Functional Abdominal Pain in Childhood: From Etiology to Maladaptation

Abstract

Objective: 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. Methods: Using electronic searches for published studies and previous reviews about functional abdominal pain. Results: An association of functional abdominal pain with internalizing symptoms, poor well-being of family members, major life events and daily stressors is 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. Conclusions: 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.

Modelling trajectories of psychosomatic health complaints in children and adolescents: results of the BELLA study

“…Both symptoms are a research field of its own and current reviews [e.g. 17,18] confirm what is known from studies on general PHC. Inconsistent time courses have not been attributed to possible inter-individual differences as yet.…”

Estado actual de los trastornos somatomorfos y conversivos en niños y adolescentes

“…Algunos factores de riesgo para el desarrollo de un TS son somatización parental, enfermedad orgánica y/o mental de un otro significativo, ambiente familiar disfuncional, experiencias traumá-ticas infantiles y apego inseguro 27 ; particularmente, el dolor abdominal funcional se asocia a síntomas internalizantes, pobre bienestar familiar, eventos familiares no normativos y estresores diarios 28 como pobres relaciones interpersonales, problemas comunicacionales intrafamiliares y conflictos con los padres en el caso de las niñas 5 , observándose por ejemplo más CPNE en niños con ambientes familiares inadecuados que en aquéllos abusados física y/o sexualmente 29 . Jellesma et al 30 comprobaron que la preocupación parental no se relacionaba con mayor freESTAdO ACTUAL dE LOS TRASTORNOS SOmATOmORFOS y CONVERSIVOS EN NIñOS y AdOLESCENTES cuencia de síntomas somáticos infantiles.…”

“…Actualmente, el reconocimiento de los TS y TC como desórdenes con plataforma traumática 15 , ha adquirido tanta importancia como su interpretación psicodinámica histórica 12,13 , mientras que la evidencia neurobioló-gica sugiere un vínculo etiológico con fenómenos evolutivos y defensivos 21,22,25 . Otras variables que se han relacionado con su aparición apuntan a la dinámica familiar 14 en torno a su funcionalidad 5,29 , al apego 27 , estresores no normativos 28 y características psicopatológicas parentales [30][31][32] . Por otra parte, un perfil de personalidad internalizante 41 y la concurrencia de ansiedad y depresión 19 favorecerían la somatización.…”

Functional Abdominal Pain in Children

“…RAP is accepted as a functional disorder that accounts for 25% of referrals to tertiary gastroenterological clinics and often gives a negative effect on children 8,9) . According to the reports of the incidence of RAP, disparate results have been reported with prevalence ranged from 10 to 25% 10∼12) .…”