SON Mental Health Exam 2
Tertiary gains: Learning Theory - May relieve conflict within the family as concern is shifted to the ill person
**think TRIANGLE (3 people) and away from the real issue
TQ - relieve familial conflicts by shifting concern to sick person and away from
TQ the real issue
TQ
- Ex: child become sick when parents fight because it will stop parents from
fighting
La Belle indifference - conversion (FUNCTIONAL - feature of conversion disorder
NEUROLOGIC) disorder - feelings of indifference (unconcerned) to s/sx that seem serious to others
TQ
TQ - Ex: Pt can't move legs but is unconcerned, continues to play guitar
TQ TQ
, SON Mental Health Exam 2
Somatic symptom disorder 1. General info
1. General info - physical s/sx (PAIN) thought to be associated with medical cause, but no
2. S/sx organic causes found with diagnostic tools
3. Interventions - thought to be a RESPONSE to repressed anxiety
4. Priorities TQ
5. Outcome TQ
TQ TQ
TQ - real to pt, but unable to find the cause
TQ - psychological distress & long-term seeking of assistance for answers
- NO MEDICAL EXPLANATION FOR THIS (all bloodwork and tests will be
NORMAL) - this is an EMOTIONAL RESPONSE (however, the S/SX are REAL
and physically manifesting)
TQ
TQ
TQ
2. S/sx
- vague, dramatized, exaggerated
- often pain, GI issues, heart racing, chest pain
- abd, back, and joint pain
- headaches
- problems w/ pain during intercourse
- difficulty breathing, excessive worry
- depression, anxiety, SI
- heightened emotionality
- strong dependencies
- preoccupation w/ s/sx
4. Nursing Interventions
- rule out PHYSICAL causes of s/sx
- limit time discussing s/sx
- explore pt's feelings and fears
- meds to treat underlying symptoms (GABAPENTIN)
TQ
TQ
TQ
- diary of physical s/sx and periods of increased stress (bring to therapy)
- individual, group, and CBT therapy
- Identify gain that the physical symptoms may be providing
- when s/sx are present, encourage patient to JOURNAL so they can see what
might be happening to trigger s/sx (this helps to reassure pts that this is a
PSYCHOLOGICAL problem, not a physical one)
TQ
TQ
TQ
5. Parameters to Monitor
- SI and DEPRESSION
- drug and alcohol dependence (pts trying to alleviate these s/sx)
6. Priorities
- assess suicide risk, drug abuse/dependence, and provider hopping
7. Patient Outcomes
- make body-mind connection of what is causing physical s/sx
- develop healthy coping to manage stressors
, SON Mental Health Exam 2
One of the MOST COMMON SOMATIC S/SX is ______ PAIN
TQ - pain w/ intercourse
TQ - joint pain
TQ - back pain
- PAIN is the reason these pts go to SEE THE DOCTOR
, SON Mental Health Exam 2
Illness anxiety disorder (Hypochondriac) 1. General info
1. General info - unrealistic, inaccurate interpretation of PHYSICAL s/sx leading to fear and
2. S/sx preoccupation of having a serious disorder
3. Tx - exaggerated reaction
TQ - 2 types = Health seeking + Care avoidant
TQ TQ
TQ TQ
TQ
- another name for this = HYPOCHONDRIAC
TQ
TQ
TQ
2. S/sx
- pt has exaggerated response to any s/sx they are actual feeling (pt sees
mole, immediately thinks it's cancer)
TQ
TQ
TQ
- restless, EXCESSIVE worry 24/7
TQ
TQ
TQ
- fatigue, insomnia, anxiety + depression
- OCD traits
- EXTREME FEAR OF GETTING AN ILLNESS (however, no organic pathology -
no actual medical cause)
TQ
TQ
TQ
- CAUSE = past experience w/ serious of life-threatening illness (my sister
had this, my mom had this, etc.) can INCREASE risk
TQ
TQ
TQ
- DOCTOR-SHOPPING PATIENTS = patient going to MULTIPLE hospitals to
see if they have a disorder, and when that hospital tests and it comes
negative, pt disregards this and goes to ANOTHER hopsital
TQ
TQ
TQ
- DOCTOR-AVOIDANT PATIENTS = patient does NOT go to doctor or regular
checkups because they DON'T want to know (although they suspect they
have the disorder)
TQ
TQ
TQ
3. Tx
- monitor physical assessments and diagnostic tests/labs
- relaxation techniques
- assess the function the client's excessive concerns are fulfilling
- meds for underlying s/sx
- individual and CBT
- same OUTCOMES as Somatic Symptoms Disorder
Tertiary gains: Learning Theory - May relieve conflict within the family as concern is shifted to the ill person
**think TRIANGLE (3 people) and away from the real issue
TQ - relieve familial conflicts by shifting concern to sick person and away from
TQ the real issue
TQ
- Ex: child become sick when parents fight because it will stop parents from
fighting
La Belle indifference - conversion (FUNCTIONAL - feature of conversion disorder
NEUROLOGIC) disorder - feelings of indifference (unconcerned) to s/sx that seem serious to others
TQ
TQ - Ex: Pt can't move legs but is unconcerned, continues to play guitar
TQ TQ
, SON Mental Health Exam 2
Somatic symptom disorder 1. General info
1. General info - physical s/sx (PAIN) thought to be associated with medical cause, but no
2. S/sx organic causes found with diagnostic tools
3. Interventions - thought to be a RESPONSE to repressed anxiety
4. Priorities TQ
5. Outcome TQ
TQ TQ
TQ - real to pt, but unable to find the cause
TQ - psychological distress & long-term seeking of assistance for answers
- NO MEDICAL EXPLANATION FOR THIS (all bloodwork and tests will be
NORMAL) - this is an EMOTIONAL RESPONSE (however, the S/SX are REAL
and physically manifesting)
TQ
TQ
TQ
2. S/sx
- vague, dramatized, exaggerated
- often pain, GI issues, heart racing, chest pain
- abd, back, and joint pain
- headaches
- problems w/ pain during intercourse
- difficulty breathing, excessive worry
- depression, anxiety, SI
- heightened emotionality
- strong dependencies
- preoccupation w/ s/sx
4. Nursing Interventions
- rule out PHYSICAL causes of s/sx
- limit time discussing s/sx
- explore pt's feelings and fears
- meds to treat underlying symptoms (GABAPENTIN)
TQ
TQ
TQ
- diary of physical s/sx and periods of increased stress (bring to therapy)
- individual, group, and CBT therapy
- Identify gain that the physical symptoms may be providing
- when s/sx are present, encourage patient to JOURNAL so they can see what
might be happening to trigger s/sx (this helps to reassure pts that this is a
PSYCHOLOGICAL problem, not a physical one)
TQ
TQ
TQ
5. Parameters to Monitor
- SI and DEPRESSION
- drug and alcohol dependence (pts trying to alleviate these s/sx)
6. Priorities
- assess suicide risk, drug abuse/dependence, and provider hopping
7. Patient Outcomes
- make body-mind connection of what is causing physical s/sx
- develop healthy coping to manage stressors
, SON Mental Health Exam 2
One of the MOST COMMON SOMATIC S/SX is ______ PAIN
TQ - pain w/ intercourse
TQ - joint pain
TQ - back pain
- PAIN is the reason these pts go to SEE THE DOCTOR
, SON Mental Health Exam 2
Illness anxiety disorder (Hypochondriac) 1. General info
1. General info - unrealistic, inaccurate interpretation of PHYSICAL s/sx leading to fear and
2. S/sx preoccupation of having a serious disorder
3. Tx - exaggerated reaction
TQ - 2 types = Health seeking + Care avoidant
TQ TQ
TQ TQ
TQ
- another name for this = HYPOCHONDRIAC
TQ
TQ
TQ
2. S/sx
- pt has exaggerated response to any s/sx they are actual feeling (pt sees
mole, immediately thinks it's cancer)
TQ
TQ
TQ
- restless, EXCESSIVE worry 24/7
TQ
TQ
TQ
- fatigue, insomnia, anxiety + depression
- OCD traits
- EXTREME FEAR OF GETTING AN ILLNESS (however, no organic pathology -
no actual medical cause)
TQ
TQ
TQ
- CAUSE = past experience w/ serious of life-threatening illness (my sister
had this, my mom had this, etc.) can INCREASE risk
TQ
TQ
TQ
- DOCTOR-SHOPPING PATIENTS = patient going to MULTIPLE hospitals to
see if they have a disorder, and when that hospital tests and it comes
negative, pt disregards this and goes to ANOTHER hopsital
TQ
TQ
TQ
- DOCTOR-AVOIDANT PATIENTS = patient does NOT go to doctor or regular
checkups because they DON'T want to know (although they suspect they
have the disorder)
TQ
TQ
TQ
3. Tx
- monitor physical assessments and diagnostic tests/labs
- relaxation techniques
- assess the function the client's excessive concerns are fulfilling
- meds for underlying s/sx
- individual and CBT
- same OUTCOMES as Somatic Symptoms Disorder
