Dissociative and Somatoform Disorders 359
Moreover, a patient’s symptoms may have been unintentionally reinforced by
friends and family (social factor). A similar shift in interpretation of sensations
(psychological factor) can occur after stressful life events (social factor). In addition,
frustrating interactions with health care providers, family members, or friends can
increase stress (social factor). As with panic disorder (see Chapter 7), the physiologi-
cal arousal that occurs in response to stress can increase troubling bodily sensations
that then become the focus of preoccupations (see Figure 8.3).
Figure 8.3g3
NeuroPsychoSocial NeuroPsychoSocial
Affect
Anxiety
Distress
Mental Processes and
Mental Contents
Bodily preoccupation
Symptom amplification
Heightened attention
to body
Catastrophic thinking
about illness
Behavior
Avoidance of
behaviors that
increase bodily
sensations
associated
with symptoms
NeuroPsychoSocial
Genetics
Genetic link with
Understanding Hypochondriasis
Brain Systems
No known major
contribution
Neural Communication
No known major
contribution
Family
Gender/Culture
Stressful Life Events
History of significant
social stressor Modeling and
reinforcement
of illness
behavior
Symptoms can be a
cultural expression of
helplessness;
members of some
ethnic and SES groups
are more likely to
develop this disorder
8.3 • Feedback Loops in Action: Somatization Disorder