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Chapter 20 Psychosocial
Nursing
19
Health Care
Undergraduate 2
12/06/2008

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Term
Somatoform disorder  (7 types)
* Body dysmorphic disorder
* Somatization disorder
* Conversion disorder
* Pain disorder
* Hypochondriasis
* Undifferentiated somatoform disorder
Somatoform disorder,not otherwise specified
Definition
Somatoform disorder is the diagnosis given to individuals who present with symptoms suggesting a physical disorder without demonstrable organ findings to explain the symptoms
Theories regarding the etiology of somatoform disorders include: 
 * Biologic and genetic factors,
 *Organ specificity theory,
 *Selye's general adaptation syndrome,
 *Familial or psychosocial theory, and the learning theory.
Term

 

Disassociative Disorders

     * disassociative amnesia

  * disassociative Fugue

                * disassociative identity disorder

         * depersonalization disorder

Definition

 

Dissociative Disorder:

* Individuals who exhibit the seperation of an idea or mental thoughts from consciouness awareness or from emotional significance and affect

Term
Dissociative Amnesia
Definition
Dissociative Amnesia
Dissociative amnesia (formerly known as psychogenic amnesia) is characterized by the inability to recall an extensive amount of important personal information because of physical or psychological trauma.
Predisposing factors include an intolerable life situation, unacceptability of certain impulses or acts, and a threat of physical injury or death.
Most cases are seen in the hospital
Term

 

 

 

 Theories Re: Dissociative Disorders

 

 

Definition

1. state dependent learning theory:

*dissassociative amnesia is caused by stress associated with traumatic experiences endured or witnessed

 *dissassociative fugue thought to remove an indivual from accountaibility to one actitons

 

2.  psychoanalytic theory

dissassociative amnesia is considered to be a defense mechanism wherby an individual alters consciouness as a way of dealing with an emotional conflict or an external stressor.

Term

 

 

Other Contributing Factors

 of

Dissociative Identiy disorder

Definition
The cause of dissociative identity disorder is unknown;
four types of causative factors have been identified:
  • a traumatic life event (usually childhood physical or sexual abuse), vulnerability for the disorder to develop,
  • environmental factors, and the absence of external support.
  •  Death of a close relative or friend during childhood
  • witnessing a trauma or death are also traumatic events
Depersonalization disorder frequently occurs in life-threatening danger such as accidents, assaults, and serious illnesses and injuries. Although it has not been studied widely, depersonalization disorder may be caused by psychological, neurologic, or systemic disease. It has been associated with epilepsy, brain tumors, sensory deprivation, and emotional trauma as well as with an array of abused substances
Term

 

 

Somatoform Disorder

Definition
Theories Regarding Somatoform Disorders
Somatoform disorder is the diagnosis given to individuals who present with symptoms suggesting a physical disorder without demonstrable organic findings to explain the symptoms

Theories regarding the etiology of somatoform disorders include:

*biologic and genetic factors

*the organ specificity theory

*Selye's general adaptation syndrome

*Familial or psychosocial theory

*Learning theory.

Term

 

 

 

Somatization Disorder

 

Definition

Somatization Disorder

  • Classified as a somatoform disorder
  • It is a chronic, severe anxiety disorder in which a client expresses emotional termoil or conflict through significant physical complaints (including pain, and GI, sexual, and neurologic symptpms,) and usually with a loss or alternation of physical functioning
  • Differs from other somatoform disorders because of the multiple complaints voiced and the multiple organ systems affected.
Term

 

 

 

Primary Gain

Definition

 

Primary Gain

  • Allows relief from anxiety by keeping an internal need or conflict out of awareness
Term

 

Secondary Gain

Definition

Secondary Gain

Refers to any benefit or support from the enviornment that a person obtains as a result of being sick

 

Ex: attention, love, financial reward, sympathy

Term

 

 

La belle indifference

Definition

La belle indifference

Is used to describe client reactions such as showing inappropriate lack of concern about the symptpms and displacing no anxiety.

This is become anxiety has been relieved by the conversion disorder

Term

 

 

 

Four Subtypes of Conversion Disorder

Definition

Subtypes of Conversion Disorder

1. Motor sx. or deficit

    2. Sensory sx. or deficit

3. Seizures of convulsions with voluntary motor or sensory components

4. Mixed Presentation

 

Term

 

 

 

Conversion Symptoms Serve Four Functions

Definition

Conversion Sx. Serve Four Functions

 1. Permit the client to express a forbidden wish or impulse in a masked form.

 2. Impose punishment via the disabling symptom for a forbidden wish or wrong-doing

 3. Remove the client from an overwhelming life-threatening situation (primary gain)

 4. Allow gratification of dependency (secondary gain)

Term

 

Indidence of Conversion Disorder

Definition

Incidence of Conversion Disorder

  • Occurs more frequently in the rural population
  •  More common in adolescents and young adults
  •  May ocur for the first time during middle age or early adulthood
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