Family Factors

According to family systems theory, somatization may serve the function of drawing attention away from other areas of tension, such as marital conflict (Stuart and Noyes 1999). Minuchin et al. (1978) suggested that family enmeshment, overprotective-ness, rigidity, and lack of conflict resolution predisposed family members to the development of somatization. Parental overprotection has been associated with somatization and hypochondriasis (Noyes et al. 2002). Problematic parent interactions have been reported to be predictive of significant somatic complaints by children and adolescents (Borge and Nordhagen 2000; Lackner et al. 2004). R.J. Brown et al. (2005) found that patients with unexplained symptoms score lower on family cohesion and higher on ratings of conflict. Children in families with significant degrees of conflict may develop somatic complaints as a mechanism to avoid emotional expression that may potentially exacerbate familial stress.

Parental psychopathology or attitudes toward illness may foster a heightened somatic focus in their children. Children who are living with a mother who has a chronic illness, a somatoform disorder, or a history of childhood adversity appear to be at greater risk to develop a somatoform disorder. Craig et al. (2002) found that mothers with somatoform disorder appear to imprint their health concerns onto their children, making them more likely to develop emotional and behavioral problems. Parents who neglect their children emotionally but respond selectively to physical symptoms reinforce illness behavior and symptom reporting, a phenomenon that could persist into adulthood (Mechanic 1977; Parker and Lipscomb 1980; Violon 1985).

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