Somatic Symptom Disorders

Question 1

what is somatization?

Answer 1

expressing stress in physical symptoms; intense

Question 2

what are the type of somatic symptom and related disorders?

Answer 2

somatic symptom disorder
illness anxiety disorder
conversion disorder/functional neurological disorder
factitious disorder

Question 3

what is somatic symptom disorder?

Answer 3

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

Question 4

what was the other name for illness anxiety disorder?

Answer 4

hypochondrias

Question 5

what is illness anxiety disorder?

Answer 5

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

Question 6

what is neurological symptoms with no neurological disorders?

Answer 6

pseudoneulogical

Question 7

what is the conversion disorder?

Answer 7

loss of or voluntary or sensory functions resulting from a psych conflict/stressor- no medical cause

Question 8

what are examples of some of the symptoms for conversion disorder?

Answer 8

paralysis, blindness, deafness, movement or gait disorders, numbness/paresthesia, episodes resembling eplipsey

Question 9

what is the la belle indifference?

Answer 9

the patient does not seem upset or emotional about it

Question 10

what is the risk factor for the somatic symptom disorder?

Answer 10

learning theory/family dynamics
past experiences with serious illness

Question 11

what is a primary gain?

Answer 11

get to avoid

Question 12

what is a secondary gain?

Answer 12

get attention

Question 13

what is a tertiary gains?

Answer 13

shifts areas of conflict

Question 14

what are the biological risk factors of somatic symptom disorders?

Answer 14

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

Question 15

what is the psychodynamic theory involving the somatic symptom disorder risk factors?

Answer 15

Freud- ego defense mechanism- covers up unwanted conflicted feelings
Behavioral- learned helplessness- high ACE scores
Cognitive- negative catastrophic thinking with reinforcement

Question 16

what are the assessment findings during a somatic symptom disorder?

Answer 16

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

Question 17

what are the comorbidities of the somatic symptom disorder?

Answer 17

depression
anxiety

Question 18

what are the nursing diagnoses/analysis for clients with somatic symptom disorder?

Answer 18

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

Question 19

what are the somatic symptom disorder interventions?

Answer 19

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)

Question 20

what are some of the risks for those with somatic symptom disorders?

Answer 20

risk for doctor shopping and polypharmacy
PCP regular time limited visits
need to be self-aware to be able to respectful and appropriate. treatment

Question 21

what is the goal for somatic symptom disorder treatments?

Answer 21

relief of discomfort from physical symptom

Question 22

what are nursing interventions of somatic symptom disorder?

Answer 22

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

Question 23

what are some coping skills for somatic symptom disorders?

Answer 23

assertiveness training and distraction

Question 24

what was the old term for the factitious disorder?

Answer 24

Munchausen Syndrome

Question 25

what is factitious disorder?

Answer 25

conscious/intentional- physical or psych
dramatic presentation with medical terms- often demanding- negative test results- usually new symptoms- doctor shop

Question 26

what is factitious disorder imposed on another?

Answer 26

Munchausen syndrome by proxy

Question 27

what are the biological risk factors of factitious disorder?

Answer 27

impaired information processing
no genetic findings

Question 28

what are the psychological risk factors for factitious disorder?

Answer 28

history of abuse/neglect/hospitalized frequently as child
masochistic

Question 29

what is a masochistic?

Answer 29

feels need to be punished

Question 30

what is malingering?

Answer 30

conscious/intentional
exaggeration of symptoms for secondary gains- disability compensation, insurance fraud, evading military service, reduced prison sentence

Question 31

what is frequent in antisocial/borderline personality disorder?

Answer 31

malingering