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.
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