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A Reconceptualization of the Somatoform Disorders

Received February 6, 2007; accepted February 9, 2007. From the Dept. of Psychiatry, Carver College of Medicine, and the Dept. of Psychology, College of Liberal Arts and Sciences, Univ. of Iowa, IA City, IA. Send correspondence and reprint requests to Russell Noyes, M.D., Psychiatry Research, Medical Education Building., Univ. of Iowa, IA City, IA 52242-1000. e-mail: russell-noyes{at}uiowa.edu
© 2008 The Academy of Psychosomatic Medicine

Since its introduction in DSM–III, the Somatoform Disorders category has been a subject of controversy. Critics of the grouping have claimed that it promotes dualism, assumes psychogenesis, and that it contains heterogeneous disorders that lack validity. The history of these disorders is one of shifting conceptualizations and disputes. A number of changes in the classification have been proposed, but few address problems that arise with the current formulation. The authors propose a dimensional reconceptualization based on marked and persistent somatic distress and care-eliciting behavior. This formulation is based on the interpersonal model of somatization. The authors propose testing of this conceptualization and indicate how this might be done.

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