Unit 9
PSYCHOPATHOLOGY, ETIOLOGY, AND P
SYCHODYNAMICS
EATING DISORDERS
- Disorders are characterized mainly by
excessive concern about food and wei
ght control.
- Common among adolescent females.
● Anorexia Nervosa
● Bulimia Nervosa
Common etiological factors
- Psychological factors: pwede iniisip n
a we are not good enough sa way ng
pagpepresent ng sarili natin sa iba.
- Individual factor (conflict about growin
g up)
- Parental factor (domineering parents):
parents are too controlling in life, espe
cially in the way how we present ours
elves. Being slim is also one way of pl
easing men.
- Sociocultural factors (effect of mass m
edia): challenge on social media like T
ikTok. Being slimmer is much better.
Types
● Anorexia Nervosa: Life-threatening d
isorder characterized by:
- Clients refuse or inability to ma
intain a minimally normal body
weight.
- Intense fear of gaining weight
or becoming fat
- Disturbed perception of the sh
ape of the body (mapayat pero
ang tingin nila sa sarili sa mirro
r ay mataba sila)
- Refusal to acknowledge the se
riousness of the problem (wala
na sa reality, ang tingin nila sa
sarili ay mataba sila)
- Body weight is 85% less than f
or their age and height (assess
ing the BMI)
Amenorrhea: no menstruation for 6 months b
ecause of disturbed hormones
No organic factor accounts for weight loss
Obviously thin but feels fat (Body Image DIstu
rbance)
Refusal to maintain normal body weight, fear
of gaining weight
Epigastric discomfort (abdominal pain) is com
mon; constipation, emaciation, elevated BUN
Xsympotms (peculiar symptoms, like hiding fo
ods)
Insomnia
Always thinking of foods
Treatment
Focus on:
- Weight restoration: gradually or unti-u
nting gagawin
- Nutritional rehabilitation
- Rehydration
- Correction of electrolyte imbalance
Drugs:
- Amitriptyline (Elavil) and Cyproheptadi
ne (Periactin) for weight gain
- Olanzapine (Zyprexa) promotes weigh
t gain and produces an antipsychotic
effect.
Bulimia Nervosa: An eating disorder charact
erized by episodic, binging on food followed b
y purging in the form of vomiting.
- Kakain ng kakain then afterward ifforc
e sarili na magsuka
- Alam sa sarili na hindi tama ginagawa
at nasa normal range ang weight
Binge eating
Under strict dieting (low-calorie foods) or vigo
rous exercise
Lacks control over eating bingers; loss of den
tal enamel; chipped ragged or moth-eaten ap
pearance to teeth
Induced vomiting; increased dental carries
Minimum of 2 binge-eating episodes a week f
or 3 months
Increase/ persistent concern of body size/ sh
ape; weight usually in the normal range, altho
ugh sometimes are overweight or underweigh
t.
Abuse of diuretics and laxatives
Common Nursing Diagnosis
- Body image disturbance
- Self steam disturbance
- Ineffective individual coping
Principles of Nursing Care
- Monitor patients weight: take weight e
very morning while wearing the hospit
al gown, check for pockets if may nila
gay na pampabigat para madagdagan
yung weight
- Encourage frequent oral hygiene
 - Stay with the patient during mealtime
and within 2 hours after the meal: bak
a mag induced ng vomiting si patient
- Encourage the patient to remain in a p
ublic place after meals
- Behavior modification therapy
Fetishism Sexual arousal elicited by inanimate object
s or specific body parts
Sexual Masoc Erotic interest in receiving psychological or
hism physical pain, real or fantasized

Nursing Interventions for Eating Disorders Autoerotic As Constriction of the neck to enhance mastur
phyxia bation experience
a. Establishing nutritional eating patterns Often leads to accidental death
b. Sit with the client during meals and sn
acks. Transvestism Erotic interest is achieved by using the app
c. Offer liquid protein supplements if the arel of the opposite sex
client is unable to complete the meal.
d. Adhere to treatment program guidelin
es regarding restrictions.
e. Observe the client following meals an TYPES COERCIVE SEXUAL ATIMULUS
d snacks for 1 to 2 hours.
f. Weight the client daily in uniform clothi Exhibition Publicly exposure of the geni
tals to a stranger
ng. May be accompanied by aro
g. Be alert for attempts to hide or discard usal and musterbation either
food or inflate weight. during or after the exposure
h. Helping the client identify emotions an
Voyeurism Secret observation of an uns
d develop non-food-related coping str uspecting person engaged in
ategies. a private act
i. Ask the client to identify feelings. Vouyer often masturbates du
ring or after the viewing
j. Self-monitoring using a journal
k. Relaxation techniques. Frotteurism Intense sexual arousal elicit
l. Distraction. by rubbing the genitals to a n
m. Assist the client in changing stereotypi on-consenting person
cal beliefs. Pedophilia Sexual intercourse or interes
n. Helping the client deal with body imag t with a child
e issues.
Urophilia Urinating on the sexual partn
o. Recognize the benefits of a near-norm
er
al weight.
p. Assist in viewing self in ways not relat Coprophilia Smearing feces on the partn
ed to body image. er
q. Identify personal strengths, interests, Sadism Erotic interest in inflicting phy
and talents. sical pain
r. Providing clients and family education.
Nursing Interventions
SEXUAL DISORDERS - Diversional Activities
- Limit-setting
Paraphilias: Abnormal expression of sexualit - Behavior Modification
y
SUBSTANCE RELATED DISORDER
- Philadelphia may lugar na tinatawag n
a “Zombie land”,kung saan talamak dit
o yung mga tao na gumagamit ng illeg
al drugs
TYPES (NON- SEXUAL STIMULUS
COERCIVE) Terminologies

Intoxication use of a substance that results i

n maladaptive behavior.

Withdrawal Symptoms refer to the negative
psychological and physical reactions that occ
ur when the use of substance abuse ceases
or dramatically decreases.
Detoxification is the process of safely withdr
awing from a substance.
Substance Abuse use of a substance for oth
er than its legitimate medical purpose.
Substance dependence is physiological and
psychological dependence of the body on a s
ubstance as evidenced by tolerance in withdr
awal.
Black-out an episode during which the perso
n continues to function but has no conscious
awareness of his or her behavior.
Tolerance the patient needs more of the sub
stance to produce the same effect.
Tolerance Break after continued heavy drinki
ng, the person experiences intoxication in a v
ery small amount of the substance.
Spontaneous remission, also known as natu
ral recovery.
Withdrawal Syndrome or a group of sympto
ms experienced by the patient when the amo
unt of the substance is reduced or the intake i
s stopped.
Factors
- Biological (Genetic/ Hereditary)
- Psychologic
- Social and environmental
Alcoholism: World Health Organisation (WH
O) defines alcoholism as a chronic disease or
disorder characterized by excessive alcohol i
ntake and interference in the individual's healt
h, interpersonal relationships, and economic f
unctioning.
- Consider to be present when there is .
1% or 100-150 mgs. of alcohol.
Level of intoxication
- 0.1-.2% (low coordination)
- .2-.3% (presence of ataxia, tremors, ir
ritability, stupor)
- .3 and above (unconsciousness)
Etiological Theories of Alcoholism
- Psychoanalytic Theories: due to fixati
on in the oral stage development
- Learning Theories: due to inherited tra
its
- Socio-cultural Theories: due to effects
of mass media
Phases of Progression of Alcoholism
- Pre-alcoholic Phase: starts with social
drinking until tolerance begins to devel
op
- Prodromal Phase: Alcohol becomes a
need: blackout’s occur; denial begins t
o develop
- Crucial Phase: cardinal symptoms of
alcoholism develop (loss of control ov
er drinking)
- Chronic Phase: the person becomes i
ntoxicated all-day
Outcomes
Brain damage
Alcoholic hallucinosis
Death
Common Behavioral Problems of the Alco
holic Patient
D: Denial, Dependency, Demanding, Destruct
ive, Domineering
Signs and Symptoms
Hallucinations, visual and tactile
Increased vital signs
Tremors
Sweating and seizure
Defense Mechanisms
Denial
Rationalization
Isolation
Projection
Withdrawal and detoxification
- Symptoms of withdrawal usually begin
4 to 12 hours after cessation or marke
d reduction of alcohol intake
- Withdrawal may take 1 to 2 weeks
Criteria: DELIRIUM TREMENS
Cause: Faulty metabolism of alcohol
Onset: Acute
Essential feature: Delirium, Increased v/s, vi Mouth wash
sual and tactile hallucinations Over-the-counter cold remedies
Other s/sx: Coarse Tremors Food sauces made up of wine
Fruit flavored extracts
Criteria: KORSAKOFF’S PSYCHOSIS Aftershave lotions
Cause: Thiamine & Niacin deficiency Vinegar
Onset: Chronic Skin products
Essential feature: Memory disturbances
Other s/sx: R - etrograde amnesia Nursing Interventions
A- nterograde amnesia - Behaviour modification: firmness-of-fa
C- onfabulation ct attitude.
K- orsakeff’s psychosis - Detoxification: the first step in rehabilit
Thiamine is not produces by the food, we can ation
get thiamine on foods such as cereals and br - Administer medicine as ordered.
eads. ❖ Antihypertensive: anti-a
nxiety: administer to pa
Criteria: WERNICKES PSYCHOSIS tients who are abusing
Cause: Thiamine deficiency stimulants.
Onset: Chronic ❖ Anti-anxiety; anti-depre
Other s/sx: C - onfusion ssants: administer to p
O - pthalmoplegia atients who are abusin
A - taxia g depressants
T - thiamine deficiency ❖ Anti-anxiety (Librium);
disulfiram (Antabuse):
Principles of Nursing Care administer to patients
- Provide a well lighted room who are abusing alcoh
- Diet as tolerated ol
- Monitor vital signs ALCOHOLIC ANONYMOUS (AA)
- Administration of glucose and vitamin - Founded in 1930’s by alcoholics
supplement - Self-help group developed by 12 step
program model for recovery which is b
Drug of Choice ased on the philosophy of total abstin
- Disulfiram (Antabuse): delays the met ences is essential and that alcoholics
abolism of alcohol need help and support of others to ma
intain sobriety
Long Term Goals of Care AA MEETINGS
- “Closed” only those who are pursuing
Community resources and support system recovery can attend
Other means of coping - “Open” anyone can attend
Personal decision to avoid alcohol
Increased self-esteem Narcotics Anonymous
Nutrition (Vit B and C) Al-anon - a support group for spouse
Group therapy, to enable the patient to devel s, partners, and friends of alcoholics
op insight into his problems Ala Teen - a group of children of pare
nts and friends of alcoholics.
Priority Nursing Diagnosis
- Ineffective individual coping Alcohol Treatment
- Vitamin B1(thiamine)
Instruction to the patient who will take Dis - Cyanocobalamin (Vitamin B1
ulfiram (Antabuse) 2)
- Avoid alcohol-based substances for at - Disulfiram
least 12 hours before giving antabuse,
like: Nursing Intervention
 - Health teaching for the client and famil
y - Withdrawal from stimulants occurs wit
- Dispel myths surrounding substance a
buse.
- Decrease codependent behaviors am
ong family members.
- Make appropriate referrals or family m
embers.
- Promote coping skills.
- Role-play potential difficult situations
- Focus on the here- and- now with the
clients
- Set realistic goals, such as staying so
ber today.
STIMULANTS: are drugs that stimulate or ex
cite the central nervous system
Amphetamines (uppers) were popular in the
past; they were used by people who wanted t
o lose weight or to stay awake
Cocaine is an illegal drug with virtually no clin
ical use in medicine, is highly addictive and a
popular recreational drug because of the inte
nse and immediate feeling of euphoria it prod
uces.
Methamphetamine is particularly dangerous;
it is highly addictive and causes psychotic be
havior
Intoxication and overdose
Clinical Manifestation
- High or euphoric
- Hyperactivity
- Hypervigilance
- Talkativeness
- Anxiety
- Grandiosity
- Hallucinations
- Sterotypic or repetitive behavior
- Anger
- Fighting
- Impaired judgment
- Tachycardia
- anorexia/ loss of appetite
- Elevated blood pressure
- Dilated pupils, perspiration or chills, n
ausea, chest pain, confusion, and car
diac dysrhythmias
- Overdose of stimulants can result in s
eizure, coma, and death
Withdrawal and Detoxification
hin a few hours to several days after c
essation of the drug and is not life-thre
atening
- Marked dysphoria is the primary symp
tom and is accompanied by fatigue, vi
vid and unpleasant dreams, insomnia,
or hypersomnia, increased appetite, a
nd psychomotor are retardation or agit
ation.
- Marked withdrawal symptoms are refe
rred to as “crashing symptoms”
- The person may experience depressiv
e symptoms including suicidal ideation
for several days.
- Stimulant withdrawal is not treated ph
armacologically.
Cannabis (marijuana): is the hemp plant tha
t is widely cultivated for its fiber used to make
rope and cloth and oil from its seed.
Effects
- Cannabis begins to act less than 1 mi
nute after inhalation
- Peak effects usually occur 20 ro 30 mi
nutes and last at least 2 to 3 hours
Clinical Manifestations
- Impaired motor coordination
- Inappropriate laughter
- Impaired judgment and short-term me
mory
- Distortion of time and perception
- Anxiety
- Dysphoria
- Social withdrawal
- Increased appetite
- Conjunctive injection (bloodshot eyes)
- Dry mouth
- Hypotension
- Delirium
- Cannabis-induced psychotic disorder
Withdrawal and detoxification
- No clinically significant withdrawal sy
mptoms is identified
- Cannabis does not cause intoxication
Opioids: popular drugs of abuse because the
y desensitize the user to both physiologically
and psychological pain and induce a sense of Intoxication and Overdose
euphoria and well being
Clinical Manifestation
Opioids - Anxiety
- Morphine - Depression
- Mepereidine (demerol) - Pranoid ideation
- Codeine - Ideas of reference
- Hydromorphone - Fear of losing one’s mind
- Oxycodone - Potentially dangerous behavior such a
- Methadone s jumping out a winow in that belief th
- Oxymorphone at one can fly
- Hydrocodone - Sweating
- Propoxyphene - Tachycardia
- Heroin - Palpitations
- Normethadone - Blurred vision
- Tremors
Clinical Manifestation - Lack of coordination
- Aggression
Pinpoint pupils - Impulsivity
Drowsiness - Unpredictable behavior
Incoordination
Treatment
Treatment for Intoxication (Opioid) - These drugs are not a direct cause of
- Administer of Naloxone (Narcan) death although fatalities have occured
from related accidents, aggression an
● An opioid antagonist d suicide.
● Is the treatment of choice beca - Treatment is supportive
use it reverses all signs of opio - Psychotuic reactions are managed be
id intoxication st by isolation from external stimuli
● Naloxene is given every few h - Physical restraints
ours until the opioid level drop - Cooling devices such as hyperthermia
s to nontoxic. blanket are used and mechanical vent
ilation is used to support respirations.

Withdrawal and Intoxication Inhalants: diverse group of drugs including a

Runny nose nesthetic, nitrates, and organic solvents that
Impotence are inhaled for their effects.
Piloerection
Inhalants:
Hallucinogens: Substances that disto - Gasoline
rt the user’s perception of reality and p - Glue
roduce symptoms similar to psychosis - Paint thinner
including hallucinations (usually visua - Spray paint
l) and depersonalization. - Cleaners
- Spay caan propellants
Examples: - Esters
- Mescaline - Ketones
- Psilocybin - Glycols
- Lysergic acid
- Lysergic acid Diethylamide (LS Intoxication
D) Clinical Manifestations
- Designer drugs such as ectasy - Dizzines
- Phencyclidine (PCP) - Nystagmus
- Lack of coordination
 - Slurred speech A-ttachment to inanimate objects
- Unsteady gait W-ants balls not blocks
- Tremors N-ot cuddly
- Muscle weakness N-o fear of danger
- Blurred vision
- Stupor and coma can occur Drug
- Belligerence - Low dose antipsychotics
- Agression Tantrums
- Impaired judgment - Involves head banging
- Inability to function - Provide safety
- Helmet
Acute Toxicity - Padded walls
- Anoxia - Monitor behavior
- Respiratory depression Communication
- Vagal stimulation - All vowels
- Dysrhytmias - Use short sentences when talking to t
- Death- bronchospasm, cardiac he child
arrest, suffocation Nutrition: Less than body requirements
- Provide well balanced diet
Treatment - Small frequent feedings
- Supporting respiratory and cardiac fun Routines
ctioning until the substance is remove - Provide consistency
d from the body Love and Belongingness
- There are no antidotes or specific me - Family therapy
dications to treat inhalants toxicity. Priority Nursing Diagnosis
- Risk for injury

Part 3 Unit 9 Attention deficit hyperactivity disorder (ADH

Autism spectrum Disorder D)
- It is a disorder characterized by impair - It is characterized by persistent patter
ment in communication skills, or the pr n of inattention hyperactive and impul
esence of stereotypes behavior, intere sive behavior that occurs between the
sts and activities with associated impa age of 7
irment in social interactions - Most common in boys
- More common among boys Main problem
- Usually diagnosed at age 2 Inattention
- treatable , but not curable Hyperactivity
- Does have a genetic link Impulsitivity
Main Problem
- Impaired interpersonal Functioning D- ifficulty remaining seated
E- asily distracted by extraneous stimuli
S- illy , laughing or giggling F-idgeting
P- oints to anything I-nterrupts/ intrudes on others
I- nsensitive to pain C-hild exhibits hyperactivity
N- o eye contact I-ndulges in destructive behavior
S-ustained odd play T-alks excessively
Drugs Nursing consideration
D-ifficulty interacting with other
E-cholalia Methylpohenidate (Ritalin Monitor for appetite suppres
sion and growth delays
A-cts as deaf Give regular tablets after me
R-esist normal teaching methods al
Alert client that full drug effe
ct takes 2 days
C-rying tantrums
L-oves to spins objects Dectroamphetamine (dexedr Monitor for insomnia
ine) Give last dose early afternoo L-ead poisoning
n
Full drug effect takes 2 days R-ecent Infections (measles)
Pemoline (cylert) Monitor for elevated liver fun E-nvironmental factors
ction T-hyroid deficiency
Drug may take 2 weeks for f
ull effect
A-lcoholic mother
R-H incompatibility
D-amage to brain from various cause
A-ids
Nursing Intervention for ADHD T-oxemia
1. Ensuring the child’s safety and that of I-nherited factor
others O-piate intoxication
- Stop unsafe behavior Neurological/ neuro developmental impairem
- Provide close supervision ent
- Give clear directions about acc
eptable and unacceptable beh
avior Mild/m IQ - 55-69 Educable
2. Improved role performance oron
- Give positive feedback for mee Modera IQ 40-54 Trainable
ting expectations te/Imbe
- Manage the environment (qui cile
et place fee of distractions) severe IQ 25-39 Needs close su
3. Simplifying instruction/directions /idiot pervision
- Get the child’s full attention
Profou Below 25 Needs custodial
- Break complex tasks into small nd care
steps
- Allows breaks
Educable
4. Structured daily routine
- Patient can be taught how to read and
- Establish a daily schedule
write
- Minimize changes
Trainable
5. Nutrition
- Vocational skills (cooking, sewing)
- Provide finger foods
Close supervision
6. Client/family education and support
- Activities of daily living (brushing, wea
- Listen to the parent’s feelings
ring clothes)
and frustrations
Custodial care
- Client is totally dependent
Mental Retardation
- Significantly subaverage interllectual f
Role of education
unctioning resulting in impairment in a
Reading and writing ‘
daptive behavior manifested before th
e age of 18
Abuse and Violence
- IQ less than 70
- Not a mental illness \
Rape
Main Problem
- According to RA 8353 (the anti-rape la
- Inadequate mental functioning
w of 1997) refers to the forcible inserti
on of the penis into the mouth, vagina,
Causes
or anus of the victim
- It is generally considered as an act of
M- aternal infection
hostility, anger and violence
E-xact getational age is not reached (prematu
- It is a crime of violence and humiliatio
re)
n of the victim expressed through sex
N-utritional deficiency
ual means
T-oxoplasmosis
- It is the penetration of an act of sexual
A-noxia
intercourse with a female against her
 will and without her consent, whether
her will is overcome by force, fear of f
orce, drugs or intoxicants
- It is also considered rape if the woma
n is incapable of excersing irrational ju
dgement because of mental deficienc
y or when she is below the age of con
sent.
Differnt kinds of rape
Power rape
- The intent of the rapist is not to injure t
he victim but to command and master
another person sexually
- The rape is the vehicle for expressing
power and potency
- This is done to prove one’s masculinit
y ed by wife beating by the husband, hu
Sadistic rape
- Involves brutality
- The use of bondage and torture is not
an expression of anger but necessary
for the rapist’s sexual excitement
- The assualt is often erocticized and is
sexually stimulating
- This is done to express erotic feelings
Rape Trauma Syndrome
- It refers to a group of signs and sympt
oms experienced by a victim in reactio
n rape
Phases of RTS
- Acute phase - characterized by shock,
numbness, and disbelief
- Denial- characterized by the victims re
fusal to talk about the event
- Heightened anxiety- caharcterized by
fear, tension, and nightmares
- Stage of reorganization - the victims lif
e normalizes
Nursing care for rape victims
- In the emergency setting, provide imm
ediate emotional support
- The nurse should allow the woman to
proceed at her own pace and not rush
her through any interview or examinati
on
- Give as much control back to the victi
m as possible by allowing her to make
decsions, when possible, about whom
to call, what to do next, what she woul
d like done.
- It is the victims decisons wheter or not
to file charges and testify against the
perpetartor and the victim must sign c
onsent forms before any photographs
of hair and nails samples are taken for
duture evidence
- The priority in the care of a rape victim
is the preservation of evidence
- Prophylactic treatment of STDs is offe
red
- Prophylaxis can be offered to prevent
pregnancy
- In some instances and areas, HIV test
ing is strongly encourage
- Referrals to rape crisis centers are en
courage
Battered wife syndrome
- Cycle of domestic violence charcateriz
miliation and other forms of aggressio
n
- The most common train of abusive me
n in low self-esteem
- The most common trait of the abused
women is dependence
Characteristics of abusive husband
- They usually come from abusive famili
es
- They are immature, dependent and no
n-assertive
- They have strong feelings of inadequa
cy
Phases
- Tension building phase: involves mino
r battering incidents
- Acute battering incident; more serious
form of battering
- aftermath/honemoon stage : the husb
and becomes loving and gives the wif
e hope
Priority in the care of the battered wife
- Provision of shelter
Child abuse
- Abuse is what happens when an older
adult take advantage of his authority o
ver a younger child
- Violence refers to the use of force
- Neglect if the lack of provision
- Two components: child abandonment
and child neglect
Physical abuse
- Abuse in the form of inflicting pain
Emotional abuse
 - Abuse in the form of insults and under
mining one’s confidence
Sexual abuse
- Abuse in the form of unwanted sexual
contact
Characteristics of abusive parents
- They come from a violent families
- Thwey were also abused by their pare
nts
- They have inadequate parenting skills
- They are socially isolated because the
y don’t trust anyone
- They are emotionally mature
- They have negative attitude towards t
he management of the abused
Indicators of child abuse
S-erious injuries in various stages of healing
H-ealthy hair in various length
A- pathy, no reason
D-epression
E-xcessive knowledge of sex
S-elf esteem is low
What is the priority
- RA 7160, anti-child abuse law require
s reporting of suspected cases to auth
orities
- Report cases to the barangay officers,
dswd personel, police within 48 hours
Part 4
Obsessive Compulsive Disorder (OCD): in
volves obsession (thoughts, impulses or imag
e) that caused marked anxiety and/or compuli
ons (repititive behaviors or mental acts) that a
ttemp to neutralize anxiety
- Preoccupation with orderliness, perfec
tionism and control
Obsessions Compulsions
- Fear of dirt and gam - Excessive handd was
es hing
- Fear of bulgary or ro - Repeated checking
bbery of door and window
locks
Grief or Loss
Grief refers to the subjective emotions and af
fect that are a normal response to the experie
nce of the loss. Grieving also known as bere
avement, refers to the the process by which a
person experiences grief.
Type of Losses
1. Physiological loss: examples includ
e amputation of a limb, a mastectomy
or hysterectomy or loss of mobility.
2. Safety loss: loss of a safe environme
nt is evident in domestic violence, chil
d abuse, or public violence.
3. Loss of security and a sense of bel
onging: the loss of a loved one affect
s the need to love and feeling of being
loved.
4. Loss of self-esteem: any change in h
ow a person is valued at work or in rel
ationships or by him or herself can thr
eaten self-esteem
5. Loss related to self-actualization: a
n external or internal crisis that blocks
and inhibits striving toward fulfillment
may threaten personal goals and indiv
idual potential.
Stages of Brief/ Grieving
DENIAL
ANGER
BARGAINING
DEPRESSION
ACCEPTANCE
Nursing Diagnosis
- Ineffective individual coping
Principles of Nursing Care
Be physically present
Be non-judgmental
Encourage verbalization of feelings
Allow the patient to cry
Recognize your own thoughts about death an
dying or grieving
SOMATIC SYMPTOM ILLNESSES
- The term psychosomatic began to b
e used to convey the connection betw
een the mind (psyche) and the body (
soma) in states of health and illness.
- Somatization is defined as the transfer
ence of mental experiences and state
s into bodily symptoms. Somatic sym
ptoms illnesses can be characterized
as the presence of physical symptoms
that suggest a medical condition witho
ut a demonstrable organic basis to ac
count fully for them.

- Malingering is the intentional producti

on of false or grossly exaggerated phy
sical or psychological symptoms, it is
motivated by external incentives such
as avoiding work, evading criminal pro
secution, obtaining financial compens
ation, or obtaining drugs.

- Factitious disorder, imposed on sel

f, occurs when a person intentionally
produces or feigns physical or psychol
ogical symptoms solely to gain attenti
on. People with factitious disorders m
ay even inflict injury on themselves to
receive attention. The common term f
or factitious disorder imposed on the s
elf is Munchausen syndrome (Quinn,
Wang Powsner, & Eisendrath, 2017).

- A variation of factitious disorder, im

posed on others, is commonly called
Munchausen syndrome by proxy a
nd occurs when a person inflicts illnes
s or injury on someone else to gain th
e attention of emergency medical pers
onnel or to be a “hero” for saving the v
ictim.