Physical Problems, psychological Sources Chapter 22 Physical Problems, psychological Sources

Learning Objectives Explain the purpose of the physiological stress response Illustrate hoe stress can affect immune system functions Describe five physical responses related to the physiological stress response Examine three theories that explain the role of emotions in the development of illness Compare three culturally related somatization disorders.

Learning Obj. Explain the differences between conversion disorders and somatization disorders Describe the most essential features of hypochondriasis Compare the differences between hypochondriasis and malingering Plan three therapeutic goals of care for clients with psychophysiological disorders

Role of Emotions in Health Health is a concept that embodies the whole person Animals have evolve a stress response mechanism that protects them during times of threat or illness - Fight or flight response

Anxiety and stress Stressors of modern life are many, but outlets for the stress response are few.  Physiological stress response Biochemical fight or flight response General adaptation syndrome  Biochemical reactions of the stress response and their effects on various body systems The immune system is affected by stress levels

Anxiety and Stress The psychological aspects of an individual have a strong impact on the ability to identify and successfully cope with stress Physical problems that arise from psychological sources create disorders such as Somatoform disorders Psychosomatic disorders Psychophysical disorders

Anxiety and Stress Childhood disorders Individuals learn how to perceive and respond to stress in childhood Children who have experienced an unstable home environment may react to stress as adults with exaggerated homonal mechanisms Family who emotionally support and encourage their children to effectively cope with their stresses have few physical complaints

Psychophysical problems Psychophysical disorder Stress related physical problems The body system that experiences much of the stress response is the Gastrointestinal tract

Theories of Psychophysical Disorders Stress response theory Individuals are biochemically patterned to react to stress. Carl Jung’s theory Focuses on the symbolism attached to a symptom or illness. Eric Fromm’s theory  Certain personality types are prone to developing certain illnesses. Organic weakness theories  Every individual has one body system that is more sensitive than other systems

Somatoform Disorders A condition in which physical symptoms are felt in the absence of disease or out of proportion to an ailment About 80% of basically healthy people have somatic symptoms in any given week. Signs and symptoms of illness may be client’s way of coping with emotional distress.

Somatoform Disorders Diagnosis is made by first excluding: Physical dysfunction Presence of drugs or other toxic substances Mental health problems If no medical condition accounts for symptoms, the diagnosis is usually a somatoform disorder.

Somatoform Disorder Cultural Influences Many somatic illnesses are based on cultural or spiritual beliefs Assessment and treatment plans must not threaten or challenge these beliefs if therapeutic interventions are to be effective The effective health care provider does not hesitate to learn as much as possible about other cultures

Somatoform Disorder How to differentiate a somatization disorder from a medical problem Involvement of multiple organ systems suggests somatization disorder The disorder is characterized by an early onset and is a chronic condition in which no physical changes occur over time The absence of any significant laboratory values indicate that the underlying problems may be emotionally based

Conversion Disorder Thought to be a somatoform disorder in whose symptoms are related to sensory or motor functions More common in Women and persons of lower socioeconomic status Those living in rural areas People with little health care knowledge

Conversion Disorder Thought to be result of emotional conflict Onset usually during late childhood through early adulthood Children usually present with gait problems or seizures. Older individuals’ signs and symptoms usually take form of sensory or motor disturbances Signs and symptom tend to be more in keeping with the individual’s idea of what the problem should be.

Hypochondriasis A somatoform disorder An intense fear of or preoccupation with having a serious disease or medical condition based on misinterpretation of physical signs or symptoms Persists even when all diagnostic test results are negative and reassurances have been given by various physicians Clients commonly “doctor shop”

Factitious Disorders and Malingering They differs from somatoform disorders in that signs and symptoms are intentionally produced for some form of gain Some make major focus of life seeking admission to or staying in health care facilities

Therapeutic Goals Rule out physical disease or dysfunction Develop trust Clients’ suffering is very real to them. Health care providers must be aware of how their behaviors and attitudes affect clients. All care providers should attempt to understand what purposes clients’ symptoms serve. Encourage expression of feelings and emotional state rather than physical symptoms Meet physical needs when necessary but encourage independence.