Chapter 21 Quiz: Somatic Symptom Illnesses and Nursing Diagnosis for Factitious Disorder

Study Notes

Somatic Symptomatic Illness

Psychosomatic refers to the connection between the mind (psyche) and the body (soma) in states of health and illness.

Somatization

Definition: Transference of mental experiences and states into bodily symptoms.
Also known as: Somatization disorder, conversion disorder, and pain disorder.
Characteristics:
- Real symptoms begin, continue, or worsen due to emotional factors.
- No organic basis for symptoms.
- Three central features:
  - Etiology: Psychosocial theories, anxiety, frustration, and feelings expressed through physical symptoms.
  - Limited verbal expression of emotions: Difficulty expressing emotions, possibly with alexithymia.
  - Difficulty with interpersonal conflict: Symptoms worsen in situations involving conflict or emotional stress.

Specific Somatoform Disorders

Somatic symptom disorder: Multiple physical symptoms, including pain, GI, sexual, and pseudoneurologic symptoms.
Conversion disorder or functional neurological symptoms disorder: Unexplained deficits in sensory or motor function, with psychological factors and attitude of la belle indifference.
Pain disorder: Pain unrelieved by analgesics, with psychological factors influencing onset, severity, exacerbation, and maintenance.
Hypochondriasis or illness anxiety disorder: Preoccupation with fear of having a serious disease or disease phobia.

Onset and Clinical Course

Somatization disorder, conversion disorder, and pain disorder are more common in women.
Hypochondriasis and body dysmorphic disorders occur equally in men and women.
All somatoform disorders are either chronic or recurrent, lasting for decades.
Onset of somatization and body dysmorphic disorder: 25 years; conversion disorder: 10 to 35 years; pain disorder and hypochondriasis: any age.

Client Characteristics

Thought process: Intact, with majority of content focused on physical symptoms.
Response to feelings: Physical, not emotional, terms.
Clients with hypochondriasis: Concerns about being gravely ill and fear of dying.
Sensorium and intellectual processes: Alert and oriented, with little or no insight.
Self-concept: Low self-esteem, lack of confidence, and difficulty coping.
Roles and relationships: Difficulty fulfilling family roles, few friends or social activities, and lack of family support.
Physiologic and self-care concerns: Legitimate health concerns, including disturbed sleep patterns, poor nutrition, and lack of exercise.

Nursing Diagnoses and Interventions

Nursing diagnoses: Ineffective Coping, Ineffective Denial, Impaired Social Interaction, Anxiety, Disturbed Sleep Pattern, Fatigue, Pain.
Interventions: Providing health teaching, assisting client to express emotion, teaching coping strategies (emotion-focused and problem-focused).
Outcomes:
- Client identifies relationship between stress and physical symptoms.
- Client verbally expresses emotional feelings.
- Client follows an established daily routine.
- Client demonstrates alternative ways to deal with stress, anxiety, and other feelings.
- Client demonstrates healthier behavior regarding rest, activity, and nutrition.
Evaluation: Client makes fewer visits to physicians with physical complaints, uses less medication, and has improved functional abilities and family and social relationships.

Description

Test your understanding of somatic symptomatic illness, including its definition, characteristics, and dynamics. Learn to distinguish it from factitious disorder and malingering, and understand the etiologic theories related to it. This quiz is perfect for students of psychology looking to assess their knowledge of chapter 21.