Discussion 1

When a client presents physical ailments for which no medical evidence confirms a condition, the client’s pain may not simply go away. Rather, the pain may persist, further disrupting the client’s life. In these cases, psychological evaluations may be used to determine if any psychological disorders exist. Specifically, somatic symptom, conversion, and factitious disorders, as well as dissociative disorders may be considered for the client’s diagnosis. Additionally, psychologists may also evaluate whether other confounding factors, such as environmental and/or individual variables, influence a diagnosis.

For this Discussion, review the case study in the Learning Resources. Consider the presenting symptoms of the client and any confounding factors that may influence diagnosis.

With these thoughts in mind:

Post

1. a diagnosis for the female in the case study and explain your rationale for assigning these diagnoses on the basis of the DSM.

2. Consider the presenting symptoms of the client and any confounding factors that may influence diagnosis.

3. Then describe three confounding factors that may influence client diagnosis and why. Be specific.

Somatic and Related Disorders, and Disassociative Disorders

FEMALE SPEAKER: No one understands. It’s so hard being on my own and taking care of myself.

FEMALE SPEAKER: I know it must be hard. And how long has it been since your husband passed away?

FEMALE SPEAKER: It’s been five years. And we used to do everything together. And now– I wasn’t always a good wife. I loved him. But I didn’t always enjoy my wifely duties.

I miss him. But I don’t miss that. Is that OK to say? No. I’m not here to talk about that.

FEMALE SPEAKER: Well, let’s talk about why you are here.

FEMALE SPEAKER: Well, I’m here because my doctor thinks that I should see a talk doctor, like you. But I’ve never needed one before in the past. I’ve always been really healthy. And now I’m like

FEMALE SPEAKER: Are you OK?

FEMALE SPEAKER: I’m in pain.

FEMALE SPEAKER: Can you tell me where it hurts?

FEMALE SPEAKER: Everywhere. My arms, my legs, my back. I’m like– It comes through my chest. There’s some days I can’t even go to work. I can’t cook or get in the bath. It’s just lay in bed all day long.

FEMALE SPEAKER: Well, chronic pain can be really agonizing.

FEMALE SPEAKER: It is.

FEMALE SPEAKER: It’s overwhelming.

FEMALE SPEAKER: It is.

FEMALE SPEAKER: I’m really sorry. What does your doctor say?

FEMALE SPEAKER: The doctors? What don’t they say? I mean, one day it’s this. One day it’s that. But they can figure out what it is. And I’m just sick of the whole mess of them. I mean one doctor even told me to get on pain management. But I do not take drugs. I don’t want to take drugs.

FEMALE SPEAKER: It sounds like you’re under a lot of stress.

FEMALE SPEAKER: Yeah.

FEMALE SPEAKER: You had mentioned missing work and not being able to take care of yourself.

FEMALE SPEAKER: Yeah.

FEMALE SPEAKER: Do you have any friends or family to help you out?

FEMALE SPEAKER: I do. I do. Thank God. I mean she’s out in the waiting room. If it wasn’t for her, I wouldn’t be able to be sitting here right now. I haven’t been able to drive myself anywhere since the accident.

FEMALE SPEAKER: That’s really kind of her. You’ve had a bad stretch, haven’t you? FEMALE SPEAKER: I have.

FEMALE SPEAKER: So what happened in the accident?

FEMALE SPEAKER: Well, I was driving to work. And this guy just comes along and sideswipes me. My car hit the curve. It broke the axle. And then the guy just took off, like you know.

FEMALE SPEAKER: Were you hurt?

FEMALE SPEAKER: Yes, I was hurt. But the people in the ER, they didn’t believe me. And they said that I didn’t have any injuries. And so that they couldn’t keep me. But I know what I felt. I was hurt.

And that’s why I’m suing them. Because I was hurt all over from that crash. And they did nothing to help me. Nothing. My stomach, my stomach is still in pain from that day. You wouldn’t believe how nauseous I get. I throw up all the time. And my throat.

And my throat. I had problems with my throat. But since the accident, it’s been really hard to swallow. You believe me, don’t you?