Abnormal Psychology

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