Somatization: Stress and Some of Its Effects on Our Children

Children can experience a significant amount of stress in our culture. The traditional family unit has changed over the past few decades to include more single parent homes as well as more homes in which both parents work outside the home. The traditional resources children utilize to work through significant stress may be less available than in times past. For example, whereby children once often had access to the nurturing and guidance of both parents as well as grandparents and other extended family members, many children of today's culture spend less than fifteen minutes of conversation a day with an adult family member.

A recent conversation with several pediatricians led to the tentative conclusion that we felt we might possibly be seeing an increase in the number of patients we see that are complaining of physical manifestations related to emotional stressors. The medical term for such a physical condition is SOMATIZATION. Somatization represents the conversion of emotional distress to physical symptoms. It is well known that stress can make many medical conditions worse but somatization is a condition whereby significant emotional distress is perceived as a physical symptom rather than as an actual mental event. Some of the more common symptoms encountered in a busy pediatrician's office that are on occasion solely related to stress include:

* Abdominal Pain
* Chest Pain
* Hyperventilation
* Headache
* Fatigue

On rare occasions the symptoms can even include temporary blindness, deafness, or paralysis that has no identifiable organic cause other than significant emotional stress. The actual incidence of somatization is unknown. However, its incidence is increased after sexual abuse, physical abuse, divorce, relocation of residence, and unresolved grief. In addition, its incidence is increased in children of parents who are seriously ill or depressed. The majority of patients have average intelligence and the condition becomes more prominent in females after the age of puberty and is almost nonexistent in children less than four years of age.

One of the more common manifestations, abdominal pain, is estimated to occur in 10-15% of children between 4 and 16 years of age.(1) A recent poll of pediatricians in the central Florida region revealed that a minimum of 1-2 patients per month were seen in a busy pediatrician's office with a complaint of chronic abdominal pain greater than six months that was felt to reflect a somatization condition. Once these patients were directed to a treatment plan of a mixture of support, encouragement, and counseling for their particular stressors, their abdominal symptoms resolved.

This information is simply to encourage parents and caretakers to seek to spend quality time with their children. Some of this time should involve open discussion of their children's emotional issues. This is best done in a setting of love, encouragement, and support as well as availability. Some practical tips that may help parents become more aware of potential emotional stressors of their children include setting aside time whereby parents ask questions about the highlights of their child's day. Then parents can ask if there were any upsetting events that particular day or week. Simply turning off television during mealtimes and turning off the car radio during drives may open up more quality time of conversation with our children. Unfortunately, the average child of today's culture spends several hours daily with various media sources (TV, internet, computer games, videos) and very little time engaged in conversation with their families. (2) Our pediatric group encourages families to "UNPLUG" from electronic entertainment sources at times and to "PLUG IN" to purposeful conversation and activities with each other. In view of recent tragic national events, this advice has become even more important to the overall health of our society.

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