The woman in the case study has been widowed for 5 years. She is struggling to live alone on her own. She was in a recent car accident and is complaining of chronic pain throughout her body, yet no injuries were found that could be causing the pain. The woman reported her chronic pain is keeping her from functioning normally; she is unable to work or care for herself. She has been seen by various doctors however, they have been unable to find an etiology for the pain, and she refuses to take medications for pain management (Laureate Education, 2012).
The woman appears to have somantic symptoms disorder with predominant, nonspecific pain. She meets the prominent criteria for this disorder which is significant distress and impairment in response to her symptoms. She is experiencing abnormal and excessive thoughts, feelings, and behaviors that are related to the somatic symptoms which has paralyzed her ability to function normally (Laureate Education, 2012; APA, 2012).
There are several confounding factors that may be influencing the diagnosis. The woman’s bereavement is a significant factor. She lost her husband five years ago and has struggled to live alone. She indicated they did everything together; it appears she is struggling with loneliness and she may have been unable to create a meaningful life for herself since then. She mentions that she had difficulty fulfilling her “wifely duties” so she appears to have some underlying issues that should be explored further (Laureate Education, 2012; APA, 2012).
The woman indicated she has family and friends however, when asked about this, she only mentioned the one woman who drove her to her appointment with the therapist. It is unknown if she has relationships with any other people, how much contact with other individuals, and the closeness of their relationships. It is unknown if she is involved in any activities or has hobbies/interests that can bring joy to her life. It is unknown what she does for a living, if she is experiencing problems in her job and, if she is satisfied with her work. Also, she indicated she is struggling to be on her own and taking care of herself. She is working however, it is unknown if her income is enough to support her. The woman stated she has never been to a therapist in the past however, it is unknown if the woman has any history of mental health conditions (Laureate Education, 2012; APA, 2012).
Additional information is needed to determine if the client is experiencing a comorbid disorder. There may be the existence of a depressive disorder or other differential diagnosis. If prior issues exist, this could be a confounding factor in this diagnosis. For example, depressive disorders can be accompanied by somatic symptoms. Comorbid anxiety and depression can exacerbate symptoms. Another confounding factor is the car accident itself. She indicated she has been unable to drive since the accident or to take care of herself. Since her symptoms began after the car accident, posttraumatic stress disorder is a consideration given that she is unable to drive her vehicle. It would important to learn is she has attempt to drive since the accident and how she felt when attempting to do so. Also, if she has experienced nightmares, panic attacks, or distressing memories of the accident (Laureate Education, 2012; APA, 2012).