9990 · 3.1.3
Misusing health services flashcards
Revision flashcards for Cambridge 9990 Misusing health services (syllabus 3.1.3). Flip, recall, then mark a real past-paper question.
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Illness anxiety disorder?
Preoccupation with having a serious illness despite minimal or no somatic symptoms — formerly hypochondriasis; leads to **excessive medical consultations**.
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Doctor shopping?
Visiting multiple physicians seeking diagnosis or treatment — may reflect **dissatisfaction**, **health anxiety**, or desire for a specific prescription.
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Munchausen syndrome?
**Factitious disorder** — deliberate fabrication or induction of symptoms to assume the **sick role**, without external reward (unlike malingering).
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Munchausen by proxy?
Caregiver fabricates or induces illness in another person (usually a child) — severe form with **child protection** implications.
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Cognitive explanation of health anxiety?
**Catastrophic misinterpretation** of normal bodily sensations as signs of serious disease — links to Beck's cognitive model.
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Systemic cost of misuse?
Unnecessary tests, A&E visits, and specialist referrals strain **NHS resources** and may delay care for genuinely ill patients.
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What is the core motivation in hypochondriasis?
An overwhelming and genuine fear of having or developing a serious, undiagnosed illness. The motivation is the alleviation of this intense anxiety.
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Define Munchausen syndrome.
A severe factitious disorder where an individual intentionally produces or feigns physical or psychological symptoms to assume the sick role and receive medical attention and sympathy.
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What is 'doctor shopping'?
The practice of consulting multiple different doctors for the same health problem, often covertly, without informing them of the other consultations.
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Distinguish between Munchausen syndrome and malingering.
In Munchausen (a factitious disorder), the motivation is internal (a psychological need to assume the sick role). In malingering, the motivation is for external gain (e.g., financial compensation, avoiding work).
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What is Munchausen syndrome by proxy?
A form of abuse where a caregiver fabricates or induces illness in a person under their care (e.g., a child) to gain attention and sympathy for themselves. It is now termed Factitious Disorder Imposed on Another.
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What is iatrogenic harm in the context of health service misuse?
Harm caused by medical examination or treatment itself. In health service misuse, this can include side effects from unnecessary medications, complications from invasive tests, or radiation exposure from excessive scans.
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What are the societal consequences of health service misuse?
Increased healthcare costs, longer waiting lists for all patients, strained medical resources (staff and equipment), and potential burnout among healthcare professionals.
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How can the Health Belief Model explain hypochondriasis?
The individual has a very high perceived susceptibility to and severity of illness, but low perceived benefits of reassurance from doctors. This imbalance drives them to continuously seek more tests and opinions, believing the 'costs' of not doing so (missing a deadly disease) are too high.
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What is a behavioural explanation for Munchausen syndrome?
The behaviour is learned through operant conditioning. The 'sick role' acts as a powerful positive reinforcer, providing attention, sympathy, and care that may be otherwise absent from the person's life. Each successful deception reinforces the behaviour.