Cause of abdominal pain in children with no apparent reason: Psychosomatic component

A systematic review that is published in the current issue of Psychotherapy and Psychosomatics by Schulte and associates (University of Bremen, Germany) analyzes what is the psychosomatic component of abdominal pain with no apparent cause in children.

The objective of this study was to review the extant literature on functional abdominal pain in childhood through the lens of the developmental psychopathology perspective and to systematize research results by means of a two-stage pathway model in which the emergence of functional abdominal pain and its potential transition into a somatoform adjustment disorder is outlined. The investigators used electronic searches for published studies and previous reviews about functional abdominal pain. An association of functional abdominal pain with internalizing symptoms, poor well-being of family members, major life events and daily stressors was found. The impact of stress on pain seems to be moderated by the children's coping style and their perceived competence and self-efficacy to manage the pain experience. There is evidence for the influence of modeling and operant mechanisms on pain experiences. A new term, 'somatoform adjustment disorder', and its relation to functional abdominal pain is discussed. It seems that those children with functional abdominal pain who cannot adapt to the pain indeed run the risk of developing a somatoform adjustment disorder.