Lecture on Psychological and Physical Disorders (Chapter 22)

Overview

• Exploration of the relationship between emotions and health
• Discussion on psychological sources of physical problems

Key Concepts

Fight or Flight Response

• Animals and humans have protective responses during threats or illness
• Physiological stress involves biochemical fight or flight
• General Adaptation includes three stages:
  • Alarm stage: Recognition of stress
  • Resistance stage: Attempt to adapt
  • Exhaustion stage: Potential for illness; affects the immune system

Psychological Impact

• Psychological state impacts ability to cope with stress
• Types of disorders: Psychosomatic, Psychophysical, and Anxiety Disorders

Children and Stress

• Children learn stress response from their environment
• Unstable home environments lead to maladaptive stress responses
• Emotional support from families reduces physical complaints

Psychobiological Conditions

• Stress affects conditions like migraines, GI issues, impotence, PMS, hyperthyroidism, diabetes
• GI tract is sensitive due to serotonin production

Psychophysical Theories

• Stress Response Theory: Biochemical pattern to stress
• Symbolism in Illness: Emotional conflicts manifest physically
• Organic Weakness Theory: Sensitivity varies by body system

Somatoform Disorders

• Feeling physical symptoms without disease
• 80% of people experience somatic symptoms weekly
• Cultural influences affect somatization

Types of Somatoform Disorders

• Somatization Disorder: Symptoms disproportionate to ailment
• Conversion Disorder: Involuntary neurological symptoms like paralysis
• Illness Anxiety Disorder: Formerly hypochondriasis; fear of serious disease

Factitious Disorders

• Symptoms produced intentionally for gain
• Includes Factitious Disorder by proxy (e.g., Munchausen by proxy)

Malingering

• Falsifying symptoms for secondary gain (e.g., financial compensation)

Implications for Care Providers

• Difficulties in diagnosing and treating psychosomatic conditions
• Importance of ruling out physical disease
• Need for comprehensive patient history, physical assessment, and therapeutic relationships

Nursing Interventions

• Encourage expression of feelings over physical complaints
• Prioritize patient safety and independence
• Use behavioral therapy, relaxation techniques, and tricyclic antidepressants for chronic pain
• Focus on psychological motivations, not just physical symptoms

Questions and Practical Applications

• Address the psychological and spiritual aspects in care plans
• Avoid focusing solely on physical limitations in conversion disorder patients

Conclusion

• End of current chapter discussion
• Opportunity for questions
• Future discussion in upcoming weeks