1. Physical Problems, psychological Sources
Chapter 22
Physical Problems, psychological Sources

2. 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.

3. 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

4. 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

5. 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

6. 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

7. 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

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

9. 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

10. 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.

11. 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.

12. 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

13. 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

14. 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

15. 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.

16. 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”

17. 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

18. 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.