“Somatization disorder” might still appear in textbooks—or in questions that test your knowledge of older terminology—but for the ASWB exam, it’s essential to know the updated DSM-5 diagnosis: Somatic Symptom Disorder (SSD).
This post breaks down the key features, exam traps, and how to recognize SSD in clinical scenarios.
In the DSM-IV, somatization disorder described a pattern of multiple, medically unexplained physical symptoms that began before age 30 and lasted several years.
In the DSM-5, that label has been retired. The modern diagnosis is Somatic Symptom Disorder—a broader and more clinically useful category that focuses on the client’s response to symptoms, not just their origin.
Key shift: The symptoms can be explained or unexplained—the diagnosis depends on the excessive thoughts, feelings, or behaviors tied to those symptoms.
To meet criteria, the client must:
Have one or more somatic symptoms that are distressing or result in disruption of daily life
Show excessive thoughts, feelings, or behaviors related to those symptoms, such as:
Disproportionate thoughts about the seriousness of symptoms
Persistent anxiety about health or symptoms
Excessive time and energy devoted to health concerns
The pattern must be persistent (typically 6 months or more).
SSD is often confused with:
Malingering: Symptoms are faked for external gain (e.g., money, housing)
Factitious disorder: Symptoms are faked or induced for internal need (e.g., attention)
Illness anxiety disorder: Preoccupation with having or getting a serious illness, often without major symptoms
Clue for the exam: SSD clients believe their symptoms are real—and may feel genuinely distressed by them. Your role is to provide support, not dismiss their experiences.
A client presents with frequent headaches, digestive problems, and joint pain. Medical workups have shown no underlying condition. The client states, “I know something’s wrong. I think I have a rare disease no one’s caught yet.” The client visits multiple specialists, constantly reads health forums, and appears highly anxious. What diagnosis is MOST likely?
A. Malingering
B. Somatic Symptom Disorder
C. Illness Anxiety Disorder
D. Factitious Disorder
The client has real symptoms and excessive worry and behaviors focused on those symptoms, meeting SSD criteria. Correct answer: B. Somatic Symptom Disorder
Don’t let outdated terminology throw you. The ASWB exam will expect you to know current DSM-5 terms—but may still test your ability to recognize older ones in context. Somatization disorder is no longer a diagnosis. But Somatic Symptom Disorder—and how a client responds to their symptoms—remains fair game.
Want more DSM-based practice questions? Take a full exam and see how you score.
Right now, get SWTP's online practice exams at a reduced price. Just $39. Get additional savings when buying more than one exam at a time-- less than $30 per exam!
Keep going till you pass. Extensions are free.
To receive our free study guide and get started!