Somatic Symptom Disorders Flashcards
Labelle indifference
A lack of concern or emotional response despite having a serious medical illness or physical symptoms related to a health condition.
Labelle indifference is most associated with…
conversion disorder
Primary gain
benefit that provides protection from (INTERNAL) anxiety or emotional symptoms and/or conflicts
Secondary gain
Relieves the individual from (EXTERNAL) expected responsibilities
Examples of secondary gain
If an individual’s sx/ disease increases the attn
and sympathy they receive, allows to miss work, admission to a med facility, get $, disability compensation, receive rx med(s), or avoids a jail sentence
Somatic symptom disorder (SSD) CM
- Actual, persistent, and distressing
physical symptoms (pain, fatigue, digestive
issues, etc.) that cause significant anxiety. - Often without a clear medical cause.
- Preoccupation with health, with excessive
time and energy devoted to symptoms
Impact of SSD on the ind
- Chronic anxiety and worry about
health, interfering with daily life. - Frequent doctor visits and unnecessary
medical tests, leading to a high
emotional and financial burden. - Impaired social and occupational
functioning due to health concerns
Tx for SSD
- Cognitive Behavioral Therapy (CBT)
- Mindfulness and relx techs to dec stress
- antideps for underlying anx and dep
Illness anx dx (IAD)
- Intense fear and/or worry with having or
acquiring a serious illness, despite having
few or no actual physical symptoms. - Constant checking for signs of illness,
checking their bodies for signs, seeking
reassurance from doctors despite normal
results or avoidance of medical situations. - Hyperfocus on health-related information
(e.g., medical websites)
IAD impact on ind
- Avoidance of certain activities or
places for fear of illness. - Can lead to doctor shopping, high
health related costs or avoiding
healthcare altogether
IAD tx
- Cognitive Behavioral Therapy (CBT) to
reduce health anxiety and correct
misinterpretations of bodily sensations. - Psychoeducation about health anxiety.
- Medication: Antidepressants or
anxiolytics may be used to manage anxiety
Conversion dx
(functional neurological sx dx) CM
- Neurological symptoms (e.g. paralysis,
tremors, non-epileptic seizures, or vision
problems) that are inconsistent with or
cannot be explained by medical tests. - Symptoms often triggered by stress or
trauma.
Conversion dx impact on ind
- Sudden disability leading to impaired
mobility and independence. - Emotional distress due to the sudden
onset of symptoms and from a lack of a
clear medical explanation. - Social and occupational disruptions due
to the disability
Conversion dx tx
- Physical therapy and rehabilitation to
help restore function. - Cognitive Behavioral Therapy (CBT) to
address stress or trauma. - Psychodynamic therapy to explore
unresolved psychological conflict. - Stress management techniques to prevent
symptom exacerbation.
Psych fx affecting medical condx
- Psychological factors (e.g. stress or mental
health issues (e.g., anxiety, depression) that
worsen a physical medical condition (e.g.,
chronic pain, asthma, heart disease)
Psychological
Factors Affecting
Medical Condition impact on ind
- Poor health outcomes due to the
interaction between psychological and
physical symptoms. - Difficulty managing multiple health
concerns at once. - Impaired quality of life due to both
physical and psychological challenges
Psychological
Factors Affecting
Medical Condition tx
- Integrated care approach combining
medical and psychological treatment. - CBT to help manage stress and coping
strategies. - Relaxation techniques and mindfulness to
reduce the impact of psychological stress on
physical health.
Factitious
Disorder (Imposed
on Self or Others)
- Intentionally pretending, lying about,
“faking” or producing physical or
psychological symptoms to assume the “sick
role” and gain things such as attention or
sympathy. - May involve falsifying medical histories,
manipulating test results, or intentionally
harming oneself.
Factitious dx impact on ind
- Emotional distress stemming from the
need for attention or care. - Trust issues in relationships and among
healthcare providers due to deceptive
behaviors. - Risk of unnecessary medical treatments
and complications
Factitious disorder tx
- Psychotherapy, particularly CBT or
psychodynamic therapy, to uncover
underlying emotional distress. - Long-term therapy to address the
psychological need to gain attention through
illness. - Family therapy if the disorder involves
imposed symptoms on others
Malingering
- Intentionally exaggerating or fabricating
physical or psychological symptoms for
external gain, such as avoiding work,
admission to a hospital or psychiatric
facility, receiving financial compensation, or
obtaining prescription medications
Malingering characteristics
- Distrust and breakdown in
relationships, especially with healthcare
providers. - Legal consequences if fraudulent
behavior is detected. - Potential for unnecessary treatments or
accommodations based on false
information.
Malingering tx
- Psychiatric evaluation to confirm the
diagnosis and underlying motivations. - If external gains are discovered, addressing
through legal or social intervention. - In some cases, behavioral therapy to
manage the underlying motives for
malingering
Diff btwn SSD and IAD
In SSD, focus is on distress from actual physical sx, but in IAD, focus on fear of actual sx despite minimal or no sx
Difference btwn factitious disorder and malingering
Malingering has external incentives, factitious dx has internal gains like sympathy for being ill
Nursing interventions for somatic disorder
- est therapeutic relx
- reduce hc dependency (help pt plan structured appts)
- edu on dx
- encourage realistic expectations like setting goals, coping skills
- assist with med management
