All ETDs from UAB

Advisory Committee Chair

Aaron D Fobian

Advisory Committee Members

Dustin Long

Margaux J Barnes

David C Schwebel

Document Type

Dissertation

Date of Award

2019

Degree Name by School

Doctor of Philosophy (PhD) College of Arts and Sciences

Abstract

Somatic symptoms, or physical symptoms that do not have an identifiable organic etiology, have a prevalence of 10-30% in children. They have been associated with poor psychosocial outcomes in children, including emotional and behavioral problems, school absences, and impaired social functioning. Further, these symptoms represent a burden on the health care system as patients with somatic symptoms are frequent users of both primary care physicians and specialists. The etiology of somatic symptoms is thought to be due to a combination of biological, psychological, interpersonal, and healthcare factors. Two theories exist regarding the etiology of somatic symptoms. Brown’s integrative conceptual model posits that exposure to illness in oneself or others leads to increased attention to physical symptoms and misattribution of those symptoms to serious disease. Social learning theory suggests that family members may either model and/or reinforce illness behaviors, including somatic symptoms. An ill family member would serve as both a model of illness behaviors within a family and may be more likely to reinforce those illness behaviors in other family members. Given that adolescents with an ill family member may be at particular risk of developing somatic symptoms based on both Brown’s model and social learning theory, the current project aimed to provide a systematic review of the existing literature and further examine the relations between somatic symptoms in adolescents and having an ill family member. A systematic review of the existing literature found limited existing research; however, identified a majority of studies supporting having an ill parent and somatic symptoms. Further, this review identified several weaknesses in the existing literature. The two remaining papers directly examined the somatic symptoms in adolescents with ill family members and found support for having an ill mother or an ill sibling and higher average somatic symptoms compared to adolescents with healthy siblings. The papers also highlighted being female and illness impairing daily functioning as possible risk factors within this population. Clinically, adolescents with family members who are ill may benefit from early prevention or monitoring for potential intervention, particularly if they are female and have family members who are ill with impaired function. Keywords: adolescents, somatic symptoms, family, chronic illness

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