Abstract
Somatoform disorders are characterized by the presence of a number of somatic symptoms without an organic cause that completely explains the symptoms. The following chapter will focus on the pathogenesis of somatoform pain disorder, which is still far from clear. Early biographical stress experiences (childhood adversities) seem to modulate the symptomatology of somatoform pain disorder. In this patient group several studies show a dysfunctional central stress regulation and stress response, an altered autonomic response with impaired interoceptive sensitivity, as well as abnormalities of brain structure and function, with an increased activity of a number of brain regions believed to be involved in the emotional appraisal, namely anterior cingulated cortex and insula. These findings are of great importance due to the fact that the extent of an individual’s sensitivity to external (environment) and internal (bodily) signals is considered to be an essential variable in social interaction. This might contribute to deficits in interpersonal relationships and emotional and social functioning.
Keywords
- Anterior Cingulate Cortex
- Childhood Adversity
- Pain Processing
- Borderline Personality Disorder
- Somatization Disorder
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Adler RH, Zlot S, Hurny C, Minder C (1989) Engel’s “Psychogenic Pain and the Pain-Prone Patient:” a retrospective, controlled clinical study. Psychosom Med 51:87–101
Anderzén I, Arnetz BB, Söderström T, Söderman E (1997) Stress and sensitization in children: a controlled prospective psychophysiological study of children exposed to international relocation. J Psychosom Res 43:259–269
APA (1994) Diagnostic and statistical manual of mental disorders (DSM IV), 4th edn. APA Press, Washington, DC
Apkarian AV, Bushnell MC, Treede RD, Zubieta JK (2005) Human brain mechanisms of pain perception and regulation in health and disease. Eur J Pain 9:463–484
Barsky AJ (1992) Amplification, somatization, and the somatoform disorders. Psychosomatics 33:28–34
Bechara A, Damasio AR (2005) The somatic marker hypothesis: a neural theory of economic decision. Games Econ Behav 52:336–372
Benjet C, Borges G, Medina-Mora ME (2010) Chronic childhood adversity and onset of psychopathology during three life stages: childhood, adolescence and adulthood. J Psychiatr Res 44:732–740
Bingel U, Lorenz J, Schoell E et al (2006) Mechanisms of placebo analgesia: rACC recruitment of a subcortical antinociceptive network. Pain 120:8–15
Bowlby J (1988) The secure base. Clinical applications of attachment theory. Tavistock/Routledge, London
Bremner JD (2005) Effects of traumatic stress on brain structure and function: relevance to early responses to trauma. J Trauma Dissociation 6:51–68
Browning M, Fletcher P, Sharpe M (2011) Can neuroimaging help us to understand and classify somatoform disorders? A systematic and critical review. Psychosom Med 73:173–184
Champagne F, Meaney MJ (2001) Like mother, like daughter: evidence for non-genomic transmission of parental behavior and stress responsivity. Prog Brain Res 133:287–302
Chrousos GP (1998) Stressors, stress, and neuroendocrine integration of the adaptive response. The 1997 Hans Selye Memorial Lecture. Ann N Y Acad Sci 851:311–335
Chrousos GP, Gold PW (1992) The concepts of stress and stress system disorders. Overview of physical and behavioral homeostasis. JAMA 267:1244–1252
Coghill RC, McHaffie JG, Yen YF (2003) Neural correlates of interindividual differences in the subjective experience of pain. Proc Natl Acad Sci U S A 100:8538–8542
Creed F, Barsky A (2004) A systematic review of the epidemiology of somatisation disorder and hypochondriasis. J Psychosom Res 56:391–408
Damasio AR (2000) The fabric of the mind: a neurobiological perspective. In: Uylings HBM, Van Eden CG, De Bruin JPC et al (eds) Progress in brain research, vol 126. Elsevier, Amsterdam, pp 457–467
Dantzer R (2005) Somatization: a psychoneuroimmune perspective. Psychoneuroendocrinology 30:947–952
De Waal MWM, Arnold IA, Eekhof JAH, van Hemert AM (2004) Somatoform disorders in general practice: prevalence, functional impairment and comorbidity with anxiety and depressive disorders. Br J Psychiatry 1846:470–476
Dimsdale JE, Dantzer R (2007) A biological substrate for somatoform disorders: importance of pathophysiology. Psychosom Med 69:850–854
Drossman DA, Talley NJ, Leserman J et al (1995) Sexual and physical abuse and gastrointestinal illness. Review and recommendations. Ann Intern Med 123:782–794
Egle UT, Hoffmann SO, Steffens M (1997) Psychosoziale Risiko- und Schutzfaktoren in Kindheit und Jugend als Prädisposition für psychische Störungen im Erwachsenenalter (Psychosocial risk and protective factors in childhood and adolescence as predisposition for psychiatric disorders in adulthood). Nervenarzt 68:683–695
Fink P, Hansen MS, Oxhoj ML (2004) The prevalence of somatoform disorders among internal medical inpatients. J Psychosom Res 56:413–418
Garralda E (2005) Somatization and somatoform disorders. Psychiatry 4:97–100
Geisser ME, Casey KL, Brucksch CB et al (2003) Perception of noxious and innocuous heat stimulation among healthy women and women with fibromyalgia: association with mood, somatic focus, and catastrophizing. Pain 102:243–250
Gianaros PJ, Jennings JR, Sheu LK et al (2007) Prospective reports of chronic life stress predict decreased grey matter volume in the hippocampus. Neuroimage 35:795–803
Gracely RH, Geisser ME, Giesecke GT et al (2004) Pain catastrophizing and neural responses to pain among persons with fibromyalgia. Brain 127:835–843
Gündel H, Valet M, Sorg C et al (2008) Altered cerebral response to noxious heat stimulation in patients with somatoform pain disorder. Pain 137:413–421
Gunnar MR (1998) Quality of early care and buffering of neuroendocrine stress reactions: potential effects on the developing human brain. Prev Med 27:208–211
Hamann SB, Ely TD, Grafton ST, Kilts CD (1999) Amygdala activity related to enhanced memory for pleasant and aversive stimuli. Nat Neurosci 2:289–293
Hansen GR, Streltzer J (2005) The psychology of pain. Emerg Med Clin North Am 23:339–348
Houtveen JH, van Doornen LJ (2007) Medically unexplained symptoms and between-group differences in 24-h ambulatory recording of stress physiology. Biol Psychol 76:239–249
Imbierowicz K, Egle UT (2003) Childhood adversities in patients with fibromyalgia and somatoform pain disorder. Eur J Pain 7:113–119
James W (1884) What is an emotion? Mind 9:188–205
Klossika I, Flor H, Kamping S et al (2006) Emotional modulation of pain: a clinical perspective. Pain 124:264–268
Laederach-Hofmann K, Ruddel H, Mussgay L (2008) Pathological baroreceptor sensitivity in patients suffering from somatization disorders: do they correlate with symptoms? Biol Psychol 79:243–249
Lee MC, Ploner M, Wiech K et al (2013) Amygdala activity contributes to the dissociative effect of cannabis on pain perception. Pain 154:124–134
McLaughlin KA, Breslau J, Green JG et al (2011) Childhood socio-economic status and the onset, persistence, and severity of DSM-IV mental disorders in a US national sample. Soc Sci Med 73:1088–1096
Melin B, Lundberg U (1997) A biopsychosocial approach to work-stress and musculosketal disorders. J Psychophysiol 11:238–247
Melzack R, Wall PD (1965) Pain mechanisms: a new theory. Science 150:971–979
Meredith P, Ownsworth T, Strong J (2008) A review of the evidence linking adult attachment theory and chronic pain: presenting a conceptual model. Clin Psychol Rev 28:407–429
Oztan O, Aydin C, Isgor C (2011) Chronic variable physical stress during the peripubertal-juvenile period causes differential depressive and anxiogenic effects in the novelty-seeking phenotype: functional implications for hippocampal and amygdalar brain-derived neurotrophic factor and the mossy fibre plasticity. Neuroscience 192:334–344
Paskitti ME, McCreary BJ, Herman JP (2000) Stress regulation of adrenocorticosteroid receptor gene transcription and mRNA expression in rat hippocampus: time-course analysis. Mol Brain Res 80:142–152
Pine DS, Charney DS (2002) Children, stress, and sensitization: an integration of basic and clinical research on emotion? Biol Psychiatry 52:773–775
Pollatos O, Herbert BM, Wankner S et al (2011) Autonomic imbalance is associated with reduced facial recognition in somatoform disorders. J Psychosom Res 71:232–239
Posada G (2008) Attachment. In: Marshall MH, Benson JB (eds) Encyclopedia of infant and early childhood development. Academic, San Diego, pp 96–106
Richter-Levin G (2004) The amygdala, the hippocampus, and emotional modulation of memory. Neuroscientist 10:31–39
Rief W, Auer C (2001) Is somatization a habituation disorder? Physiological reactivity in somatization syndrome. Psychiatry Res 101:63–74
Rief W, Hessel A, Braehler E (2000) Somatization symptoms and hypochondriacal features in the general population. Psychosom Med 63:595–602
Rief W, Shaw R, Fichter MM (1998) Elevated levels of psychophysiological arousal and cortisol in patients with somatization syndrome. Psychosom Med 60:198–203
Schachter S, Singer J (1962) Cognitive, social, and physiological determinants of emotional state. Psychol Rev 69:379–399
Schaefer M, Egloff B, Witthöft M (2012) Is interoceptive awareness really altered in somatoform disorders? Testing competing theories with two paradigms of heartbeat perception. J Abnorm Psychol 121:719–724
Seminowicz DA, Davis KD (2006) Cortical responses to pain in healthy individuals depends on pain catastrophizing. Pain 120:297–306
Sensky T, MacLeod AK, Rigby MF (1996) Causal attributions about common somatic sensations among frequent general practice attenders. Psychol Med 26:641–646
Stoeter P, Bauermann T, Nickel R et al (2007) Cerebral activation in patients with somatoform pain disorder exposed to pain and stress: an fMRI study. Neuroimage 36:418–430
Tak LM, van Roon AM, Rosmalen JG (2009) Is baroreflex sensitivity really pathological in patients with somatization disorder? Comment on: Laederach-Hofmann et al. (2008). Biol Psychol 82:97–98
Thayer JF, Brosschot JF (2005) Psychosomatics and psychopathology: looking up and down from the brain. Psychoneuroendocrinology 30:1050–1058
Tracey I, Becerra L, Chang I et al (2000) Noxious hot and cold stimulation produce common patterns of brain activation in humans: a functional magnetic resonance imaging study. Neurosci Lett 288:159–162
Van Houdenhove B, Egle UT (2004) Fibromyalgia: a stress disorder? Piecing the biopsychosocial puzzle together. Psychother Psychosom 73:267–275
Van Houdenhove B, Neerinckx E, Lysens R et al (2001) Victimization in chronic fatigue syndrome and fibromyalgia in tertiary care: a controlled study on prevalence and characteristics. Psychosomatics 42:21–28
Weaver ICG, La Plante P, Weaver S et al (2001) Early environmental regulation of hippocampal glucocorticoid receptor gene expression: characterization of intracellular mediators and potential genomic target sites. Mol Cell Endocrinol 185:205–218
Wiech K, Ploner M, Tracey I (2008) Neurocognitive aspects of pain perception. Trends Cogn Sci 12:306–313
Williams DT, Harding KJ (2010) Somatoform disorders. In: Kompoliti K, Verhagen LM (eds) Encyclopedia of movement disorders. Academic, Oxford, pp 121–127
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2014 Springer-Verlag France
About this chapter
Cite this chapter
Matthias, E., Pollatos, O. (2014). Why Does My Body Hurt? Somatoform Disorders and Pain. In: Marchand, S., Saravane, D., Gaumond, I. (eds) Mental Health and Pain. Springer, Paris. https://doi.org/10.1007/978-2-8178-0414-9_10
Download citation
DOI: https://doi.org/10.1007/978-2-8178-0414-9_10
Published:
Publisher Name: Springer, Paris
Print ISBN: 978-2-8178-0413-2
Online ISBN: 978-2-8178-0414-9
eBook Packages: MedicineMedicine (R0)