a traumatic event. D : all of these are correct Correct Answer : D 80 : Some theorists suggest that dissociative identity disorder is an extreme subtype of A : dissociative amnesia. B : obsessive-compulsive disorder. C : posttraumatic stress disorder. D : antisocial personality disorder. Correct Answer : C 81 : Which of the following statements is true about dissociative identity disorder (DID)? A : DID is easy to fake. B : DID is absolutely impossible to fake. C : Dissociative symptoms may be the result of sleep deprivation. D : DID is made up of false memories. Correct Answer : C 82 : The process of changing from one personality to another generally occurs ________ in most patients with dissociative identity disorder. A : slowly B : quickly C : rarely D : only after many warning signs that a change is about to occur Correct Answer : B 83 : Regarding evidence for the scientific validity of dissociative identity disorder, the most accurate statement is that A : most patients are faking. B : research suggests that faking dissociative experiences is possible. C : it is virtually impossible to fake the types of changes that occur in dissociative identity disorder. D : objective tests can always determine which patients are faking dissociative identity disorder. Correct Answer : B 84 : Comparisons of optical functioning in the various personalities of dissociative identity disorder patients show changes that would be A : easy to fake. B : absolutely impossible to fake. C : consistent with an individual who was trying to fake. D : difficult to fake. 14 / 20 Correct Answer : D 85 : Which of the following statements is the most accurate? A : While DID symptoms can be faked or developed through suggestion, many physiological changes observed in DID patients would be very difficult to fake. B : DID symptoms and the many physiological changes observed in DID patients can be developed through suggestion and are easily faked. C : While physiological changes associated with DID are relatively easy to fake, the symptoms of DID are very difficult to fake or to develop through suggestion. D : Almost all cases of DID are probably faked or developed through therapist suggestion. Correct Answer : A 86 : The average number of alters observed in individuals with dissociative identity disorder is A : 1. B : 2. C : 15. D : 100. Correct Answer : C 87 : Dissociative identity disorder is most commonly found in A : females. B : males. C : children. D : elderly. Correct Answer : A 88 : The average length of time between an individuals first symptoms of dissociative identity disorder and the identification and diagnosis of the disorder by a professional is A : one year. B : 20 years. C : less than one month. D : seven years. Correct Answer : D 89 : Without treatment, it is expected that dissociative identity disorder will last A : 10 years. B : a lifetime. C : several months. D : 20 years. Correct Answer : B 90 : Sue has dissociative identity disorder. It is extremely likely that she also has A : at least one other psychological disorder. B : a problem with her weight. C : a history of problems with the law. D : no desire to get better. 15 / 20 Correct Answer : A 91 : Semi-structured interviews of large numbers of severely disturbed inpatients found prevalence rates of DID in North America are between A : 15% and 17%. B : 10% and 14%. C : 7% and 9%. D : 3% and 6%. Correct Answer : D 92 : The main reason why dissociative identity disorder patients tend to have many additional psychological disorders is that A : the number of personalities increases the number of disorders. B : the severe trauma of childhood leads to many problems in later life. C : they seek attention. D : they are substance abusers. Correct Answer : B 93 : The common feature in almost every case of dissociative identity disorder is A : hallucinations and delusions. B : unrelenting substance abuse. C : a history of body dysmorphic disorder. D : a history of severe child abuse. Correct Answer : D 94 : Of the following, which child would be most likely to develop dissociative identity disorder later in life? A : Mary, who has a few good friends B : Susan, who was repeatedly sexually abused as a child C : Cindy, who has a learning disability D : Jody, who has attention-deficit hyperactivity disorder Correct Answer : B 95 : The experience of dissociation (feelings of unreality; blunting of emotional experience and physical pain) during or immediately following a life-threatening situation is A : a sign of psychopathology. B : extremely rare in nondisordered individuals. C : not well documented. D : a normal reaction. Correct Answer : D 96 : One of the individual differences that appears to help explain who is likely to develop dissociative identity disorder following childhood trauma is A : physical health. B : suggestibility. C : number of siblings. D : number of abusers. 16 / 20 Correct Answer : B 97 : In studies conducted by Elizabeth Loftus and her colleagues, individuals were told about false events that had supposedly occurred when they were children. The results of these studies indicate that A : people cannot be convinced of events that did not happen. B : people can become quite convinced of events that never happened. C : only individuals with diagnosable disorders can be convinced of events that never happened. D : people can become convinced of events that did not happen only during hypnosis or other dissociative states. Correct Answer : B 98 : Putname et al. (1986) examined 100 cases of dissociative identity disorder and found that _______% of the subjects had experienced significant trauma. A : 25 B : 53 C : 97 D : 100 Correct Answer : C 99 : The victims most likely to have amnesia as a result of trauma are those who A : suffered infrequent and relatively minor abuse. B : suffered frequent but relatively minor abuse. C : were victims of severe abuse and trauma. D : were victims of natural disasters. Correct Answer : C 100 : The general treatment plan for dissociative identity disorder patients usually centers on A : integration of the personality fragments. B : hypnotic regression of the host and each alter. C : confrontation of the abuser. D : the typical substance abuse treatment model. Correct Answer : A 101 : The part of the treatment plan for dissociative identity disorder that is similar to the treatment plan for posttraumatic stress disorder is A : integration of personality fragments through psychoanalysis. B : use of antipsychotic medications. C : reliving and reprocessing the trauma, similar to treatments for PTSD. D : hypnotic regression to early life experiences. Correct Answer : C ESSAY 102 : Compare and contrast illness anxiety disorder and somatic symptom disorder. 17 / 20 Correct Answer : Sample Answer: Somatic symptom disorder shares some features with illness anxiety disorder, including a history of family illness or injury during childhood. However, 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 of 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. 103 : Compare and contrast depersonalization and derealization. Correct Answer : Sample Answer: During an episode of depersonalization, your perception alters so that you temporarily lose the sense of your own reality, as if you were in a dream and you were watching yourself. During an episode of derealization, your sense of the reality of the external world is lost. Things may seem to change shape or size; people may seem dead or mechanical. These sensations of unreality are characteristic of the dissociative disorders because, in a sense, they are a psychological mechanism whereby one “dissociates” from reality. Depersonalization is often part of a serious set of conditions in which reality, experience, and even identity seem to disintegrate. 104 : Describe the subtype of dissociative amnesia referred to a dissociative fugue. Correct Answer : Sample Answer: Fugue literally means “flight.”In these curious cases, memory loss revolves around a specific incident—an unexpected trip (or trips). Mostly, individuals just take off and later find themselves in a new place, unable to remember why or how they got there. Usually they have left behind an intolerable situation. During these trips, a person sometimes assumes a new identity or at least becomes confused about the old identity. 105 : Vicki, who suffers from illness anxiety disorder (aka hypochondriasis), comes from a very concerned and loving family that takes her physical complaints quite seriously. Describe three treatment approaches (and their level of effectiveness) that may help Vicki get better. Correct Answer : Sample Answer: Clinical reports indicate that reassurance and education seem to be effective in some cases—“surprisingly” because, by definition, patients with illness anxiety disorder 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 18 / 20 was more effective after treatment and at each follow-up point for both symptoms of illness anxiety disorder 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 illness anxiety disorder. 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. 106 : Hannah was diagnosed with asthma six months ago. Presently, Hannah is experiencing a phobic response to her inhaler and is not using it to improve her asthma. Explain how this is an example of a somatic symptom-related disorder. Correct Answer : The essential feature of this disorder is the presence of a diagnosed medical condition, asthma, which is adversely affected by one or more psychological or behavioral factors. These behavioral or psychological factors would have a direct influence on the course or perhaps the treatment of the medical condition. In Hannah’s case, the pattern would have to be consistent in the neglect of appropriate monitoring and intervention, and the neglect is clearly a behavioral or psychological factor that is adversely affecting the medical condition. 107 : Elsas mother is poisoning her breakfast cereal. At least once a week Elsas mother takes her to a pediatrician, who is very consoling and empathetic. Despite efforts to determine why Elsa is sick, the pediatrician overlooks the possibility of Elsa being poisoned by her mother because he and his staff have a positive relationship with her mother. Correct Answer : The situation that Elsa is in with her mother shows an offending parent resorting to extreme tactics to create the appearance of illness in a child. Because her mother has established a positive relationship with the medical staff, the true nature of the illness is unsuspected and the staff members perceive her mother as remarkably caring, cooperative, and involved in providing for Elsa’s well-being. At the present time, Elsa’s mother is successful at eluding suspicion. 108 : Compare and contrast posttraumatic stress disorder and dissociative identity disorder. How are the two disorders similar? How are they different? Correct Answer : Sample Answer: DID seems similar in its etiology to PTSD. One perspective suggests that DID is an extreme subtype of PTSD, with a much greater emphasis on the process of dissociation than on symptoms of anxiety, although both are present in each disorder. While a sense of depersonalization or dissociation may be a symptom of PTSD, it would not be adequate for a diagnosis of DID because the other symptoms of a dissociative disorder would not be present. Some evidence also shows that the “developmental window” of vulnerability to the abuse that leads to DID closes at approximately nine years of age. After that, DID is unlikely to develop, although severe PTSD might. If true, this is a particularly good example of the role of development in the etiology of psychopathology. 109 : A 30-year-old woman recovers memories of childhood sexual abuse, the existence of which she was seemingly and previously unaware. Explain what is currently known about the accuracy of recovered memories. Can we determine whether these memories are accurate? Correct Answer : Sample Answer: A controversial issue in abnormal psychology involves the extent to which memories of early trauma, particularly sexual abuse, is really accurate or not. Some argue that these memories are simply the result of strong suggestions by therapists; others believe they reflect memories that were repressed and must be reexperienced to relieve 19 / 20 suffering. It turns out memory can be altered through suggestion, therefore the use of recovered memories legally has been especially problematic. Children in particular may be affected by how questions about past events are phrased. Further research is required to resolve these issues. 110 : Describe three ways that a person with a conversion disorder might differ from an individual with a biologically caused physical malfunction. Correct Answer : 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. Often, this stress takes the form of a physical injury. In one large survey, 324 out of 869 patients (37%) 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. 111 : Describe the treatment that is generally used to treat patients with dissociative identity disorder. What is the rationale for each part of the treatment? Correct Answer : Sample Answer: The strategies that therapists use today in treating DID are based on accumulated clinical wisdom. The fundamental goal is to identify cues or triggers that provoke memories of trauma, dissociation, or both and to neutralize them. More important, the patient must confront and relive the early trauma and gain control over the horrible events, at least as they recur in the patient’s mind. To instill this sense of control, the therapist must skillfully, and slowly, help the patient visualize and relive aspects of the trauma until it is simply a terrible memory instead of a current event. Because the memory is unconscious, aspects of the experience are often not known to either the patient or the therapist until they emerge during treatment. Hypnosis is often used to access unconscious memories and bring various alters into awareness. Because the process of dissociation may be similar to the process of hypnosis, the latter may be a particularly efficient way to access traumatic memories. (There is as yet no evidence that hypnosis is a necessary part of treatment.) DID seems to run a chronic course and seldom improves spontaneously, which confirms that current treatments, primitive as they are, have some effectiveness. 20 / 20