Somatoform Disorder is also known as body dysmorphic syndrome, a psychiatric malady, which is characterized by extreme preoccupation with fictional defects in the physical look ( Kallivayalil & Punnoose, 2010) . The disorder is classified as an anxiety disorder and many researchers believe that it is a variant of obsessive-compulsive disorder. The condition causes bodily symptoms, which can be drawn back to any bodily cause. The somatoform sicknesses include somatization, conversion, pain, undifferentiated somatoform, hypochondriasis, and body dysmorphic disorders. These disorders have serious effects on the patient as they can cause emotional distress and therefore are a challenge for the physicians. A patient with unexplained symptoms should first be tested for these disorders to prevent unnecessary testing and interventions, which may affect the patient. Treatment success depends on patient’s cooperation in discussions with the physicians so as to determine the cause of the somatoform disorder. That, therefore, allows the physicians to decide on how to manage the condition rather than performing unnecessary diagnostics and issuing wrong medications. During the management process, physicians are required to ensure they maintain a good and collaborative relationship with the patients so that they can be able to well manage the condition ( Kallivayalil & Punnoose, 2010) . By using different articles, we shall identify in the discussion the various theories, assessment strategies and treatment plans that are available for psychopathology and abnormal behavior.
Theories
Abnormal psychology brings under its umbrella many theorists who have come up with just as many theories regarding the subject. Through the influence of these theorists, the subject has grown through time and it presently well understood than before. For instance, in the past, abnormalities, such as the somatoform disorders, was mainly linked to spiritual and supernatural beliefs like evil spirits and witchcraft. However, as medicine advanced over time, different modern perspectives regarding abnormality arose, including interpersonal, social, biological and psychological theories.
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Biological theories with regard to abnormality examine human behavior and classy abnormality as being caused by various biological factors like neurotransmitter and hormone imbalance, defective genes and brain abnormalities ( Krueger, Tackett & MacDonald, 2016) . For instance, the Phineas P. Gage case, allows us to understand how brain injuries can quickly alter human behavior. Biological theories are, however, more medicalized and consider the disorders as a disease and not environmentally influenced ( Rief & Barsky, 2005) .
Challenges linked to environment, like chronic stress and lack of social support, make up the social approach. One of the social theory linked to mental disorders includes the interpersonal theory, which precisely discusses how various mental illness can occur due to poor or negative relationships. The social structure theory highlights how the society contributes to the occurrence of stress in people, which can influence the development of mental disorders. The family systems theory explains how the family contributes to the influence and maintenance of mental disorders.
The Psychological theory centers on the person’s belief system, skills, earlier childhood experiences and inner conflicts ( Rief & Barsky, 2005) . These factors can influence abnormal behavior and therefore cause abnormal disorders. The theory includes areas like psychodynamic, humanistic, existential, cognitive and behavioral theories.
Assessment
A clinical assessment is a process by which the physicians gather key information about the patient and his or her environment so that they can come up with viable decisions concerning the nature, status and the treatment of the abnormal or psychological problems ( Hiller & Janca, 2003) . A patient suspected to be suffering from a somatoform disorder undergoes overall screening so that the problems can be identified. For abnormal behavior, a clinical assessment, which results in a diagnosis normally includes the evaluation of the severity and the symptoms of the disorder, the patient’s weakness and strength, and the patterns of the symptom for a given period of time. The assessment may include results from behavioral assessment, personal tests and/or neuropsychological tests.
As for the assessment of somatoform ailments, four diagnostic resolutions have been acknowledged including; screening for probable cases, assessment for associated clinical features, dimensional measurement of the severity of the condition and grouping according to the diagnostic scheme ( Hiller & Janca, 2003) . For each of these purposes, different instruments are used.
Diagnostic Classification and Case Identification
Decisions made by physicians with regard to whether somebody satisfies or does not satisfy the criteria for the somatoform disorder is critical aspect and important goal for diagnostic assessment. Different approaches using checklists or structured interviews have been developed so as to attain the goal of identifying and classifying the somatoform disorders. This is stage is complex and requires that only experts get involved, therefore, all diagnosticians are expected to attend to various systematic training so as to be able to make a reliable and valid diagnosis.
The most used instruments for diagnostic classification of the somatoform disorders are the structured clinical interviews for DSM-IV (SCID) and the composite international diagnostic interview (CIDI). These tools cover many other major psychological illnesses and contain a distinct subdivision on somatoform disorders. In this subdivision, specific measures for each somatoform disorder is assessed. While SCID is confined to DSM- IV, CIDI covers both DSM –IV and ICD-10 classes. Also, SCID is different from CIDI, in that SCID is a firm professional score interview gadget, where the physician makes conclusions based on the patients’ replies and any additional existing evidence. In disparity, CIDI is controlled in a manner that answers given by the patient are scored without the application of clinical judgments ( Claassen-van Dessel et al, 2016) .
Another approach that can be used instead of the diagnostic interviews is the international diagnostic checklists. These checklists are usually administered by only professional clinicians who have been trained and have much experience in using them. The use of the checklist as recommended by the world health organization (WHO), should be for daily patient examinations and for research. These instruments are advantageous as they force the clinicians into logically, standardized and structured clear diagnostic procedures that guarantee high levels of reliability.
Screening for Possible Cases
In cases where a large number of people are involved in community studies, using self-rating instruments may be advantageous in indicating whether or not the somatoform disorders are present. It is important to note that, sometimes these instruments may not be precise, however, they remain important in categorizing subclasses that are expected to be diagnosed with somatoform disorders throughout the consequent professional- valued interviews. In addition, these instruments are also efficient in identifying possible negative cases.
Questionnaires or shortened symptom list are the most used instruments during the process of screening. For instance, the screening questionnaire, screening for somatoform disorders (SOMS) lists fifty-three bodily symptoms, which the patients or respondents are expected to indicate whether they have been present or absent for the past two years ( Claassen-van Dessel et al, 2016) . That, therefore, makes this instrument important for identifying and indicating whether or not the patient is suffering from a somatoform disorder or not. To note is that the SOMS list of symptoms includes all symptoms listed by ICD-10 and DMS-IV, therefore making it easier for a clinician to state whether the patient has a somatoform disorder or not.
Quantification for Somatoform Disorders
As for DSM-IV and ICD-10, the diagnostic systems are highly limited to definite no- yes choices. Here, the various scales that are used enable the physicians to identify whether the sickness is severe, mild or moderate.
Assessment for Additional Features Associated with Somatoform Disorder.
In several occasions, it is extremely important to consider other additional cognitive, emotional, psychological and behavioral aspects. For instance, one of the key traits linked to somatoform clients is their tendency to visit many physicians and therefore, undergoes numerous repeated somatic treatments and examinations, a phenomenon known as illness behavior ( Claassen-van Dessel et al, 2016) . Therefore, this phenomenon needs to be assessed and addressed, so as to help in managing the condition well.
However, the DSM -5, offers a clear and accurate diagnostic criterion, which is not so different from the DSM –IV. In the DSM -5, the somatoform condition is characterized by the presence of symptoms indicating physical illness, which may not be fully explained by another mental disorder, medical condition or substance abuse side effects. While the DSM –IV focused on the unexplained symptoms, DSM -5, requires that more focus and emphasis be on the effects the symptoms have to someone’s feelings, thoughts and actions ( Claassen-van Dessel et al, 2016) . Therefore, for a patient to be examined for a somatoform disorder unlike with DSM- IV, that required the presence of medically unexplained conditions, DSM-5 makes it compulsory that the patient having these symptoms must express changes in behavior, thoughts, and feelings ( Mayou et al, 2005) . For instance, a patient with physical conditions like cancer can experience excessive thoughts, behaviors, and feelings associated with their condition, depending on the seriousness of the symptoms these persons may qualify for a somatic symptom disorder diagnosis.
Treatment
Methods for treating somatoform disorders can include hospitalization, biomedical therapy, psychotherapy and community-based treatment. The most appropriate psychotherapy treatment for somatoform disorders is through cognitive behavioral therapy. This therapy helps the patients to gain an understanding of the feelings and thoughts that influence personal behaviors ( Allen & Woolfolk, 2010) . The therapy can also be used in treating depression, anxiety, addictions, and phobia. The basic concept behind this therapy is that human feelings and thoughts are fundamental determinants of how they behave. For instance, if a person continuously thinks about how dangerous air traveling is, they can find themselves avoiding to use air travel. Therefore, the main goal of this therapy is to help the patients take control of how they handle and deal with different things within their environment. A number of specific therapeutic interventions, which involve the applicability of cognitive behavioral therapy include multimodal, dialectical behavior, rational emotive behavior, and cognitive therapies.
Patients suffering from somatoform disorder may experience thoughts and feelings that result to faulty beliefs that can result in a change in behavior ( Allen & Woolfolk, 2010) . Sometimes the changes in behaviors can be problematic affecting different lie area including family, work, academics and romantic relationships. For instance, if a patient suffering from cancer, for example, can develop negative thoughts about their abilities and appearance. With such thoughts, they may begin to avoid social situations or even skip attending lectures. To be able to combat these destructive behaviors and thoughts, the therapist begins by assisting their clients to identify the awkward beliefs. This stage is known as functional analysis, which is helpful in allowing the patient understand how feelings, thoughts, and situations can affect and change human normal behaviors. The second stage deals with the actual human behaviors and situations which contribute to abnormal behaviors. For example, a patient suffering from skin cancer may be helped with skills on how to manage the condition without developing problematic thoughts or feelings ( Allen & Woolfolk, 2010) .
The other psychotherapy treatments used include humanistic, behavior, cognitive and psychodynamic therapies ( Palermo & Scher, 2001) . All these therapies just like cognitive behavioral therapy are aimed at helping the patients resolve emotional conflicts and learn how to avoid abnormal behaviors. Therefore, identifying how somatoform symptoms affect human feelings and thoughts, allows the clinicians choose best practices that suit the patient, so as to restore normal behaviors.
Additionally, the use of biomedical therapies can also help in managing somatoform disorders. These therapies involve the use of medications in managing abnormal behaviors. Biomedical therapies are normally targeted at reducing or eliminating symptoms associated with the disorder or condition ( Palermo & Scher, 2001) .However, of importance to remember is that biomedical therapy alone in managing abnormal behaviors may not work unless it is in conjunction with psychotherapy. Biomedical therapies include pharmacotherapy, which involves the use of medications that exist in four classes including antidepressants, Hypno anxiolytics, antipsychotics and anti-cycling agents ( Palermo & Scher, 2001) . For instance, antidepressants, help in lowering both the pain and the worrying or stress that is associated with the agony. Frequently used antidepressants comprise of selective serotonin reuptake inhibitors and tricyclic antidepressants. However, some patients may refuse to take up these medications especially if they are not in agreement that emotional factors can increase pain.
Conclusion
As has been discussed above, somatoform disorders are conditions which result to non-medically explained symptoms, which affect human feelings and thoughts. Assessment plan involves the use of interviews so that the patient suspected to be suffering from the condition receive effective treatment so that the condition is properly managed. Main treatment plans that have been applied in managing the condition include psychotherapy and biomedical their pies, which in most cases are applied together so as to effectively and holistically manage somatoform disorders.
References
Allen, L. A., & Woolfolk, R. L. (2010). Cognitive behavioral therapy for somatoform disorders. Psychiatric Clinics of North America , 33 (3), 579-593.
Claassen-van Dessel, N., van der Wouden, J. C., Dekker, J., & van der Horst, H. E. (2016). Clinical value of DSM IV and DSM 5 criteria for diagnosing the most prevalent somatoform disorders in patients with medically unexplained physical symptoms (MUPS). Journal of psychosomatic research , 82 , 4-10.
Hiller, W., & Janca, A. (2003). Assessment of somatoform disorders: a review of strategies and instruments. Acta Neuropsychiatrica , 15 (4), 167-179.
Kallivayalil, R. A., & Punnoose, V. P. (2010). Understanding and managing somatoform disorders: Making sense of non-sense. Indian journal of psychiatry , 52 (Suppl1), S240.
Krueger, R. F., Tackett, J. L., & MacDonald, A. (2016). Toward validation of a structural approach to conceptualizing psychopathology: A special section of the Journal of Abnormal Psychology. Journal of Abnormal Psychology , 125 (8), 1023.
Mayou, R., Kirmayer, L. J., Simon, G., Kroenke, K., & Sharpe, M. (2005). Somatoform disorders: time for a new approach in DSM-V. American Journal of Psychiatry , 162 (5), 847-855.
Palermo, T. M., & Scher, M. S. (2001). Treatment of functional impairment in severe somatoform pain disorder: A case example. Journal of Pediatric Psychology , 26 (7), 429-434.
Rief, W., & Barsky, A. J. (2005). Psychobiological perspectives on somatoform disorders. Psychoneuroendocrinology , 30 (10), 996-1002.
