Somatic/ Dissociative Disorders Flashcards
What is a somatic symptom?
Characterized by physical symptoms, suggesting medical disease, but without demonstrable organic pathology
Considered mental disorder, because excessive focus on physical symptoms is beyond any medical explanation, and it causes significant distress and impairment in one’s functioning
What is a dissociative disorder?
Defined by a disruption in the usual integration, functions of consciousness, memory identity
What is a dissociative response?
Occurs when anxiety becomes overwhelming in the personality becomes disorganized
What is the definition of dissociation?
An unconscious defense mechanism in which there is a separation of normally related mental processes, such as identity, memory recognition from affect the detachment of ideas and memories from events or experiences
What is somatic symptom disorder?
Syndrome of multiple somatic symptoms that cannot be explained by medically in associated with psychosocial distress and frequent visits to healthcare professionals
Symptoms, dramatize, or exaggerated
Lots of energy, devoted to worry and concern about symptoms
What are frequent comorbidities of somatic symptom disorder?
Anxiety and depression
Is somatic symptom disorder chronic
Yes, this disorder usually runs with a fluctuating course with periods of remission and exacerbation
How do patients usually seek treatment for somatic symptom disorder?
Receive medical care from several physicians
Seek relief through over medication and drug abuse
How long does a symptom have to be present to be diagnosed with somatic symptom disorder?
Although anyone symptom may not be consistently present, the state of being somatic is persistent, typically more than six months
What is illness anxiety disorder?
Defined as unrealistic or inaccurate interpretation of physical symptoms or sensations, leading to a preoccupation with a fear of having a serious disease
Hypochondriac
Individuals with illness, anxiety disorder are extremely conscious of what
Bodily sensations and changes
Cleanly aware of even the slightest change in feeling or sensation
How do individuals with illness? Anxiety disorder seek treatment
Long history of Dr. shopping others avoid seeking medical assistance because to do so, will increase their anxiety to intolerable levels
How long is the illness preoccupation present for to be diagnosed with illness anxiety disorder?
Illness. Preoccupation has been present for at least six months, but the specific illness that is feared may change over that period of time.
What is conversion disorder?
Loss of, or change in body function, that cannot be explained by any known medical disorder
What do conversion symptoms affect?
Voluntary motor or sensory functioning
Examples, included, paralysis, atonia, seizures, coordination, disturbances, difficulty, swallowing, urinary retention, blindness, deafness and insomnia, loss of pain sensation, hallucinations, abnormal, limb, shaking signs of epileptic, seizure,pseudocyesis
What is Labelle indifference
Clients display apparent indifference to symptoms that seem very serious. For example, a client who finds themselves suddenly unable to walk, but appears un concerned about the dramatic change.
Do symptoms of conversion disorder go away
Most symptoms of conversion disorder resolved in a few weeks
Some have a relapse within one year
What is factitious disorder?
Conscious intentional lying of physical or physiological symptoms
Pretend To be ill to receive emotional care and support commonly associated with role of patient
Deliberate and intentional
How do patients with fictitious disorder gain admission to hospitals?
Become so skilled presenting their symptoms, they may aggravate existing symptoms induce, new ones or even inflict painful injuries on themselves
What is fictitious disorder by proxy?
Disorder may be imposed on oneself or another person
Intentionally imposed on a person under the care of a perpetrator
Gypsy Rose
How does someone make themselves sick?
Manipulating data, contaminating laboratory, samples, inducing, illness, or injury on child through substances or physical assault
Lying about medical history
A client experiencing lower extremity paralysis is admitted to a medical unit extensive test confirmed disability, but rule out any underlying organic pathology. The nursing concludes that this is most suggestive of which disorder.
Conversion disorder
Illness, anxiety disorer
Malingering
Somatic symptom disorder
Conversion disorder
The client is experiencing pain that has no organic ideology. This pain allows the client to avoid going to work at a job that he hates what best describes with the client is experiencing.
Altered social interaction
Disturbed thought process
Primary gain
Secondary gain
Primary gain
What is dissociative amnesia?
Inability to recall, important personal information, usually of a traumatic or stressful nature that is too extensive to be explained by ordinary forgetfulness, and not due to the direct effects of substance
What does dissociative amnesia stem from?
Extreme, emotional or physical trauma
Usually temporary
What is localized amnesia?
Unable to recall all incidents as associated with stressful. Maybe broader than just a single event
What is selective amnesia?
Individual can recall only certain incidents associated with stressful event for specific periods after the event
What is generalized amnesia?
Individual has amnesia for his or her identity and total life history
How do clients with amnesia usually end up in hospital?
They are in states of alteration and consciousness they are brought in by police, who have found them wandering, confused around the streets
What is dissociative fugue of dissociative amnesia
Characterized by sudden, unexpected, travel away from customary places, or by bewildered wandering with the inability, to recall some or all of ones passed
What is an individual in a fugue state of dissociative amnesia like
May not be able to recall personal identity, and sometimes assumes a new identity
What is dissociative identity disorder?
Multiple personality disorder
Characterized by the existence of two or more personality states in a single individual
fragments of personality
In dissociative identity disorder, what is someone’s altar like
Only one personality is evident at a given moment, and one of them is dominant most of the time over course of disorder
They are unique and composed of complex set of memories, behavior, planner, and social relationships that surface at different times
Transition from one personality to another, may be sudden or gradual
Do clients with DID experience amnesia
They can for events that took place when another personality was being manifested clients report gaps last time or blackouts
Wake up in unfamiliar situations with no idea where they are how they got there or who the people are around them
What is depersonalization in derealization disorder?
Temporary change in the quality of self-awareness, which often takes the form of feeling of unreality changes and body image feeling of detachment from the environment, or sense of observing oneself outside the body
What does depersonalization
A disturbance in the perception of oneself
What does derealization
Alteration in the perception of an external environment
What are some comorbidities of depersonalization and derealization disorder?
Anxiety, depression, fear of going insane, obsessive thoughts
According to psychodynamic theory, which primary defense mechanism with the nurse expected in a client with dissociative amnesia
Suppression
Sublimation
Displacement
Repression
Repression
When working with a client diagnosed with somatic system disorder, which of them is the most appropriate nursing action
Avoiding discussing social impersonal problems
Focus on physical symptoms
Always meet the clients dependency needs
Gradually minimize time focusing on physical symptoms
Gradually minimize the time focusing on physical symptoms
 what is individual psychotherapy for somatic symptom disorder?
Help clients develop healthy and adaptive behaviors. Encourage them to move beyond there’s somatization and enable them to manage their lives more efficiently
How was group psychotherapy beneficial for somatic syndrome disorders
Provides a setting where clients can share their experiences of illness learn to verbalize, thoughts and feelings, and be confronted by group members and leaders when they were direct responsibility for male adaptive behaviors
Does dissociative amnesia go away?
Many cases of dissociative amnesia, resolves spontaneously when removed from stressful situation
What happens if dissociative amnesia does not resolve
Intravenous administration of amobarbitol is useful in retrieval of loss memories
Many clinicians, recommend supportive psychotherapy to reinforce adjustment and retrieve memories associated with emotions
What are some treatments of dissociative amnesia?
IV. Amobarbital.
Hypnosis
Cognitive therapy
All used to retrieve memories and recall details about traumatic events
What is the goal of therapy in patients with DID?
Achievement of integration, a blending of all personalities into one
Why do some patients with DID choose not to pursue integration
It is a lengthy therapeutic regimen, which is intensive and long-term
Course of treatment is often difficult and anxiety provoking
How does someone integrate personalities in a patient with DID
Client is directed toward uncovering, underlying psychological conflict and uncovering, and recalling past traumas in detail, they must mentally experienced the abuse that caused their illness
What is abreaction
Recalling past traumas in detail, mentally reexperiencing the abuse that causes their illness, remembering with a feeling
Very painful
What is the three phase process of standard of care for clients with DID
Stabilization in which the focus is on safety and symptom control
Intensive focus on trauma issues
Re-integration of personality, and moving away from framework of traumatization and victimization
