Top

Gepubliceerd in:

04-01-2018 | Original Paper

Linking Family Functioning and Self-Discrepancies among Children with Functional Somatic Symptoms

Auteurs: Tamar Silberg, Hila Drucker-Bezalel, Maya Gerner, Tal Krasovsky, Ety Berant, Amichai Brezner, Jana Landa

Gepubliceerd in: Journal of Child and Family Studies | Uitgave 5/2018

Abstract

Functional somatic symptoms (FSS), defined as physical symptoms of unknown pathology, are common among children and adolescents and are often associated with high levels of functional impairment. Self-discrepancy theory (SDT) suggests that discrepancies between one’s ideal, ought, or undesired self-states and one’s actual self-representation may lead to emotional distress. Among families with dysfunctional patterns, such emotional distress may result in FSS. The current study examined the relationship between familial patterns and children’s levels of self-discrepancies, among children with and without FSS. Twenty-three children diagnosed with FSS and 23 children with orthopedic problems (non-FSS) and their mothers participated in the study. Mothers and children completed the Child Somatization Inventory and the Integrated Self-Discrepancies Index. Mothers also completed the general scale of the Family Assessment Device. Higher levels of symptom intensity were found in the FSS group than in the non-FSS group. Dysfunctional familial patterns were significantly higher in the FSS group, and higher levels of discrepancies were reported in the FSS group, compared with the non-FSS group. No significant relationship was found in the FSS group between level of self-state discrepancies and level of family functioning. Higher levels of dysfunctional patterns are observed among families of children with FSS. Furthermore, children with FSS and their mothers hold relatively high levels of self-state discrepancies. However, these elevated discrepancies are not significantly related to familial dysfunctional patterns. Viewing self-state discrepancies together with family maladaptive patterns might help address both inter- and intrapersonal conflicts within the family and reduce children’s symptoms.

vorige artikel Interparental Interactions and Adolescent Mood: A Daily Diary Approach

volgende artikel Family Coping During Hospitalization of Children with Chronic Illnesses

Achenbach, T. M., & Edelbrock, C. S. (1983). Manual for the child behavior checklist and revised child behavior profile. Burlington, VT: Department of Psychiatry, University of Vermont.

Akister, J., & Stevenson-Hinde, J. (1991). Identifying families at risk: Exploring the potential of the McMaster Family Assessment Device. Journal of Family Therapy, 13, 411–421. https://doi.org/10.1046/j.1991.00437.x.CrossRef

Al-Krenawi, A., Graham, J. R., & Kanat-Maymon, Y. (2009). Analysis of trauma exposure, symptomatology and functioning in Jewish Israeli and Palestinian adolescents. The British Journal of Psychiatry, 195, 427–432. https://doi.org/10.1192/bjp.bp.108.050393.CrossRefPubMed

Alderfer, M. A., Fiese, B. H., Gold, J. I., Cutuli, J., Holmbeck, G. N., Goldbeck, L., & Patterson, J. (2008). Evidence-based assessment in pediatric psychology: Family measures. Journal of Pediatric Psychology, 33, 1046–1061. https://doi.org/10.1093/jpepsy/jsm083.CrossRefPubMed

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5). Washington, DC: Author.CrossRef

Ani, C., Reading, R., Lynn, R., Forlee, S., & Garralda, E. (2013). Incidence and 12-month outcome of non-transient childhood conversion disorder in the U.K. and Ireland. The British Journal of Psychiatry, 202, 413–418. https://doi.org/10.1192/bjp.bp.112.116707.CrossRefPubMed

Aronson, E. (1969). The theory of cognitive dissonance: A current perspective. Advances in Experimental Social Psychology, 4, 1–34. https://doi.org/10.1016/S0065-2601(08)60075-1.CrossRef

Beck, J. E. (2008). A developmental perspective on functional somatic symptoms. Journal of Pediatric Psychology, 33, 547–562. https://doi.org/10.1093/jpepsy/jsm113.CrossRefPubMed

Bellak, L., & Abrams, D. M. (1997). The thematic apperception test, the children’s apperception test, and the senior apperception technique in clinical use. Boston, MA: Allyn and Bacon.

Bihun, J. T., Wamboldt, M. Z., Gavin, L. A., & Wamboldt, F. S. (2002). Can the family assessment device (FAD) be used with school aged children?. Family Process, 41, 723–731. https://doi.org/10.1111/j.1545-5300.2002.00723.x.CrossRefPubMed

Bronfenbrenner, U. (1979). Contexts of child rearing: Problems and prospects. American Psychologist, 34, 844–850. https://doi.org/10.1037/0003-066X.34.10.844.CrossRef

Brown, R. J. (2004). Psychological mechanisms of medically unexplained symptoms: An integrative conceptual model. Psychological Bulletin, 130, 793–812. https://doi.org/10.1037/0033-2909.130.5.793.CrossRefPubMed

Campo, J. V. (2012). Annual research review: Functional somatic symptoms and associated anxiety and depression—Developmental psychopathology in pediatric practice. Journal of Child Psychology and Psychiatry, 53, 575–592. https://doi.org/10.1111/j.1469-7610.2012.02535.x.CrossRefPubMed

Campo, J. V., & Fritz, G. (2001). A management model for pediatric somatization. Psychosomatics, 42, 467–476. https://doi.org/10.1176/appi.psy.42.6.467.CrossRefPubMed

Cramer, P., & Gaul, R. (1988). The effects of success and failure on children’s use of defense mechanisms. Journal of Personality, 56, 729–742. https://doi.org/10.1111/j.1467-6494.1988.tb00474.x.CrossRef

Cruz, C., Chudleigh, C., Savage, B., & Kozlowska, K. (2014). Therapeutic use of fact sheets in family therapy with children and adolescents with functional somatic symptoms. Australian and New Zealand Journal of Family Therapy, 35, 223–243. https://doi.org/10.1002/anzf.1059.CrossRef

Duval, S., & Wicklund, R. A. (1972). A theory of objective self awareness. New York, NY: Academic Press.

Dweck, C. S. (2000). Self-theories: Their role in motivation, personality, and development. Philadelphia, PA: Psychology Press.

Essau, C. A., Olaya, B., Bokszczanin, A., Gilvarry, C., & Bray, D. (2013). Somatic symptoms among children and adolescents in Poland: A confirmatory factor analytic study of the Children Somatization Inventory. Frontiers in Public Health, 1, 72. https://doi.org/10.3389/fpubh.2013.00072.CrossRefPubMedPubMedCentral

Epstein, N. B., Baldwin, L. M., & Bishop, D. S. (1983). The McMaster family assessment device. Journal of Marital and Family Therapy, 9, 171–180. https://doi.org/10.1111/j.1752-0606.1983.tb01497.x.CrossRef

Garralda, M. E. (1996). Somatisation in children. Journal of Child Psychology and Psychiatry, 37, 13–33. https://doi.org/10.1111/j.1469-7610.1996.tb01378.x.CrossRefPubMed

Hardin, E. E., & Lakin, J. L. (2009). The integrated self-discrepancy index: A reliable and valid measure of self-discrepancies. Journal of Personality Assessment, 91, 245–253. https://doi.org/10.1080/00223890902794291.CrossRefPubMed

Haug, T. T., Mykletun, A., & Dahl, A. A. (2004). The association between anxiety, depression, and somatic symptoms in a large population: The HUNT-II study. Psychosomatic Medicine, 66, 845–851. https://doi.org/10.1097/01.psy.0000145823.85658.0c.CrossRefPubMed

Hewitt, P. L., & Flett, G. L. (1991). Perfectionism in the self and social contexts: Conceptualization, assessment and association with psychopathology. Journal of Personality and Social Psychology, 60, 456–470. https://doi.org/10.1037/0022-3514.60.3.456.CrossRefPubMed

Higgins, E. T. (1987). Self-discrepancy: A theory relating self and affect. Psychological Review, 94, 319–340. https://doi.org/10.1037/0033-295X.94.3.319.CrossRefPubMed

Higgins, E. T., Klein, R., & Strauman, T. (1985). Self-concept discrepancy theory: A psychological model for distinguishing among different aspects of depression and anxiety. Social Cognition, 3, 51–76. https://doi.org/10.1521/soco.1985.3.1.51.CrossRef

Holahan, C. J., & Moos, R. H. (1981). Social support and psychological distress: A longitudinal analysis. Journal of Abnormal Psychology, 90, 365–370. https://doi.org/10.1037/0021-843X.90.4.365.CrossRefPubMed

Kabacoff, R. I., Miller, I. W., Bishop, D. S., Epstein, N. B., & Keitner, G. I. (1990). A psychometric study of the McMaster Family Assessment Device in psychiatric, medical, and nonclinical samples. Journal of Family Psychology, 3, 431–439. https://doi.org/10.1037/h0080547.CrossRef

Keitner, G. I., Heru, A. M., & Glick, I. D. (2009). Clinical manual of couples and family therapy. Washington, DC: American Psychiatric Publishing.

Kozlowska, K. (2007). Intergenerational processes, attachment and unexplained medical symptoms. Australian and New Zealand Journal of Family Therapy, 28(2), 88–99. https://doi.org/10.1375/anft.28.2.88.CrossRef

Kozlowska, K. (2009). Attachment relationships shape pain-signaling behavior. The Journal of Pain, 10, 1020–1028. https://doi.org/10.1016/j.jpain.2009.03.014.CrossRefPubMed

Kozlowska, K. (2016). The body comes to family therapy: Utilising research to formulate treatment interventions with somatising children and their families. Australian and New Zealand Journal of Family Therapy, 37, 6–https://doi.org/10.1002/anzf.1133.CrossRef

Kozlowska, K., English, M., & Savage, B. (2013). Connecting body and mind: The first interview with somatising patients and their families. Clinical Child Psychology and Psychiatry, 18, 224–245. https://doi.org/10.1177/1359104512447314.CrossRefPubMed

Lewandowski, A. S., Palermo, T. M., Stinson, J., Handley, S., & Chambers, C. T. (2010). Systematic review of family functioning in families of children and adolescents with chronic pain. The Journal of Pain, 11, 1027–1038. https://doi.org/10.1016/j.jpain.2010.04.005.CrossRefPubMedPubMedCentral

Miller, I. W., Ryan, C. E., Keitner, G. I., Bishop, D. S., & Epstein, N. B. (2000). The McMaster approach to families: Theory, assessment, treatment and research. Journal of Family Therapy, 22, 168–189. https://doi.org/10.1111/1467-6427.00145.CrossRef

Miller, R. B., Anderson, S., & Keals, D. K. (2004). Is Bowen theory valid? A review of basic research. Journal of Marital and Family Therapy, 30, 453–466. https://doi.org/10.1111/j.1752-0606.2004.tb01255.x.CrossRefPubMed

Minuchin, S., Baker, L., Rosman, B. L., Liebman, R., Milman, L., & Todd, T. C. (1975). A conceptual model of psychosomatic illness in children: Family organization and family therapy. Archives of General Psychiatry, 32, 1031–1038. https://doi.org/10.1001/archpsyc.1975.01760260095008.CrossRefPubMed

Minuchin, S., Rosman, B. L., Baker, L., & Minuchin, S. (2009). Psychosomatic families: Anorexia nervosa in context. Cambridge, MA: Harvard University Press.

Miranda, M. C., Affuso, G., Esposito, C., & Bacchini, D. (2016). Parental acceptance–rejection and adolescent maladjustment: mothers’ and fathers’ combined roles. Journal of Child and Family Studies, 25, 1352–1362. https://doi.org/10.1007/s10826-015-0305-5.CrossRef

Naz, F. (2012). Parental rejection and comorbid disorders in adolescents with somatization disorder. Journal of Behavioural Sciences, 22(1), 125–142.

Ogilvie, D. M. (1987). The undesired self: A neglected variable in personality research. Journal of Personality and Social Psychology, 52, 379–385. https://doi.org/10.1037/0022-3514.52.2.379.CrossRef

Palermo, T. M., & Chambers, C. T. (2005). Parent and family factors in pediatric chronic pain and disability: An integrative approach. Pain, 119(1–3), 1–4. https://doi.org/10.1016/j.pain.2005.10.027.CrossRefPubMed

Palermo, T. M., Valrie, C. R., & Karlson, C. W. (2014). Family and parent influences on pediatric chronic pain: A developmental perspective. American Psychologist, 69, 142–152. https://doi.org/10.1037/a0035216.CrossRefPubMedPubMedCentral

Rickles, W. H. (1986). Self psychology and somatization: An integration with alexithymia. Progress in Self Psychology, 2, 212–226.

Rohner, R. P. (2004). The parental “acceptance–rejection syndrome”: Universal correlates of perceived rejection. American Psychologist, 59, 827–840. https://doi.org/10.1037/0003-066X.59.8.830.CrossRef

Silberg, T., Brezner, A., Gilad, G., Ahonniska-Assa, J., & Levav, M. (2016). The role of maternal distress on the report of behavioral and emotional problems among children with chronic disabilities. Israel Journal of Psychiatry and Related Sciences, 53, 17–24.PubMed

Sullivan, H. S. (1953). The interpersonal theory of psychiatry. New York, NY: Norton.

Turner, R. H. (1956). Role-taking, role standpoint, and reference-group behavior. American Journal of Sociology, 61, 316–328. https://doi.org/10.1086/221763.CrossRef

Van, As,N., & Janssens, J. (2002). Relationships between child behavior problems and family functioning: A literature review. International Journal of Child and Family Welfare, 5(1/2), 40–51.

Vetere, A. (2001). Structural family therapy. Child and Adolescent Mental Health, 6, 133–139. https://doi.org/10.1111/1475-3588.00336.CrossRef

Walker, L. S., Beck, J. E., Garber, J., & Lambert, W. (2009). Children’s somatization inventory: Psychometric properties of the revised form (CSI-24). Journal of Pediatric Psychology, 34, 430–440. https://doi.org/10.1093/jpepsy/jsn093.CrossRefPubMed

Waller, E., & Scheidt, C. E. (2006). Somatoform disorders as disorders of affect regulation: A development perspective. International Review of Psychiatry, 18, 13–24. https://doi.org/10.1080/09540260500466774.CrossRefPubMed

Winnicott, D. (1966). Psycho-somatic illness in its positive and negative aspects. The International Journal of Psychoanalysis, 47, 510–516.PubMed

Yahav, R., & Sharlin, S. (2000). The symptom-caring child as a preserver of the family unit. Child & Family Social Work, 5, 353–364. https://doi.org/10.1046/j.1365-2206.2000.00175.x.CrossRef

Zentner, M., & Renaud, O. (2007). Origins of adolescents’ ideal self: an intergenerational perspective. Journal of Personality and Social Psychology, 92(3), 557. https://doi.org/10.1037/0022-3514.92.3.557.CrossRefPubMed

Zilber, N., Auerbach, J., & Lerner, Y. (1994). Israeli norms for the Achenbach child behavior checklist: Comparison of clinically and non-referred children. The Israel Journal of Psychiatry & Related Sciences, 31, 5–12.

Titel: Linking Family Functioning and Self-Discrepancies among Children with Functional Somatic Symptoms
Auteurs: Tamar Silberg
Hila Drucker-Bezalel
Maya Gerner
Tal Krasovsky
Ety Berant
Amichai Brezner
Jana Landa
Publicatiedatum: 04-01-2018
Uitgeverij: Springer US
Gepubliceerd in: Journal of Child and Family Studies / Uitgave 5/2018
Print ISSN: 1062-1024
Elektronisch ISSN: 1573-2843
DOI: https://doi.org/10.1007/s10826-017-0985-0

Andere artikelen Uitgave 5/2018

Youth Subgroups who Receive John F. Chafee Foster Care Independence Program Services

Original Paper

Parents’ Views of Father–Child Rough-and-Tumble Play

Original Paper

Does Parent Training Format Affect Treatment Engagement? A Randomized Study of Families at Social Risk

Original Paper

Parents’ Understanding of Adopted Children’s Ways of Being, Belonging, and Becoming

Original Paper

Emotional Separation, Autonomy in Decision-Making, and Psychosocial Adjustment in Adolescence: A Proposed Typology

Original Paper

A Preliminary Study Investigating the Effectiveness of the Caring for Body and Mind in Pregnancy (CBMP) in Reducing Perinatal Depression, Anxiety and Stress

Original Paper