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  • Mental Health
  • Somatic Symptom Illnesses and Sleep/Wakefulness Disorders
  • Clinical Manifestations, Assessment, and Diagnosis
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Clinical Manifestations, Assessment, and Diagnosis

- The clinical manifestations of somatic symptom illnesses vary depending on the type and severity of the disorder, but they generally include:

  1. Physical symptoms that are persistent, recurrent, or multiple, and that cause significant distress or impairment in daily functioning.
  2. Symptoms that are not fully explained by a medical condition, substance use, or another mental disorder, or that are excessive or disproportionate to the underlying cause.
  3. Symptoms that may change over time in location, intensity, or type, or that may migrate from one body system to another.
  4. Symptoms that may mimic or resemble those of a medical condition (such as chest pain, abdominal pain, headache, fatigue, weakness, numbness, etc.).
  5. Symptoms that may be influenced by psychological factors (such as stress, emotions, beliefs, expectations, etc.).
  6. Symptoms that may be associated with other psychological problems (such as depression, anxiety, anger, guilt, shame, low self-esteem, etc.).

- The assessment and diagnosis of somatic symptom illnesses involve a comprehensive evaluation of the physical, psychological, and social aspects of the person’s health. This may include:

  • A thorough medical history and physical examination to rule out any organic causes of the symptoms or to identify any coexisting medical conditions.
  • A detailed review of the onset, duration, frequency, severity, location, and characteristics of the symptoms and their impact on the person’s functioning and quality of life.
  • A careful assessment of the person’s cognitive style, emotional regulation, coping skills, stressors, personality traits, and mental health status.
  • A screening for any substance use or abuse that may contribute to or exacerbate the symptoms.
  • A consideration of the person’s cultural background and expectations regarding health and illness expression and communication.
  • A consultation with other health care professionals (such as psychiatrists, psychologists, neurologists, etc.) to obtain additional information or tests if needed.
  • A diagnosis based on the criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) or the International Classification of Diseases (ICD-10) for the specific type of somatic symptom illness.

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Questions on Clinical Manifestations, Assessment, and Diagnosis

Correct Answer is C

Explanation

<p>Factitious disorder involves intentionally falsifying or inducing physical or psychological symptoms for the purpose of assuming the sick role. This choice does not reflect the chronic nature of the symptoms in the scenario, nor does it address the distress experienced by the client.</p>

Correct Answer is C

Explanation

<p>Experiencing chronic physical symptoms with excessive responses might be seen in somatic symptom disorder, where the distress and impairment caused by the symptoms are disproportionate. However, this choice does not specifically address the preoccupation with serious illness that defines illness anxiety disorder.</p>

Correct Answer is A

Explanation

<p>Intentionally inducing symptoms for attention is a characteristic of factitious disorder, not conversion disorder. This choice does not align with the involuntary nature of the symptoms described in the scenario.</p>

Correct Answer is C

Explanation

<p>&quot;I&#39;m worried about having a serious illness.&quot;. Choice D does not align with the behavior of intentionally falsifying psychological symptoms for attention. Expressing concern about a serious illness might indicate genuine health-related anxiety but does not reflect the behavior described in the question.</p>

Correct Answer is B

Explanation

<p>&quot;Illness anxiety disorder.&quot;. Choice D is not the correct answer. Illness anxiety disorder, formerly known as hypochondriasis, involves excessive worry about having a serious illness despite minimal or no medical evidence of such an illness. The focus is on the fear of having a disease, rather than the distressing physical symptoms described in the question.</p>

Correct Answer is C

Explanation

<p>&quot;Somatic symptom disorder.&quot;. Choice D is not the correct answer. Somatic symptom disorder involves experiencing distressing physical symptoms that interfere with daily life. While the symptoms are real and genuinely felt, the central issue in somatic symptom disorder is the excessive response to these symptoms and the preoccupation with health concerns. It is not primarily about intentionally falsifying symptoms for attention.</p>

Correct Answer is B

Explanation

<p>Gaining attention and sympathy. While seeking attention and sympathy may be an outcome of the client&#39;s behavior, it is not the primary motivation. The client&#39;s behavior is rooted in their belief of having a serious illness, leading to intentional symptom production, rather than solely seeking attention or sympathy.</p>

Correct Answer is ["A","C","E"]

Explanation

<p>Somatic symptom disorder. Somatic symptom disorder involves distressing and disruptive physical symptoms that may or may not have an identifiable medical cause. The key characteristic is the disproportionate and excessive focus on the symptoms themselves, leading to impaired functioning. This disorder can include intentional symptom production but is not solely defined by it.<strong></strong>​​​​​​​</p>

Correct Answer is ["B","C","E"]

Explanation

<p>The client&#39;s symptoms are not intentionally produced and cause distress. This choice accurately characterizes illness anxiety disorder. The symptoms experienced by individuals with this disorder are not intentionally produced but are associated with distress due to the individual&#39;s persistent fear and belief in having a serious illness.<strong></strong>​​​​​​​</p>

Correct Answer is C

Explanation

<p>Physical therapy - Physical therapy primarily deals with musculoskeletal and movement-related issues. While it can be beneficial for individuals with certain physical symptoms, it doesn&#39;t primarily target the emotional factors that underlie somatic symptom illnesses.</p>

Correct Answer is A

Explanation

<p>Social isolation and cultural expectations regarding health - While social isolation and cultural expectations can influence an individual&#39;s perception of health and illness, they are more likely to play a secondary role in the context of somatic symptom illnesses. These illnesses are primarily rooted in the interaction between psychological and physiological factors.</p>

Correct Answer is D

Explanation

<p>Symptoms that do not affect psychological well-being - Somatic symptom illnesses inherently involve a significant impact on psychological well-being. The distress and impairment caused by the physical symptoms are a core aspect of these illnesses, differentiating them from purely physical conditions.<strong></strong>​​​​​​​</p>

Correct Answer is C

Explanation

<p>Providing excessive attention and sympathy to the client might inadvertently reinforce their focus on physical symptoms rather than addressing the underlying emotional issues. This approach could potentially contribute to the maintenance of somatic symptom illness.</p>

Correct Answer is D

Explanation

<p>Assisting the client to identify and use healthy coping strategies is a sound intervention. Coping strategies can help the client manage both physical symptoms and emotional distress in adaptive ways, improving their overall quality of life.</p>

Correct Answer is C

Explanation

<p>Exploring the client&#39;s childhood hobbies and interests may not directly contribute to the assessment of somatic symptom illness. While understanding the client&#39;s background is important, focusing on medical and psychological aspects is more relevant in this context.</p>

<p>Using sarcasm to help the client confront their behavior is inappropriate and unprofessional. Sarcasm can damage the therapeutic relationship, making the client feel ridiculed and unheard. Respectful and empathetic communication is crucial in nursing care, especially when dealing with individuals

<p>Advising the client to continue avoiding physical activities is not recommended. Encouraging physical activity within the client&#39;s capabilities can have positive effects on their overall well-being. Avoidance of physical activities might lead to deconditioning and worsen the client&#39;s phys

<p>A balanced diet provides essential nutrients that support physical and mental health. Nutritional factors can influence the body&#39;s response to stress and affect mood. Encouraging the client to maintain a balanced diet can contribute to their overall well-being.<strong></strong>​​​​​

<p>Repressing emotions is not a recommended coping strategy for somatic symptom illness. Repression can lead to increased stress and potentially worsen physical symptoms. Encouraging emotional awareness and expression is more beneficial for the client&#39;s psychological well-being.<strong></strong>

<p>Encouraging the client to focus solely on their illness behavior is counterproductive. Overemphasis on illness behavior can perpetuate the symptoms and prevent the client from developing a broader sense of identity and well-being.</p>

<p>Gabapentin is an anticonvulsant medication that is often used to manage neuropathic pain, including pain associated with somatic symptom illnesses. It can help alleviate pain by affecting nerve signals in the brain.</p>

<p>Hypnosis is a relaxation technique that aims to induce a trance-like state of focused attention and heightened suggestibility. During hypnosis, individuals may experience deep relaxation and increased responsiveness to suggestions. It can be used to manage pain, anxiety, and other symptoms.<stron

<p>While mood improvement is possible with treatment, stating that the physical symptoms will remain unchanged (Choice D) is overly pessimistic. Treatment approaches aim to address both physical and psychological aspects of somatic symptom illnesses.</p>

<p>Biofeedback involves using electronic devices to monitor physiological functions like heart rate, muscle tension, and skin conductance. Individuals receive real-time feedback and learn to control these functions through relaxation techniques. It is an effective approach for managing conditions li

<p>Somatic symptom illnesses are not exclusively caused by psychological factors. While psychological factors can contribute to the onset and exacerbation of these illnesses, there is often a biological basis as well. The interplay between psychological, biological, and social factors is essential t

<p>The client&#39;s preference for alternative medicine may influence their treatment approach, but it is not a key factor that universally affects outcomes in managing somatic symptom illnesses. These illnesses are typically addressed through a combination of psychological interventions and, in som

<p>Physical therapy focuses on improving physical function and mobility through exercises and techniques. It does not involve the use of needles or energy flow stimulation, making it less relevant to somatic symptom illness treatment compared to acupuncture.</p>

<p>Duloxetine is an SNRI that is used to treat major depressive disorder, generalized anxiety disorder, and certain pain conditions. Like other SNRIs, it acts on both serotonin and norepinephrine systems to alleviate symptoms of depression and anxiety.<strong></strong>​​​​​​​</p>

<p>Developing a dislike for medical appointments - This is not a realistic or relevant goal for the treatment of somatic symptom illnesses. Medical appointments are necessary for proper assessment, diagnosis, and treatment of these conditions. Encouraging a dislike for medical appointments could hin

<p>Interpersonal therapy - Interpersonal therapy focuses on improving interpersonal relationships and communication. While these skills are valuable, this type of therapy might not be the primary choice for directly addressing the cognitive aspect of somatic symptom illnesses.</p>
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