Somatic Symptom Disorders Flashcards
what is somatization?
expressing stress in physical symptoms; intense
what are the type of somatic symptom and related disorders?
somatic symptom disorder
illness anxiety disorder
conversion disorder/functional neurological disorder
factitious disorder
what is somatic symptom disorder?
physical symptoms suggesting medical disease but with no organic pathology found
excessive concern with persistent thoughts and fear seriousness of symptoms- high anxiety-getting in way of life
client feels misunderstood/do not perceive self as having psych issue
what was the other name for illness anxiety disorder?
hypochondrias
what is illness anxiety disorder?
extreme worry or fear of the possibility of having a disease
causes frequent scanning of body-very in touch with body sensations= unrealistic of inaccurate interpretation of physical symptoms or sensations- feeds into preoccupation or fear of having serious disease
fear disabling despite reassurance no pathology- obsessive/intrusive thoughts
actual symptoms are minimal or absent
what is neurological symptoms with no neurological disorders?
pseudoneulogical
what is the conversion disorder?
loss of or voluntary or sensory functions resulting from a psych conflict/stressor- no medical cause
what are examples of some of the symptoms for conversion disorder?
paralysis, blindness, deafness, movement or gait disorders, numbness/paresthesia, episodes resembling eplipsey
what is the la belle indifference?
the patient does not seem upset or emotional about it
what is the risk factor for the somatic symptom disorder?
learning theory/family dynamics
past experiences with serious illness
what is a primary gain?
get to avoid
what is a secondary gain?
get attention
what is a tertiary gains?
shifts areas of conflict
what are the biological risk factors of somatic symptom disorders?
decreased serotonin and endorphins in somatic/pain disorder
low tolerance for physical discomfort- feel more pain than the average person
high cortisol in only half of the hemisphere
what is the psychodynamic theory involving the somatic symptom disorder risk factors?
Freud- ego defense mechanism- covers up unwanted conflicted feelings
Behavioral- learned helplessness- high ACE scores
Cognitive- negative catastrophic thinking with reinforcement
what are the assessment findings during a somatic symptom disorder?
full assessments of symptoms- must have medical rule out to truly understand there is nothing wrong
history of ACE or trauma
assess for gains- need to stop the primary and secondary gains
coping skills
communication of emotional needs
dependence of medication- pain, anxiety, and sleep meidcations
what are the comorbidities of the somatic symptom disorder?
depression
anxiety
what are the nursing diagnoses/analysis for clients with somatic symptom disorder?
risk for suicide
ineffective coping
anxiety
hopelessness
deficient knowledge [psychological causes for physical symptoms]
chronic pain
social isolation
fear [of having a serious disease]
chronic low self-esteem
disturbed sensory perception
self-care deficit
what are the somatic symptom disorder interventions?
reattribution treatment- feeling understood, broadening the agenda, making the link (remove sense of blame), negotiating further treatment
CBT
if secondary or tertiary gain found= family therapy
psychopharmacology- antidepressants (SSRIs and SNRIs)
what are some of the risks for those with somatic symptom disorders?
risk for doctor shopping and polypharmacy
PCP regular time limited visits
need to be self-aware to be able to respectful and appropriate. treatment
what is the goal for somatic symptom disorder treatments?
relief of discomfort from physical symptom
what are nursing interventions of somatic symptom disorder?
physical complaints are real to client- don’t deny them
gradually reduce amount of time spent on physical complaint
nursing must use matter of fact approach
shift focus from somatic symptoms to neutral topic
do not imply that symptoms are not real
spend time other when patient voices physical complaint
what are some coping skills for somatic symptom disorders?
assertiveness training and distraction
what was the old term for the factitious disorder?
Munchausen Syndrome
what is factitious disorder?
conscious/intentional- physical or psych
dramatic presentation with medical terms- often demanding- negative test results- usually new symptoms- doctor shop
what is factitious disorder imposed on another?
Munchausen syndrome by proxy
what are the biological risk factors of factitious disorder?
impaired information processing
no genetic findings
what are the psychological risk factors for factitious disorder?
history of abuse/neglect/hospitalized frequently as child
masochistic
what is a masochistic?
feels need to be punished
what is malingering?
conscious/intentional
exaggeration of symptoms for secondary gains- disability compensation, insurance fraud, evading military service, reduced prison sentence
what is frequent in antisocial/borderline personality disorder?
malingering
