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How to Use the New DSM-5 Somatic Symptom Disorder Diagnosis in Research and Practice: A Critical Evaluation and a Proposal for Modifications
Open accessAbstract
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) changed the term “somatoform disorders” to “somatic symptom and related disorders” and further modified diagnostic labels and criteria. We review evidence for the validity of the new criteria, specifically of somatic symptom disorder (SSD), and present a critical discussion of unsolved and new problems. We also provide an update of mechanisms and interventions that have been empirically evaluated in somatoform disorders. For many mechanisms, it is unclear whether their role can be easily transposed to SSD. Therefore more research is needed on the similarities and differences between medically unexplained and medically explained conditions. To overcome the obvious shortcomings of the current classification, we offer a modification of this DSM-5 section as well as a crossover system to apply these criteria for somatic symptom and related disorders. This proposal allows working with DSM-5 but also continuing successful lines of research with concepts such as hypochondriasis/illness anxiety, chronic pain, and medically unexplained versus medically explained syndromes.
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“Hence, all of these three “third wave” therapies could have a positive impact on emotion regulation processes and interrupt patients' reinforcement processes related to their symptoms (8), thus also reducing comorbid depression and anxiety (4).”
From Efficacy of mindfulness- and acceptance-based cognitive-behavioral therapies for bodily distress in adults: a meta-analysis (2023) · cites this paper as [8]
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“These findings suggest that the distinction in somatic symptom severity between these disorders might be arbitrary [25, 27].”
From Illness Anxiety Disorder: A Review of the Current Research and Future Directions (2024) · cites this paper as [27]
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Metadata
- Authors
- Rief, W., & Martin, A.
- Affiliations
- Philipps University of Marburg (DE)
- University of Wuppertal (DE)
- Venue
- Annual Review of Clinical Psychology
- Publisher
- Annual Reviews
- Published
- 2014-03-28
- Volume
- 10
- Issue
- 1
- Pages
- 339-367
- ISSN
- 1548-5943 (ISSN-L)
- 1548-5951
- OpenAlex
- W2129470539
- Cited by
- 251
- References
- 154
- Citations by year
- 2026: 17 · 2025: 16 · 2024: 15 · 2023: 16 · 2022: 30 · 2021: 24 · 2020: 20 · 2019: 20 · 2018: 17 · 2017: 24 · 2016: 19 · 2015: 18 · 2014: 12
- FWCI
- 3.38
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Annual Review of Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- somatic symptom disorder, somatic symptom and related disorders, DSM-5, diagnostic criteria, somatoform disorders, medically unexplained symptoms, health anxiety, fear of illness, chronic pain, diagnostic classification, intervention
- MeSH terms
- Humans, Somatoform Disorders, Reproducibility of Results, Diagnostic and Statistical Manual of Mental Disorders
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