Somatic Symptom Disorders/Somatiform Flashcards
Somatization
putting or channeling emotional distress into the body and through physical s/s
- insomnia, high Pulse,
La Belle indifference
paradoxical absence
- not concerned with s/s as they do not have mental pain
Malingering
exaggerates and fakes an illness to get out of something for secondary and primary gains
- avoid homelessness or jail
- get aware from harm
- cope mechanism to get away
Primary gain
- mainfesting a stomach ache to avoid a bully
Secondary gain
- attention from mom
Self-compassion
caring and understanding to one’s self with faced with own failures
- protect and emotional resilence
Psyche + Soma =
Psycho-somatic
(mind-body)
- missed in psych because they are seen by HCP or med-surg
What are some medical diagnoses that the emotional state influences?
HTN
Colitis
What are some somatic symptoms not necessarily related to a separate medical diagnosis?
tension HA
GI upset
i’m worried sick, so nervous i might throw up
Hysteria (hysterical neurosis)
Somatic complaints unexplained by organic pathology
Somatic related disorders
Pain Disorder (somatic symptom disorder)
Illness Anxiety Disorder (Hypochondriasis)
Functional Neurobiological (Conversion)
Psychological factors affecting other conditions
Factitious Disorder (Munchausen Syndrome)
Which somatic disorder is the most common?
pain disorder
Which somatic disorder is the least common?
Munchausen Syndrome (Factitious)
Theories of Pathology for Somatic Disorders
genetic and biological vulnerability
- higher sensitivity to pain, trauma
- big and small sensory stimuli equally intense
environment
psychological theory
interpersonal theory
decreased levels of serotonin and endorphins
How does the environment cause somatic disorder?
childhood trauma
- fmaily with illness
overprotective parents
high wanting of child perfection
What is the psychological cause of somatic disorder?
illicit care and nurturing
- coping for needs to be met
culture of not having mental pain goes to physical pain which is acceptable
How does the interperonal model cause somatic disorder?
attention from the pain
Somatic S/S Disorder
- Risk Factors
females (more common)
decreased serotonin and endorphins
with depression, personality disorders, and anxiety disorders
childhood trauma, abuse, neglect
1st degree relative to the disorder
learned helplessness - maladaptive coping strategy
Key features of somatic symptom disorder
1+ s/s present for 6 months+
excessive thoughts/feelings/behaviors r/t somatic s/s
state of being symptomatic is persistent while s/s may vary
Excessive Thoughts
out of proportion with the seriousness of s/s
client has high anxiety about health
= SOB, sweating, sense of impending doom,
excessive time and energy given to s/s
The most common s/s of somatic symptom disorder
pain
- specific or nonspecific
- possibly associated with another medical condition
The appraisal of s/s for somatic symptom disorder is
disproportionate to nurse findings
Typical somatic symptom disorders include what in their chart
long, complex medical hx
- chronic or recurrent
Somatic symptom disorder patients will seek out
multiple HCPs for answers/relief/dx
- believe HCPs are incompetent
- pt lacks insight into the disorder
- if the HCP does not know what is going on, they might dump them into this category and forgotten
= known as frequent fliers
Somatic disorder nursing interventions
- 4 things to ask
- ask what is making them anxious and rate the anxiety
- **anxiety and depression s/s
periods of sadness or difficulty concentrating or worry - ask about the ability to care for themselves
- how does the family react to the s/s (help, enable, cause)**
do not acknowledge the physical s/s
decrease stimulation
ground them
Tx of Somatic Symptom Disorder
1st priority = thorough physical assessment r/o other illnesses
symptom and pain mgmt - NSAIDs,
SSRIs = tx underlying depression
Referral to pain clinic (pain disorder)
relax therapy and visual imaging
Group Therapy: peer support, coping mechanisms, and expression of emotions
Journaling - into heads and connects with events
Discourage “doctor shopping”
What medications could be given for somatic symptom disorder?
NSAIDs
SSRIs
What therapy is used for somatic symptom disorder?
Relaxation therapy
visual imaging
Group therapy: peer support, coping mechanisms, & expression of emotions
Journaling