Chapter 19 Somatoform Disorders

Three central features of somatoform disorders

1. Physical complaints suggest medical issues, but have no known origin 2. Psychologic factors and conflicts seem important initiating, exacerbating, or maintaining the symptoms 3. Symptoms or magnified health concerns are not under the client's conscious control

Somatoform Disorders

A class of psychological disorders involving physical ailments with no authentic organic basis that are due to psychological factors.

Body Dysmorphic Disorder

A preoccupation with an imagined or exaggerated defect in appearance. If a slight physical anomaly is present, the person's concern is markedly excessive.

Hypochondriasis

A preoccupation with fears of having a serious disease. Ordinary physical signs are interpreted as proof that the person has a disease, but no physical disorder can be found.

Secondary Gains

Benefits received from others because one is sick, such as attention from friends and family members and comfort measures such as being brought tea or receiving a back rub

Somatization Disorder

Characterized by multiple physical symptoms. Begins by age 30 and extends over several years, and includes a combination of pain and gastrointestinal, sexual, and pseudoneurologic problems

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Clients with somatoform disorders are unlikely to be employed. They often lose their jobs because of excessive absenteeism or inability to perform work due to disorder

True

Clients with somatoform disorders focus on the physical concern? True or False

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Clients with somatoform disorders often have sleep disturbances, lack basic nutrition, and get no exercise

Primary Gains

Direct external benefits that being sick provides, such as relief of anxiety, conflict or distress

Low self-esteem

Do patients suffering from somatoform disorders usually have high or low self-esteem?

Munchausen Syndrome

Faking illness to gain attention to one's self

Narcotic analgesics because they have a high risk for dependency or abuse. Instead suggest NSAIDs if indicated

HCPs should avoid administering or prescribing these for pain to those experiencing a somatoform disorder

Pain Disorder

Has the primary physical symptoms of pain, which generally is unrelieved by analgesics and greatly affected by psychologic factors in terms of onset, severity, exacerbation, and maintenance

Problem-Focused Coping Strategies

Help to resolve or change a client's behavior or situation or manage life stressors

Emotion-Focused Coping Strategies

Helps clients relax and reduce feelings of stress

Malingering

Intentional production of false or exaggerated physical or psychological symptoms motivated by incentives such as avoiding work, evading criminal prosecution, obtaining financial compensation, or obtaining drugs

Munchausen by proxy Syndrome

Intentionally hurting or making another person ill so that one can gain attention by taking care of this person on a day to day basis, or "rescue" the hurt/ill person and look like the "Hero" that saved the day in order to gain attention

Conversion Disorder

Involves unexplained, unusual sudden deficits in sensory or motor function (e.g. blindness, paralysis)

Factitious Disorder (Munchausen Syndrome)

Occurs when a person fakes physical or psychological symptoms solely to gain attention

Women

Somatoform disorders occur more frequently in men or women?

Body Identity Integrity Disorder (BIID)

Term given to people who feel alienated from a part of their body and desire amputation

Internalization

Term used for people with somatoform disorders that keep stress, anxiety ,or frustration inside rather than expressing them outwardly

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The nurse must help the client to establish a daily routine that includes improved health behaviors. Adequate nutritional intake, improved sleep patterns, and realistic balance of activity and rest are all areas with which the client may need assistance

Physical Health

The nurse should investigate ______ ______ to ensure there are no underlying pathology requiring treatment

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The nurse should not attempt to confront clients about somatic symptoms or attempt to tell them that these symptoms are not "real". They are very real to clients, who actually experience the symptoms and associated distress

Somatization

The transference of mental experiences and states into bodily symptoms

True

True or False Client's who suffer from somatoform disorders are convinced that they harbor serious physical problems despite negative results during diagnostic testing

SSRI's

What class of drugs are most commonly used to treat somatoform disorder associated depression?

The United States

What country are somatoform disorders least prevalent?

Treatment focuses on managing symptoms and improving quality of life

What is the primary focus of treating somatoform disorders?

Depression

What psychological disorder commonly accompanies those sufferingg from somatoform disorders?

They may be the manifestation of an actual physical illness or injury

Why is it important not to dismiss future complaints as part of the somatoform disorder?

Selective Serotonin Reuptake Inhibitors (SSRI)

fluoxetine, sertraline, and paroxetine all fall under what classification of antdepressant medications?

Chronic Pain clinics, visual imaging, and relaxation techniques

methods of pain control for those suffering from somatoform disorders