CHAPTER 7 – SOMATOFORM AND DISSOCIATIVE DISORDERS:
Somatoform and dissociative disorders are related to anxiety disorders in that, in early versions of
the DSM, all these disorders were subsumed under the heading of neuroses because anxiety was
considered the predominant underlying factor in each case.
somatoform disorder: the individual complains of bodily symptoms that suggest a physical defect
or dysfunction – sometimes rather dramatic in nature – but for which no physiological basis can be
dissociative disorder: the individual experiences disruptions of consciousness, memory and
The onset of both classes of disorders is assumed by many to be related to some stressful
experience and the two classes sometimes co-occur.
Psychological problems take a physical form, no known physiological explanation and are not under
The bodily symptoms of these disorders fall typically into two groups:
(a) One group of symptoms reflects arousal in the autonomic nervous system and is
accompanied by palpable distress in the form of anxiety and depression.
(b) The second group of symptoms reflects thoughts and intentions that are not consciously
recognized. (SEE TABLE 7.1, page 194).
Argument that somatoform disorders should be removed from the pending DSM-V has seven
• The terminology of the somatoform category is often unacceptable to patients
• The distinction between symptoms that are disease-based vs, those that are psychogenic may
be more apparent than real
• There is great heterogeneity among the disorders – the only common link is physical illness that
is not attributable to an organic cause
• Somatoform disorders are incompatible with other cultures
• There is ambiguity in the stated exclusion criteria for the disorders
• The subcategories have often failed to achieve accepted standards of reliability.
• Somatoform disorders lack clearly defined thresholds in terms of the symptoms needed for a
Pain disorder: the person experiences pain that causes significant distress