No abstract

The aim of the current systematic review and meta-analysis was to examine the prevalence and incidence of somatoform symptoms and disorders (also referred to as medically unexplained symptoms, psychosomatic symptoms, functional syndromes, somatization disorder, or somatic symptom disorder) in childhood and adolescence. The PRISMA guidelines were followed, and the review was registered prior to initiation (PROSPERO CRD42022339735). Fitting search terms were entered in Web of Science, Scopus, and PubMed in June, 2022. Included were articles, reports, book chapters, and conference papers that reported on the prevalence or incidence rates of somatoform symptoms and disorder in under-18-year-olds with empirical primary data; these needed to be published in English or German. Publications were excluded if they focused on abuse, trauma, serious illness, or hypochondria, as well as if they had a qualitative or experimental (intervention) study design. To be included in the meta-analysis, studies needed to report values suitable to calculate a pooled prevalence or incidence rate. After the full-text screening, 33 articles remained, of which 29 were used for the meta-analysis. The quality evaluation criteria proposed by Loney and colleagues (1998) were utilized for quality assessment. The pooled global prevalence rate was 31.0% for somatoform symptoms and 3.3% for somatoform disorders, yet heterogeneity remained high. The noteworthy prevalence rates have important implications for healthcare professionals, as well as school nurses and counselors.

The present study was investigating the predictive role of maternal mentalizing and general as well as depressive symptom burden for attachment security at the end of the first year on a sample of 44 mother-child-dyads from a low-risk community study. Maternal mentalizing was assessed in a multidimensional way as Reflective Functioning (off-line) and Mind-Mindedness (on-line). The design was longitudinal measuring maternal Mind-Mindedness from a videotaped mother-child-play-interaction at the age of three months. General and depressive symptom burden was assessed using the SCL-90-R when the children were nine months old. Maternal attachment and Reflective-Functioning, using the Adult-Attachment-Interview, as well as children's attachment behavior, using the Strange-Situation-Test, were investigated at the age of twelve months. Secure maternal attachment was associated with higher Reflective Functioning, higher frequency of Mind-Mindedness and lower general and depressive symptom burden. A moderation-analysis showed a statistical trend (p = .08) that the interaction of the frequency of mind-related comments, general symptom severity and maternal attachment has a predictive value for infantile attachment security. Results can be tentatively interpreted that mothers with insecure attachment who had a lower general symptom burden and who related to their three-months old babies with a high frequency of mind-related-comments were more likely to have securely attached children. Thus, results may serve as a groundwork for projects aiming to prevent the transmission of insecure attachment by strengthening maternal Mind-Mindedness and working on the reduction of maternal general symptom burden.

Emotion dysregulation is a transdiagnostic factor in the development of various mental and behavioral disorders, thus requiring ample evidence for prevention and intervention approaches. The aim of the current systematic review and meta-analysis was to investigate the association between parenting dimensions/styles and emotion dysregulation in childhood and adolescence. Following the PRISMA guidelines, the review was registered (PROSPERO CRD42021251672) and search terms were entered in Web of Science, Scopus, PsycINFO, and PubMed in May 2021. Articles needed to report on empirical studies that examined the association between parenting dimensions/styles and emotion dysregulation in children/adolescents with primary data, and be published in English in a peer-reviewed journal. Additionally, articles were excluded based on certain designs and focus on special populations. The narrative synthesis includes 30 articles, and of which 27 are included in the meta-analysis. An NHLBI tool with 14 items (e.g., validity) was utilized for assessing the quality of the included studies. General trends indicate that positive parenting (e.g., warmth, supportiveness) is negatively associated with emotion dysregulation, whilst negative parenting (e.g., psychological control, authoritarian) is positively associated. The meta-analysis reveals an overall small yet significant effect, however, the heterogeneity of the studies is moderate to high. A funnel plot demonstrated no evidence of publication bias. Limitations include the varying conceptualizations of emotion dysregulation, as well as a lacking focus on specific types of emotion. Although more research is needed, addressing factors such as culture, gender, and age, the review provides first indications of the significance of parenting dimensions/styles for emotion dysregulation.

Repeatedly occurring somatoform complaints often cause disruptions in children’s daily life, both in family and school settings. Associated with these complaints, there is an increased demand for medical help in the affected children. Despite the frequent occurrence of somatoform complaints in childhood, only a small number of studies have focused on this subject, and the development and maintenance of somatoform complaints have not sufficiently explained to date. Previous research suggests that many different factors are involved, including insecure attachment, a lack of emotion regulation (ER) strategies, and psychiatric behavior problems. The aim of this study is to examine possible pathways describing the interplay of aforementioned factors, in order to contribute to a deeper understanding of the underlying mechanisms. A nonexperimental cross-sectional study was conducted. Questionnaires were completed by 221 children (female n = 115; Mage = 9.70 years, SDage = .56) reporting on their attachment and ER strategies, and their parents reported on the behavior problems and somatoform complaints. Path analysis revealed a good model fit (Χ2 = p .798, Χ2/df = .415, NFI = .994, CFI = 1.000, RMSEA = .000). Results revealed that attachment anxiety predicted maladaptive ER strategies, and attachment avoidance predicted emotion control. In turn significant paths were found between ER strategies, behavior problems, and somatoform complaints. This study provides a first insight into the underlying mechanisms describing the occurrence of somatoform complaints. Results revealed two developmental pathways, based on attachment quality and mediated through different emotion regulation strategies.Clinical Trial Registration: The project “Impact factors and conditions of somatoform symptoms in childhood within familial and school contexts” is listed in the German Clinical Trails Register (DRKS-ID: DRKS00012444) and the WHO International Clinical Trials Registry Platform.