Conversion Disorder
How long do symptoms from conversion disorder take to resolve?
Within a few weeks and only 20% have a relapse within a year
Whats another name for factious disorder?
Muchanusen syndrome
Muchanusen by proxy (Caused by a family member or care giver)
What is dissociative fugue?
(ACUTE)Sudden unexpected travel away from customary places or by bewildered wandering with inability to recall some/all one's past
Define depersonalization
Disturbance in the preception of ones self
What are 3 predisposing factors for Depersonalization-derealization disorder.
neuroanatomical brain impairment
Pain
Psychosocial impairment???(Mr labowitz study guide had the ? lol)
What is conversion disorder?
A loss or change in body function that cannot be explained by any known medical disorder or pathophysiological mechanism
Is factitious disorder intentional or unintentional?
Intentional... Pt pretends to be ill to receive emotional care and support commonly associated with the role of the "patient"
What is Dissociate identity disorder also known as?
Multiple personality disorder (split into multiple personalities to protect themselves)
Who is Depersonalization-derealization disorder more prevalent in?
Women
What is psychodynamic theory?
Ego defense mechanism a low self esteem, feeling of worthlessness
Define Anosmia
Inability to perceive smell
Define suppression
Voluntary avoidance
Define dissociation
Unconscious defense mechanism in which there is separation of identity, memory, and cognition from affect
What is derealization
Alteration in perception of external environment
-defined as a disturbance in perception of ones self
-Schizo, depression, NCD, anxiety
What learning theory is for primary gain?
Learning theory: Somatic complaints are often reinforces when the sick person learns they:
-May avoid stressful obligations or be excused from unwanted duties (PRIMARY GAIN)
What are some things you will see in a person with conversion disorder? (symptoms affecting voluntary motor or sensory functioning suggestive of neurological disease)
Paralysis, seizures, coordination disturbances, difficulty swallowing, urinary retention, akinesia, blindness, deafness
What is localized amnesia?
individual unable to recall ALL incident associated with a stressful event or event
What is dissociative identity disorder most commonly mistaken for?
depression, borderline and antisocial, schizo, epilepsy or bipolar
Are children at risk for Depersonalization-derealization disorders?
YES! Younger ages
What learning theory is for secondary gain?
Learning theory: Somatic complaints are often reinforces when the sick person learns they:
-May become the prominent focus of attention because of the illness. A shifting focus onto self (SECONDARY GAIN)
Define Aphonia
Define repression
unconsciously avoiding/forgetting things-involuntary avoidance
What is some things you'll see in a child with dissociative identity disorder?
increased anger or violent behavior
-Could be caused by physical or sexual abuse
What populations are at higher risk for Depersonalization-derealization disorder?
Military personnel, Lower socioeconomic status, rural populations, less educated
What learning theory is for tertiary gain?
Learning theory: Somatic complaints are often reinforces when the sick person learns they:
-May relieve conflict within family as concern is shifted to the ill person and away from the real issue (TERTIARY GAIN)
What is a nursing intervention you will do for these patients?
Give praise when they come to the realization of their disorder
What is selective amnesia?
Individual can recall ONLY certain incidents associated with a stressful event or a specific period after an event
What is the onset like with dissociative identity disorder?
Can be sudden, gradual or quite dramatic transitions
What medication will you give for Depersonalization-derealization disorder?
Antidepressants- clomipramine(Anafranil)
Why would a child manifest illness?
to possibly make parents stop fighting constantly
Nursing care for a patient with conversion disorder
Deal with physical symptoms a detached manner to avoid reinforcing SECONDARY GAIN!
What is generalized amnesia?
Individual has amnesia for their identity and total life history
-If they can answer 2 or 3 A/O questions full out generalized amnesia
-Ask A/ questions if they have experiences any trauma or or hx of memory problems
What disorder is dissociative identity disorder commonly seen in?
Schizo affective
(You need another medical disorder for it to be considered schizo affective not regular schizo)
What are some symptoms with Depersonalization-derealization disorder?
Anxiety, depression, fear of going insane, obsessive thoughts, somatic complaints, disturbance in subjective sense of time
What happens when a child becomes ill? What level of the learning theory is this?
Focus shifts from open conflict to the Childs illness and leaves unresolved underlying issues that the family is unable to confront openly (Tertiary gain)
What are some symptoms you may see with psychological stress in a person with conversion disorder?
Double vision, aphasia, seizures, inability to feel pain, hallucinations, pseudocyesis (FAKE pregnancy)
Define dissociative amnsia
Inability to recall important PERSONAL information that is too extensive to be explained by ordinary forgetfulness.
What is the primary therapeutic goal with dissociative identity disorder?
Collaborate among subpersonalities to improve functioning
What is illness anxiety disorder?
Past experience with serious to life threatening physical grief and you start to thing you have it to (hypochondriac)