Somatic symptom disorder Quiz: Ace Your Exams

A 27-year-old woman presents to the emergency department to evaluate a wound infection. The patient reports an abscess that needs to be drained on her right lower extremity. The patient states, “I don’t know why, but I keep getting these skin infections. I don’t use intravenous drugs, so something must be wrong with my immune system.” The patient does not have any significant past medical history, does not use illicit drugs, and does not drink alcohol. The patient currently works as a nursing assistant at an outside hospital. Vitals are within normal limits. Physical examination demonstrates a  3 cm x 3 cm abscess over the anterior tibia. Scattered track marks are noted throughout her bilateral lower extremities. The patient has an admission band from a nearby hospital around her left wrist. Urine drug screen is negative. After the physician leaves the room, the patient is found injecting saline into a vein in the opposite leg. Which of the following best describes the symptom origin and motivation for this patient's underlying condition?