Module 3
NUR 175
Chapter 12
Compare and contrast the essential characteristics of somatic symptom disorders
versus those of dissociative disorders
● Somatic Symptom Disorder:
○ Persistent preoccupation with and distress over physical symptoms
○ Client experiences symptoms of significant anxiety and life impairment
○ Associated with increased healthcare use, functional impairment, provider
dissatisfaction, psychiatric comorbidity, and failed treatment response.
○ May be exacerbated by comorbidity of other physical disorders
● Dissociative Disorders:
○ Disturbances in normally well-integrated continuum of consciousness,
memory, identity, and perception
○ Dissociation - the unconscious defense mechanism to protect an
individual against overwhelming anxiety
○ Intact reality testing - is not delusional and not hallucinating
○ Includes amnesiac states
Differentiate the key characteristic differences among somatic symptom disorders,
malingering, and factitious disorders
● Somatic Symptom Disorders: Group of disorders characterized by the presence of
physical symptoms in the absence of known physical findings or mental illnesses
that would explain the symptoms.
● Malingering: A conscious process of intentionally producing symptoms for an
obvious benefit.
○ Ex: An employee complains of nonexistent back pain to claim disability.
● Factitious Disorders: Deliberate fabrication of symptoms or self-injury without
obvious gains (e.g. economic incentive).
○ Thought to be for the purpose of assuming the sick role and receiving
nurturance, comfort, and attention.
○ A person may exaggerate a symptom, fabricate a symptom, or simulate
and/or induce a symptom.
○ Ex: Person injects a caustic substance into the skin to form an abscess,
exacerbate a wound, use medication inappropriately, or self-induce fever or
seizures.
NUR 175
Chapter 12
Compare and contrast the essential characteristics of somatic symptom disorders
versus those of dissociative disorders
● Somatic Symptom Disorder:
○ Persistent preoccupation with and distress over physical symptoms
○ Client experiences symptoms of significant anxiety and life impairment
○ Associated with increased healthcare use, functional impairment, provider
dissatisfaction, psychiatric comorbidity, and failed treatment response.
○ May be exacerbated by comorbidity of other physical disorders
● Dissociative Disorders:
○ Disturbances in normally well-integrated continuum of consciousness,
memory, identity, and perception
○ Dissociation - the unconscious defense mechanism to protect an
individual against overwhelming anxiety
○ Intact reality testing - is not delusional and not hallucinating
○ Includes amnesiac states
Differentiate the key characteristic differences among somatic symptom disorders,
malingering, and factitious disorders
● Somatic Symptom Disorders: Group of disorders characterized by the presence of
physical symptoms in the absence of known physical findings or mental illnesses
that would explain the symptoms.
● Malingering: A conscious process of intentionally producing symptoms for an
obvious benefit.
○ Ex: An employee complains of nonexistent back pain to claim disability.
● Factitious Disorders: Deliberate fabrication of symptoms or self-injury without
obvious gains (e.g. economic incentive).
○ Thought to be for the purpose of assuming the sick role and receiving
nurturance, comfort, and attention.
○ A person may exaggerate a symptom, fabricate a symptom, or simulate
and/or induce a symptom.
○ Ex: Person injects a caustic substance into the skin to form an abscess,
exacerbate a wound, use medication inappropriately, or self-induce fever or
seizures.
