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
