ABSTRACT
Somatic symptom disorder (SSD) is increasingly prevalent in youth and is associated with impaired later health and social functioning. SSD in youth is linked to emotional awareness and mentalising deficits; however, these factors, together with parental mentalising, have rarely been examined together. This cross-sectional case–control study aims to investigate these key factors in early adolescents with SSD and their mothers, compared with a community sample. The sample included 360 participants: a clinical group (
n = 112) of 56 adolescents with SSD (Mage = 12.98, SD = 1.72) and their mothers, recruited from two paediatric hospitals; and a comparison group (
n = 248) of 124 adolescents (Mage = 13.04, SD = 1.21) and their mothers from the general population. The adolescents completed the Emotional Awareness Questionnaire (EAQ) and the Reflective Functioning Questionnaire for Youth (RFQ-Y), and their mothers completed the Parental Reflective Functioning Questionnaire for Adolescents (PRFQ-A). A logistic regression predicting clinical (vs. comparison) group membership (
R2 = 0.24;
p < 0.001) revealed that greater adolescent verbal emotion sharing (OR = 0.41,
p = 0.015), higher RFQ-Y curiosity (OR = 0.45,
p = 0.014) and higher RFQ-Y certainty (OR = 0.53,
p = 0.011) were associated with reduced odds of belonging to the clinical group. Additionally, higher maternal PRFQ certainty was linked to lower odds of clinical group membership (OR = 0.56,
p = 0.003). These findings inform interventions to enhance mentalising and emotional awareness in adolescents with SSD and their mothers, particularly deficits concerning others' mental and affective states.
Summary
- Clinical assessment of adolescents with somatic symptom disorder should consider emotional awareness and reflective functioning, alongside the evaluation of somatic symptoms.
- Particular attention should be paid to adolescents' difficulties in expressing emotions verbally and in understanding others' mental and emotional states.
- Interventions for somatic symptom disorder may benefit from addressing not only affect labelling but also broader mentalising capacities.
- Assessment and treatment planning should consider parental mentalising, as greater maternal certainty in interpreting adolescents' emotions and thoughts was associated with a lower likelihood of SSD in adolescents.
- Findings support therapeutic approaches that promote the symbolisation and interpersonal processing of emotions underlying somatic symptoms, particularly deficits in emotional investment towards others.
Open access
