ABSTRACT
Since the creation of the Dissociative Disorders category in the third edition of the Diagnostic and Statistical Manual (American Psychiatric Association (APA), 1980), dissociation has typically been identified with symptoms such as amnesia, identity disturbance, or alterations in awareness such as depersonalization and derealization. In contrast, the earliest psychological models of dissociation encompassed a much wider range of phenomena, including a host of physical symptoms such as convulsions, paralyzes, sensory disturbances, pain and gastrointestinal problems for which no medical cause could be found. Recent years have seen a resurgence of interest in the role of dissociation in these complaints, which are now classified within the somatoform disorders section of the fourth edition of the Diagnostic and Statistical Manual, text revision edition (DSM IV-TR) (APA, 2000). This chapter summarizes research and theory concerning dissociation in somatoform disorders, 1 focusing on a recent approach (the Integrative Cognitive Model; (ICM)) which identifies dissociative compartmentalization as a core process in many such complaints, particularly functional neurological symptoms. 2 The implications of this model for the assessment, formulation and treatment of these conditions are then outlined.
