Somatization Flashcards
Final exam
Psychosomatic
connection between mind (psyche) and body (soma)
Hysteria
multiple physical complaints with no organic basis
What was proposed by Freud:
Proposal by Freud that people can convert unexpressed emotions into physical symptoms
Hysteria
Somatization
transference of mental experiences, states into body symptoms
Somatic Symptom Illness have how many central features?
3
What are the three central features of somatic symptom illnesses?
- Physical complaints suggest major medical illness but have no demonstrable organic basis.
- Conflicts and/or stress seem important in initiating, exacerbating, and maintaining symptoms.
- Symptoms or magnified health concerns are not under client’s conscious control.
Types of Somatic Symptom Illnesses are described as:
Medical Conditions that can not be explained by medical evaluation
Three types of somatic symptom illnesses
- Somatic symptom disorder
- Conversion disorder
- Pain Disorder
When are somatic symptom disorders diagnosed?
Somatic symptom disorder isdiagnosed when a person has a significant focus on physical symptoms, such as pain, weakness or shortness of breath, to a level that results in major distress and/or problems functioning.
Conversion disorder
Conversion disorder isa condition in which a person experiences physical and sensory problems, such as paralysis, numbness, blindness, deafness or seizures, with no underlying neurologic pathology.
When do symptoms of conversion disorder usually begin?
Symptoms usually begin suddenly after a period of emotional or physical distress or psychological conflict
What does conversion disorder display?
Conversion disorder, displays la belle indifférence )
la belle indifférence
lack of concern about health condition
Pain disorder
Pain disorder ischronic pain which is believed to be caused by psychological stress. The pain is often so severe that it disables the patient from proper functioning.
When is the onset of somatization? When is diagnosis made?
Symptoms often experienced in adolescence; diagnoses may not be made until early adulthood.
Are somatic illnesses chronic or recurrent?
Either chronic or recurrent
How do patients relieve symptoms of somatic illnesses?
Clients go from one physician or clinic to another, or see multiple providers at once, to obtain relief of symptoms except conversion disorder
Patients with what disorder do not go to different doctors to relieve symptoms?
Clients go from one physician or clinic to another, or see multiple providers at once, to obtain relief of symptoms except conversion disorder
How do patients with somatic illnesses feel about healthcare in general?
Clients tend to be pessimistic about medical establishment.
How are somatic illnesses controlled by the patient?
The symptoms of somatic symptom illness are not under the client’s voluntary control.
Treatment of somatic illnesses
Symptom management, improvement in quality of life
Antidepressants for accompanying depression: SSRIs
Therapy
Stress Management
Somatic Illness Nursing Process Application Assessment- What do you do first
Investigation of physical health status; screening
Somatic Illness Nursing Process Application Assessment- History
usually detailed medical history; distress about health status (except client with conversion disorder, who displays la belle indifférence )lack of concern about health condition
Somatic Illness Nursing Process Application Assessment- appearance and motor behavior
General appearance and motor behavior
Somatic Illness Nursing Process Application Assessment- Mood and Affect
labile; exaggerated emotions; or extremely calm
Nursing Process Application: Assessment- Thought and process content
unlikely to be able to think about emotional feelings—focus on physical health/sensations
Nursing Process Application: Assessment- Judgment and insight
little or no insight into behavior
Nursing Process Application: Assessment- Roles and relationships
unlikely to be employed/impairment in relationships
Nursing Process Application: Outcome identification
Identify relationship between stress and physical symptoms
Verbally express emotions/feelings
Establish and follow a daily routine
Demonstrate alternate ways to deal with stress, anxiety, and other feelings
Demonstrate healthy behaviors regarding rest, activity, and nutritional intake
Nursing Process Application: Intervention
Provide health teaching: improved health behaviors
Help client express emotions: journaling; limiting time focused on physical complaints
Teach coping strategies
Self-Awareness Issues
Deal with feelings of frustration.
Be realistic about small successes.
Accept client and his or her continued complaints without being judgmental.
Validate client’s feelings.
Remember the complaints are not under client’s voluntary control.
Related Disorders (Intentional)
Malingering
Factitious disorder
Factitious disorder
Malingering
intentional production of false or grossly exaggerated symptoms; external incentives as motivation
Factitious disorder- 2 types
- Munchausen syndrome
- Munchausen syndrome by proxy
Factitious disorder-Munchausen syndrome
imposed on self (Munchausen syndrome)
for attention
Factitious disorder-Munchausen by proxy
imposed on others (Munchausen syndrome by proxy)
When do factitious disorders occur?
Factitious disorder occurs when a person intentionally produces or feigns physical or psychological symptoms solely to gain attention.
Etiology of Intentional somatic illnesses?Psychosocial theories
Primary gains
Secondary gains
Etiology of Primary gains
direct internal benefits of being sick— relief of anxiety, conflict, or distress
Etiology of Secondary gains
external or personal benefits from others because one is sick—attention and comfort measures
