exam ii: ch17 - somatic symptom disorder

Question 1

the expression of psychological stress thru physical symptoms

Answer 1

somatization

Question 2

what s/s do children usually experience with somatic symptom disorders

Answer 2

abd pain, HA, fatigue, nausea

Question 3

meds for this disorder? what tx necessary

Answer 3

none - no FDA approved meds; pts need CBT

Question 4

what should the focus be on for somatic symptom disorder pts

Answer 4

focus on coping and LESS on complaints

Question 5

what is needed before a dx of any somatic symptom disorder

Answer 5

cleared and negative of ALL medical aspects

Question 6

somatic disorder;
- predominant in women 16-25
- s/s triggered by biological/outside cues
- s/s need to be persistent for 6+ months
- pain is real but too obsessed with it
- s/s: chest pain, fatigue, HA, back pain, abd pain, numbness

Answer 6

somatic symptom disorder

Question 7

somatic disorder;
- misinterpretation of physical sensation
- preoccupied with having illness for at least 6 months
- pain not usually present for very minor, but pt believes it is massive
- care seeing OR care avoidant

Answer 7

illness anxiety disorder (hypochondriasis)

Question 8

how long does preoccupation take to be dx with illness anxiety disorder

Answer 8

at least 6 months

Question 9

somatic disorder;
- functional neurological symptom disorder without actual neuro distress
- no actual injury, but neurologically chooses to have injury if it can serve benefit
- la belle indifference
- s/s: paralysis, blindness, gait disorder, paresthesias, loss of senses

Answer 9

conversion disorder

Question 10

“i don’t care” vibe; pt plays ignorance to mental illness if it serves benefit

Answer 10

la belle indifference

Question 11

somatic disorder;
- artificially, deliberately, and dramatically fabricate s/s or self inflict injury
- goal: assuming sick role (factitious) for SECONDARY GAIN (malingering)
- manipulate, lie, falsify

Answer 11

factitious (munchausen syndrome)

Question 12

what are the 7 key elements for effective tx

Answer 12

1. cont of care without implying s/s are real
2. avoid unnecessary procedures
3. freq brief/reg visits
4. physical exam
5. avoid disparaging comment (derogatory)
6. focus on COPING
7. set reasonable therapeutic goals