Choice A rationale:

Avoidance of distressing situations. This choice suggests that the primary motivation for the client's behavior is to avoid situations that cause distress. While this may be a factor in some cases of illness-related behaviors, it is not the primary motivation described in the scenario. The client's persistent fear and belief of having a serious illness despite minimal or no symptoms indicate a different underlying motivation.

Choice B rationale:

Intentional symptom production. This choice accurately captures the primary motivation for the client's behavior. Intentional symptom production refers to the deliberate creation or exaggeration of physical symptoms, often driven by psychological factors. In this case, the client's persistent fear and belief in having a serious illness point toward intentionally producing symptoms to validate their belief and seek attention or emotional relief.

Choice C rationale:

Seeking emotional relief. While seeking emotional relief may be a secondary motivation for some individuals with somatic symptom disorders, it is not the primary motivation described in the scenario. The client's behavior is primarily driven by the intentional production of symptoms and the associated beliefs, rather than a sole focus on emotional relief.

Choice D rationale:

Gaining attention and sympathy. While seeking attention and sympathy may be an outcome of the client's behavior, it is not the primary motivation. The client's behavior is rooted in their belief of having a serious illness, leading to intentional symptom production, rather than solely seeking attention or sympathy.