Topic Three (1.3): Misusing Health Services

Introduction

In this topic, you will explore some of the explanations for misusing health services. This might be due to a condition called hypochondriasis. This was described by Sarafino (2006) as ‘the tendency of individuals to worry excessively about their own health, monitor their bodily sensations closely, make frequent unfounded medical complaints, and believe they are ill despite reassurances by physicians that they are not’. (Reference: Rohleder, P. [2012] Critical Issues in Clinical and Health Psychology, Sage Publications.)

You will also explore Munchausen’s syndrome (also known as ‘factitious Disorder’). This is a mental health disorder in which a person repeatedly and deliberately acts as if they have a mental or physical illness to draw attention to themselves in order to receive care and sympathy. 

Turner and Reid (2002) found three main features of this illness: 

  1. Simulated illness; 
  2. Pseudologia fantastica – pathological lying about health conditions; 
  3. Peregrination – constantly changing doctors and hospitals. 

(Reference: National Library of Medicine https://pubmed.ncbi.nlm.nih.gov/11830219/ Links to an external site.

For the exam you need to know:

  • Delay in seeking treatment:
    • reasons for delay, including a study, e.g. Safer et al. (1979);
    • alternative explanations for delay, e.g. the health belief model.
  • Munchausen syndrome versus malingering. Diagnostic features of Munchausen (essential and supporting features), including a study, e.g. Aleem and Ajarim (1995).

Relevant issues and debates and methodology for this topic include: reductionism versus holism, idiographic versus nomothetic, interviews, case study, generalisations from findings.

Read and Make Notes

  • Read and make notes on pages 313 to 318 in the textbook.
  • Read the article ‘Munchausen Syndrome – Presenting as Immunodeficiency: A Case Report and Review of Literature’ by Aleem and Ajarim (1995) and make notes:

Download READ – Aleem and Ajarim (1995) Original Research Paper (PDF)

Watch

Watch the following videos and make notes on hypochondriasis and Munchausen syndrome:

WATCH – Psychiatrist Dr Chris Bass Describing Münchausen Syndrome (YouTube) Links to an external site.

WATCH – Dr Laphook on Hypochondriasis (YouTube) Links to an external site.

WATCH – Factitious Disorder: Causes, Signs and Symptoms, Diagnosis and Treatment (YouTube) Links to an external site.

Terminology

Make sure you understand all the key terms covered in this topic. You may like to make flashcards of key terms now, to help you with revision later on.

Activities in the Book

  • It is important that you complete Questions 1, 2 and 3 on page 318 in the textbook.
  • Suggested answers can be found in the digital textbook and in General Resources.

Consolidate

  • Please now have a go at the following exam-style questions in the textbook:
    • Questions 1, 2a, 2b and 2c on page 366.
  • Suggested answers can be found in the digital textbook and in General Resources.

Assignment

When you have completed all the activities and are fully prepared and feel confident with the material, you should complete Assignment One and submit it to your tutor via Canvas for marking and feedback.