Psychological And Social Mechanism Of Children’s Functional Somatic Symptoms

Functional somatic symptoms (FSS) is defined as medically unexplained symptoms, are commonly experience by children and adolescents in clinical sample. FSS are often diagnosed as functional abdominal pain, chronic fatigue syndromes etc. by pediatrician; severe FSS could be diagnosed as somatoform disorder by psychiatrist. FSS are also common in community sample which is less severe and do not meet the clinical diagnostic criteria. However, community sample report a variety of complaints, associated with attendance rate, academic achievement and family disfunctioning. FSS usualy could not be explained medically, may induced by psychological and social factors.The research uses sample of students from primary and secondary school; and emply crosssectional and longitudinal research design. Questionnaires are used to explore the occurrence rate, developmental tendency, psychological mechanism and related social factors of FSS. The research composed of3parts. The first part revised the questionnaire used to evaluation FSS in children and adolescents, and verified all the other tools used in this research; the second part explore the developmental trendency, and how the psychological variable affect FSS in children including emotion, cognitive style, behavior; the third part discussed how the environmental factor affect FSS in children.Based on the results, the following conclusions could be drawn.1. FSS in children is common in community sample.In this research, only5.6%children did not experience any somatic symptom at all in the past3-month.36.5%experienced "slightly" or "a lot" somatic symptom in the past3months.29.4%experienced at least1symptom frequently in the past3months. The most prevalent functional somatic symptoms are fatigue (65.3%), sore muscle (55.9%), pain of limbs (52.2%) and headache (48.5%).2. FSS in children grow along with the increase of age.The research find growth tendency of FSS in children. Furthermore, there are gender and differences in the growth tendency. Every nine-month, FSS in girls grow faster than FSS in boys by0.41point. FSS in children with high initial anxiety grow faster than children with low initial anxiety by0.44every9month.3. FSS in children have close relationship with mental health status.Children’s anxiety, depression, social withdrawal, hyperactivity, maladaptive behavior can predict FSS in children."pain and fatigue" FSS have closer relationship with mental health.4. Rumination is cognitive vulnerability factor of FSS in children.Symptom rumination, ponder, reflection and ruminant thinking dimensions could positively predict FSS in children. Controlling depression, the relationship between rumination and FSS are still significant. Depression moderated the relationship between rumination and FSS, the relationship is stronger while the depression is more severe. Children’s depression partly mediated the relationship between rumination and FSS in children.5. FSS in children would not result in severe functional disability.FSS in children could not predict children’s functional disability, FSS have slightly effect on children’s daily life.6. FSS in children were affected by family environment.FSS maternal intergenerational transmission, mothers with more somatization symptoms not only suffered from more emotional distress, but also have more paranoid, phobia and worse overall mental health status.Parenting style also related to FSS in children, especially parental over-protection and paternal rejection. Maternal over-protection mediated the maternal intergenerational transmission, paternal parenting style has no effect on the maternal intergenerational transmission.7. FSS in children have slightly relationship with classroom enviromentAmong classroom environment dimensions, only academic pression could significantly predict FSS in children.8. Life event and coping style can predict FSS in children.Life event, specifically, Interpersonal relationship, academic pressure and punishment could positively predict the occurrence of FSS. Positive reasonable explaination of streesors can predict less FSS in children, wihle tolerance and venting emotions can predict more FSS in children.