Physical Problems, Psychological Sources | Elsevier 2021

Physical Problems, Psychological Sources Chapter 22 Copyright © 2021 by Elsevier, Inc. All rights reserved. 1  Learning Objectives Lesson 22.1: Physical Problems, Psychological Sources (Slide 1 of 2) 1. Explain the purpose of the p...

Physical Problems, Psychological Sources Chapter 22 Copyright © 2021 by Elsevier, Inc. All rights reserved. 1  Learning Objectives Lesson 22.1: Physical Problems, Psychological Sources (Slide 1 of 2) 1. Explain the purpose of the physiological stress response. 2. Illustrate how stress can affect immune system functions. 3. Describe five physical responses related to the physiological stress response. 4. Examine three theories that explain the role of emotions in the development of illnesses. 5. Compare three culturally related somatization disorders. Copyright © 2021 by Elsevier, Inc. All rights reserved. 2  Learning Objectives Lesson 22.1: Physical Problems, Psychological Sources (Slide 2 of 2) 6. Explain the differences between conversion disorders and somatization disorders. 7. Describe the most essential feature of illness anxiety disorder. 8. Compare the differences between illness anxiety disorder and malingering. 9. Plan three therapeutic goals when caring for clients with psychophysiological disorders. Copyright © 2021 by Elsevier, Inc. All rights reserved. 3  Role of Emotions in Health ⬤Health is a concept that embodies the whole person. ⬤It’s a state of well being. ⬤Its a balance of psychological and physical realm (homeostasis). Copyright © 2021 by Elsevier, Inc. All rights reserved. 4  Anxiety and Stress ⬤Physiological stress response: Is the Biochemical fight-or-flight system (fight or flee from the threat). Stress activates regions of the brain that control eating, aggression and immune response. ⬤Our psychological side has a strong impact on the ability to identify and successfully cope with stress. Copyright © 2021 by Elsevier, Inc. All rights reserved. 5  Childhood sources Individuals learn how to perceive and respond to stress in childhood. Infants develop stress related symptoms such as colic, atopic dermatitis, allergic reactions and obesity. Older children develop allergic reactions, asthma, GI complaints and pain. Adolescent may develop anorexia or bulimia. Adults may have physical problems. Families who emotionally support and encourage their children to effectively cope with their stresses have few physical complaints Copyright © 2021 by Elsevier, Inc. All rights reserved. 6  Anxiety and Stress pg 255 Psychophysical Problems - are physical signs and symptoms the individual experiences with stress (box 22.1). Migraines Angina Pain Impotence Pruritus Copyright © 2021 by Elsevier, Inc. All rights reserved. 7  Theories of Psychophysical Disorders Biological Theory Fight or flight response. ⮚ Carl Jung’s psychoanalytic Theory Focuses on Symbolism attached to a symptom or illness ⮞ Example a young executive who needs to vent but feels that displaying his anger is inappropriate. ⮞ Erich Fromm’s Psychodynamic Theory States that certain personality types are prone to certain illness. Overly ambitious executive or overburdened clerk. Copyright © 2021 by Elsevier, Inc. All rights reserved. 8  Somatic Symptom Disorders ⬤Somatization ⮚ Is feeling the physical symptoms in the absence of disease or out of proportion to an ailment. Almost 80% of basically healthy people have somatic symptoms in any given week ⮚ Signs and symptoms of illness may be the client’s way of coping with emotional distress Copyright © 2021 by Elsevier, Inc. All rights reserved. 9  Cultural influences ⮚ Many somatic illnesses are based on cultural or spiritual beliefs. ⮚ Assessments and treatment plans must not threaten or challenge beliefs if therapeutic interventions are to be effective. ⮚ Nursing interventions are based on knowledge of and respect for another’s way of living. Copyright © 2021 by Elsevier, Inc. All rights reserved. 10  Criteria for diagnosis ⮚ First criteria: No organic medical condition explains the symptoms. ⮚ Second criteria: The disorder significantly disrupts or impairs one’s level of functioning. The individual is unable to engage in daily activities. ⮚ Third criteria: Emotions, thoughts or behaviors are focused on the symptoms. Copyright © 2021 by Elsevier, Inc. All rights reserved. 11  Somatic Symptom Disorder (Slide 1 of 2) ⬤Historically referred to as Briquet’s syndrome or hysteria. ⮚ It is a Polysymptomatic disorder A condition associated with many signs and symptoms. It begins before age 30. ⮚ Both genetic and environmental factors contribute to the risk of developing a somatization disorder ⮚ Complaints are described in colorful and exaggerated terms. ⮚ Clients with somatization disorder seek treatment from several physicians at the same time. Copyright © 2021 by Elsevier, Inc. All rights reserved. 12  Somatic Symptom Disorder (Slide 2 of 2) ⬤How to differentiate a somatization disorder from a medical problem. ⮚ 1. Involvement of multiple organ systems suggests a somatization disorder. ⮚ 2. The disorder is characterized by early onset and is a chronic condition in which no physical changes occur over time. ⮚ 3. The absence of any significant laboratory values indicates that the underlying problems may be emotionally based. Copyright © 2021 by Elsevier, Inc. All rights reserved. 13  Illness Anxiety Disorder ⬤Formerly known as hypochondriasis ⮚ A disorder in which one has an intense preoccupation with having a serious disease or medical condition based on misinterpretation of body signs and symptoms. ⮚ Clients commonly “doctor shop”. ⮚ Can begin at any age. ⮚ Often difficult to treat due to being critical and suspicious of health care provided. Copyright © 2021 by Elsevier, Inc. All rights reserved. 14  Conversion Disorders (Slide 1 of 2) Considered to be a somatoform disorder in which the individual presents problems related to sensory or motor functions. ⮚ Disorder appears more commonly in: Persons of lower socioeconomic status Those living in rural areas Individuals with little health care knowledge ⬤Onset is from late childhood to early adult. ⬤Children present with gait problems or seizures Copyright © 2021 by Elsevier, Inc. All rights reserved. 15  Conversion Disorders (Slide 2 of 2) ⬤Older adults present with sensory or motor disturbances (coordination of muscles, sight, smell, taste, hearing). ⬤Symptoms may occur suddenly, slowly and increase overtime ⬤ Are thought to result from emotional conflict. ⬤Signs and symptoms tend to be more in keeping with the individual’s ideas of what the problems should be. Example: The individual is able to suspend a paralyzed arm for a moment. Copyright © 2021 by Elsevier, Inc. All rights reserved. 16  Conversion Disorders ⬤Treatment: ⬤Goal focuses on eliminating the possibility of any physical causes. ⬤Then on helping the client identify the conflict responsible for their symptoms. ⬤Psychotherapy. ⬤Antidepressants and antianxiety medication. ⬤Behavior modification. 17  Factitious Disorders and Malingering ⬤Factitious disorders and malingering differ from somatoform disorders in that signs and symptoms are produced intentionally. Clients willfully produce the signs or symptoms of illness for some form of gain Copyright © 2021 by Elsevier, Inc. All rights reserved. 18  Factitious Disorders and Malingering ⬤Factitious disorder by proxy (Munchausen’s syndrome) involves intentionally producing signs and symptoms in another person. ⬤Involve caregiver (mom/babysitter) who induces (persuade someone) signs of illness. ⬤Symptoms depend on medical knowledge of caregiver. ⬤Malingering: Individual produces symptoms to meet a recognizable goal. ⬤Example: student fakes a stomach to be excused from school. ⬤Producing symptoms to avoid something or receive compensation. 19  Implications for Care Providers ⬤Goals of care ⮚ First goal: Rule out the presence of any physical disease or dysfunction. ⮚ Develop a trusting caregiver-client relationship. ⮚ Encourage the expression of feelings and emotional states rather than physical complaints. ⮚ Meet physical needs when necessary, but encourage independence. ⮚ Encourage to explore more adaptive ways of handling stressors. Copyright © 2021 by Elsevier, Inc. All rights reserved. 20