Somatoform Dissociation

Abstract

In most of the recent scientific and clinical literature, dissociation has been equated with dissociative amnesia, depersonalization, derealization, and fragmentation of identity. However, according to Pierre Janet and several World War I psychiatrists, dissociation also pertains to a lack of integration of somatoform components of experience, reactions, and functions. Some clinical observations and contemporary studies have supported this view. Somatoform dissociation, which can be measured with the Somatoform Dissociation Questionnaire (SDQ-20), is highly characteristic of dissociative disorder patients, and a core feature in many patients with somatoform disorders and in a subgroup of patients with eating disorders. It is strongly associated with reported trauma among psychiatric patients and patients with chronic pelvic pain presenting in medical healthcare settings. Motor inhibitions and anesthesia/analgesia are somatoform dissociative symptoms that are similar to animal defensive reactions to major threat and injury. Among a wider range of somatoform dissociative symptoms, these particular symptoms are highly characteristic of patients with dissociative disorders. The empirical findings reviewed in this article should have implications for the contemporary conceptualization and definition of dissociation, as well as the categorization of somatoform disorders in a future version of the DSM.

Psychogenic Seizures in an Espiritismo Context: The Role of Culturally Sensitive Psychotherapy.

“…Nayda's dissociative states probably were reinforced by social denial, induction of guilt, and pressure for the secrecy of the traumatic material. According to Nijenhuis (1999) and van der Kolk (1996), such traumatic memories are predominantly expressed in a somatosensory way, so that affected individuals repeat acts and emotions as well as possess visual and somatoform perceptions pertaining to past trauma, as if the event is unfolding at present. Nayda's dissociative behaviors of burning towels and hitting herself constituted behavioral reenactments of her unresolved traumatic memories.…”

“…It involves symptoms such as analgesia, anesthesia, motor inhibitions, specific pains, and psychogenic attacks. Nayda inscribed her conflicts and traumatic memories in her body, repeating acts and emotions as well as visual, auditory, and other somatoform perceptions pertaining to past trauma as if the event was unfolding in the present (Nijenhuis, 1999).…”

Functional (psychogenic) movement disorders associated with normal scores in psychological questionnaires: A case control study

“…The presence of clinically relevant psychological symptoms was established by using published clinical norm scores for PDQ-4 (N25; [29]), SCL-90 (males N131, females N150; [30]), DIS-Q (N2.5; [31]), and SDQ-20 (N28; [32]). To provide a detailed psychological description of our sample, the percentage of patients and controls that scored above the normal scores (i.e.…”

The Validity and Reliability of the German Version of the Somatoform Dissociation Questionnaire (SDQ-20)

“…pain, anaesthesia or paralysis (Dell, 2002;Öztürk & Sar, 2008;Espirito-Santo & Pio-Abreu, 2009;Saxe et al, 1994). Nijenhuis and colleagues (Nijenhuis, 2000;Nijenhuis, 2004;Nijenhuis, Spinhoven, Van Dyck, Van der Hart, & Vanderlinden, 1996, 1998aNijenhuis et al, 1999;Nijenhuis, 2009) introduced the term somatoform dissociation which emphasizes the equal importance of dissociation's disintegrating effect on both psychoform and somatic processes. Within their theory of structural dissociation of the personality, Van der Hart, Nijenhuis, & Steele (2006) propose that both psychoform and somatoform dissociative symptoms are manifestations of the existence of a structural dissociation of the personality into two or more insufficiently integrated biopsychosocial subsystems.…”