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Silvestre Psychology Diagnosis of somatoform disorders is made by no physical dysfunction no presence of drugs or other toxic substances no other mental health problems •
Conversion disorder is more common in Women and persons of lower socioeconomic status Those living in rural areas People with little health care knowledge
a stage of illness Symptom experience Assuming sick role Medical personnel are contacted Dependent patient role Recovery and rehabilitation stages of hospitalization stabilization adaptation being overwhelmed • • • • • • • • • • loss Can be actual, potential, imagined, temporary or permanent, maturational or situational, expected or unexpected Can occur suddenly or gradually
a stage of the grieving process denial yearning depression and identification
Affect may be described as: labile flat blunted Elizabeth Kübler-Ross’s stages of dying anger bargaining acceptance Depression can be associated feelings of worthlessness personal appearance declines suicidal thoughts stress hormones norepinephrine dopamine cortisol criteria for diagnosis of somatoform disorders medical condition can not be found to explain the symptoms the disorder significantly disrupt or impair one’s level of functioning the client is not aware of or is not able to express his or her emotional distress Reactions to loss level of development Past experiences current support system The dying process the last stage of growth and development it is an intensely personal process more than two thirds of all deaths now occur in health care facilities. or nursing homes . hospitals.
dysthymic disorder bipolar disorder major depression disorder cyclothymic disorder a mood stabilizing drug Lithium (Lithobid. renders people unable to shift attention from their loss to realities of every day. they become so preoccupied with the loss that they are unable to function effectively. The goal is to make the remainder of a person’s life as meaningful and comfortable as humanly possible.Unresolved grief can result from mental health problems. hospice care Episodes of depression alternate with episodes of mania. Lithonate) Divalproex (Depakoate) Carbamazepine (Tegretol) a mood disorder dysthymic disorder bipolar disorder major depression disorder cyclothymic disorder Hypomania dysthmyic disorder bipolar disorder cyclothymic disorder “la belle indifference” somatization disorder conversion disorder factitious disorder malingering hypochondriasis .
Caucasians. imagined temporary permanent. Health is a dynamic state in which aspects of the social. Bipolar disorder individuals who cycle rapidly have poorer prognosis. Situational crisis is an event with which persons are unable to cope. Loss can be actual. Women. The highest rates in elderly women. Depression Is not a normal consequence of aging. Major depression affects as many as 80% of older Americans. potential. or intellectual condition illness function of a person are diminished or impaired. and individuals with fewer than 12 years of school risk of depression.Grief is the set of emotional reactions that accompany a loss. emotional. it expected or unexpected. Children older than 8 years understand the permanency of death. medically ill persons. . physical. and individuals receiving long-term care. Types of unresolved grief bereavement-related depression and complicated grief.
symptoms commonly relate to minor abnormalities. those living in rural areas. more common in women and persons of lower socioeconomic status. fake an illness. or pretend to have a seizure Hypochondriasis an intense fear of or preoccupation with having a serious disease or medical condition based on misinterpretation of physical signs or symptoms. the disorder significantly disrupts or impairs one’s level of functioning. ingest medications to produce dramatic side effects.somatization disorder at least four pain symptoms two gastrointestinal symptoms one sexual symptom one neurological symptom factitious disorder symptoms are purposefully produced to assume the sick role. produce abscesses by injecting saliva into skin. persists even when all diagnostic test results are negative and reassurances have been given by various physicians. producing symptoms to avoid military service. jury duty. purposefully and willfully produce the signs or symptoms for some form of gain (secondary gain – being relieved of responsibilities. they commonly “doctor shop” seeing several physicians at the same time malingering signs and symptoms are intentionally produced. receiving special attention from others). food. will produce symptoms to receive compensation. people with little health care knowledge somatoform disorder no medical condition can be found to explain the symptoms. or vague physical sensations. or social obligations. body functions. or shelter Conversion an interesting feature is “la belle indifference” – a lack of concern about the signs or symptoms. self-inflicted illnesses or injuries or exaggerated symptoms of actual physical problem. the client is unaware of or unable to express his or her emotional distress . the police.
poor decision-making skills. it is characterized by chronic sadness and self-criticism. feelings of worthlessness. symptoms include low energy levels. thoughts. behaviors range from paralysis to agitation. and despair. but less than the extreme emotional swings of bipolar disorder Body dysmorphic disorder characterized by a preoccupation with a physical difference or defect in one’s body. loss of confidence . to grandiose. eating and sleeping habits deteriorate. and eating and sleeping difficulties Cyclothymic disorder a pattern of repeated mood swings alternating between hypomania and depressive symptoms. can often carry out ADL’s but are seldom able to enjoy them. guilt. and activities that follow a loss potential loss facing a layoff. most common site of concern is the face or head. often describe themselves as “ugly” or “unacceptable” Major depressive disorder severe and lasts more than 2 weeks. feelings.dysthymic disorder daily moderate depression that lasts for more than two years. suicidal thoughts Bipolar disorder sudden and dramatic shifts in emotional extremes between mania and depression. and behaviors swing cyclically from normal. poor concentration and an inability to follow through on tasks lead to feelings of powerlessness and helplessness. to depressed Bereavement the behavioral state of thoughts. moods. personal appearance declines.
Situational loss death of a loved one. to conserve energy and be free from pain third level in hierarchy of a dying person’s needs to talk. to maintain independence and to feel like a normal person . to be listened to with understanding fourth level in hierarchy of a dying person’s needs to maintain respect in face of increasing weakness. divorce actual loss an actual threat or a family whose house burns in flames Maturational loss individual must give up something to gain a higher level of development second level in hierarchy of a dying person’s needs to be given opportunity to voice hidden fears fifth level in hierarchy of a dying person’s needs to share and come to terms with unavoidable future first level in hierarchy of a dying person’s needs to obtain relief from physical symptoms.