From attachment to parents to somatic symptoms in children: exploring the mediation role of anxiety, attachment to peers and depressive symptoms

Despite the fact that somatic symptoms are related to the quality of attachment, few studies have been conducted to explore the variables that mediate this relationship in childhood. The present study investigates the role of anxiety, attachment to peers, and depressive symptoms as mediators of the relationship between attachment to parents and somatic symptoms. 340 children (49.1% males) between the ages of 8-11 (Mean age=9.25, SD=0.89) participated in this study. They completed the Inventory of Parent and Peer Attachment-Revised (IPPA-R), the Screen for Child Anxiety Related Emotional Disorders (SCARED), the Children's Depression Inventory 2 (CDI-2) and the Children's Somatization Inventory (CSI-24). We analyzed whether the effect of attachment to parents on somatic symptoms could be explained through anxiety (mediator one), attachment to peers (mediator two) and depressive symptoms (mediator three) using the Macro PROCESS (model 6). Results show that half of the total sample (52.1%, n=177) report at least one somatic symptom during the last two weeks. According to the SCARED and CDI-2 cut-off, 34.7% (n=118) and 27.1% (n=92) of participants are at risk for anxiety and depressive disorder. The total effect of attachment to parents on somatic symptoms is significant (b=-.186, SE=.051; 95%C.I.=-.285;-.086, p<.001, R2=.08). Three indirect effect are found: through anxiety symptoms (b=-.066, Bootstrap SE=.026, 5000 bootstrap samples 95%C.I.=-.123;-.022); through anxiety and depressive symptoms (b=-.005, Bootstrap SE=.004, 5000 bootstrap samples 95%C.I.=-.016;-.001); through attachment to peers and depressive symtpoms (b=-.008, Bootstrap SE=.006, 5000 bootstrap samples 95%C.I.=-.027;-.001). After controlling for the mediators, a nonsignificant total direct effect of attachment to parents is found. Serial multiple mediation help us to clarify the link between attachment and somatic symptoms in children. Findings from this study provide evidence that somatic symptoms are associated with the quality of attachment and internalizing symptoms. Longitudinal studies are needed to test the validity of the model.