A diagnosis of dissociative identity disturbance has been ...

[hubes95]

A diagnosis of dissociative identity disturbance has been identified for a patient who has stated that he is unable to distinguish between himself and his surroundings. What is an appropriate outcome for this patient?
 
  a. Refers to himself as the patient
  b. Identifies the onset of increasing anxiety
  c. Uses manipulative behaviors to meet needs
  d. Displays ability to suppress feelings of dissatisfaction

Question 2

A patient reports severe pain during intercourse since being sexually assaulted three years ago. What is the first step in confirming the diagnosis of a pain disorder?
 
  a. Evaluating the patient's understanding of the emotional effects of the assault
  b. Asking the patient to keep a journal of her feelings regarding the assault
  c. Assessing the patient for posttraumatic stress disorder
  d. Ruling out a physical cause of the pain

[katheyjon]

Answer to Question 1

ANS: B
Dissociative identity disturbance is exacerbated when the patient's anxiety escalates. Identi-fication of increasing anxiety permits the patient to exercise anxiety-management strategies and prevent dissociation. The patient should be expressing such feelings to others. The pa-tient should refer to himself in the first person. Use of manipulative behavior is not desirable in this or any other patient.

Answer to Question 2

ANS: D
While psychological factors have an important role in the onset, severity, exacerbation, or maintenance of the pain, initially the presence of a physical cause of the pain must be ruled out. The assessment of the patient's understanding of the disorder or recording of feelings regarding the trauma are not priorities until a diagnosis of pain disorder is made. Posttrau-matic stress disorder is not generally characterized with reports of sustained pain.