PSY Test 3L. Somatoform Disorders

Hypochondria

the obsession over serious or life threatening disease that hasnt been diagnosed.

conversion disorder

characterized by a loss of body function of physical impairment in the absence of physical findings. the reactions occur suddenly and are often as the result of a major stressor. individual does NOT willfully or consciously produce the symptoms

symptom criteria required for a diagnosis of hypochondria include

-a preoccupation lasting for at least 6 months that one has serious illness based on bodily symptoms -worry about the preoccupation -difficulty with social life, work or other daily routines -continuously talking about your symptoms or suspected diseases with family and friends -obsessively doing health research -frequently checking the body for problems, such as lumps or sores -frequently checking vital signs -thinking one has disease after reading or hearing about it

symptoms of somatization disorder

-abdominal pain -amnesia -back pain -bloating -chest pain -diarrhea -difficulty swallowing -dizziness -headaches -joint pain -nausea and vomiting -pain in legs or arms -paralysis or muscle weakness -shortness of breath -vision changes

risk factors for factitious d/o are:

-childhood trauma, such as emotional, physical or sexual abuse -a serious illness during childhood that allowed them to be cared for and nurtured -a relative with a serious illness -a poor sense of identity or self esteem -loss of a loved one through death, illness, or abandonment early in life -unfulfilled desire to be a doctor or other health professional -personality disorders

symptoms of factitious d/o

-dramatic stories about numerous medical problems -frequent hospitalizations -vague or inconsistent symptoms -conditions that get worse for no apparent reason -eagerness to undergo frequent testing or risky operations -extensive knowledge of medical terminology and disease -seeking treatment from many different doctors or hospitals -having few visitors when hospitalized -reluctance to allow health professionals to talk to family or friends -frequent requests for pain relievers or other medications

hypochonrdia symptoms

-having a long-term intense fear or anxiety about having a serious disease or health condition -worrying that minor symptoms or bodily sensations mean one has a serious illness -seeing doctor repeated times or having involved medical exams such as magnetic resonance imaging (MRI), echocardiograms or exploratory surgery -frequently switching doors

criteria for diagnosis of factitious d/o: three criteria must be met

-intentionally faking or producing symptoms -a motivation to be seen as sick -the motivation isnt for financial or legal reasons, such as collecting a settlement

individuals with factitious d/o may:

-make up stories -faking symptoms -self harm -preventing healing -tampering

OT implications for somatization d/o

-meaningful activity -biofeedback -graded exercises -beliefs -stress management -relaxation -tai chi -ID emotions and emotional regulation -sensory integration -engagement in pain free ADL/IADL identified as dysfunctional

common symptoms of conversion disorder

-poor coordination -paralysis in one arm or leg -difficulty swallowing or lump in throat -inability to speak -vision problems, including double vision and blindness -deafness -seizure or convulsions -loss of balance -numbness or loss of the touch sensation -hallucinations -difficulty with walking -urinary retention

symptoms of body dysmorphic disorder

-preoccupation with physical appearance -strong belief that one has an abnormality or defect in your appearance that makes them ugly -frequent examination of yourself in the mirror or, avoidance of mirrors all together -belief that others take special notice of one's appearance in a negative way -the need to seek reassurance about one's appearance from others -frequent cosmetic procedures with little satisfaction -excessive grooming -extreme self-consciousness -refusal to appear in pictures -skin picking -comparison of one's appearance with that of others -avoidance of social situations -the need to wear excessive makeup or clothing to camouflage perceived flaws

typical interventions for somatization d/o include

-psychotherapy -cognitive behavior therapy -antidepressants

hypochondria treatment

-psychotherapy is the primary treatment -cognitive behavioral therapy -exposure therapy, in which you directly confront your health fears in a safe environment and learn skills to cope with them -psychoeducation -antidepressant medications

conversion d/o risk factors include

-recent significant stress or emotional trauma -being female, being an adolescent or young adult -having a mental health condition, such as mood and anxiety disorders, dissociative disorder and certain personality disorders -having a family member with conversion disorder - a history of physical or sexual abuse -financial problems

body dysmorphic disorder may be associated with

-suicidal thoughts or behavior -repeated hospitalizations -depression and other mood disorders -anxiety disorder -OCD -eating disorders -social phobia -substance abuse -low self-esteem -social isolation -difficulty attending work or school -lack of close relationships -unnecessary medical procedures, especially cosmetic surgery -inability to leave home

t/f although the obsessions with body dysmorphic disorder are intense, the individual will not likely seek out cosmetic procedures

FALSE they often seek out cosmetic procedures but are displeased with the outcomes

t/f/ hypochondria is very minor and typically does not cause disturbances with work, relationships or other areas of life.

FALSE it can cause problems in all areas of life and severe cases can be disabling

t/f there is evidence that there isnt an inflammatory or immune response with cases of somatoform d/o

FALSE there is evidence that there may be inflammatory or immune response in cases of somatoform d/o

OT implications for hypochondria

OT interventions are not likely to benefit these clients as they are not likely to perceive that there is much benefit in the service

t/f Although OT interventions are sought out for conversion disorder due to physical presentations, interventions are typically not beneficial due to the nature of the disorder

TRUE

t/f a person with conversion d/o will obsessively worry about their condition, see multiple doctors, and believe the physician has not done enough

TRUE

t/f when a person has body dysmorphic disorder, they intensely obsess over heir appearance and body image, often for many hours a day.

TRUE

somatization disorder

chronic condition in which a person has physical symptoms that involve more than one part of the body, but no physical cause can be found. the pain and symptoms are real and are not intentionally produced

factitious disorders

disorders that are physical or psychological that are intentionally produced and under voluntary control of the individual. the individual will actively induce the symptoms and is unable to control the impulse to do so

somatoform disorders include:

dysmorphic disorder, conversion disorder, hypochondriasis, somatization disorder, somatoform pain disorder

body dysmorphic disorder is also referred to as:

dysmorphophobia: which is the fear of having a deformity

Body dysmorphic disorder

has to do with an obsessive dissatisfaction with a portion of the body. it may involve a flaw that is either minor or imagined.

treatment of body dysmorphic disorder

medication cognitive behavioral therapy

treatments for conversion disorder may include

psychotherapy cognitive behavioral therapy medication for depression and anxiety hypnosis trans cranial magnetic stimulation

treatment for factitious d/o

psychotherapy medications for anxiety, depression

OT implications for factitious d/o are based on areas of dysfunction:

self esteem roles, values, beliefs stress management relaxation

OT implications for body dysmorphic disorder will be based on areas of dysfunction, but may include

self esteem stress management role, values, beliefs relaxation tai chi/yoga social skills journaling positive self talk ther. act. sensory integration/modulation

Munchausen syndrome

the best known factitious d/o

how is somatization d/o different from hypochondria

the client has a specific physical complaints not just a fear that something is wrong