Exploring emotional functioning in adolescents and their mothers: implications for pediatric psychosomatic disorders

Psychosomatic symptoms are defined as clinical manifestations that may or may not be explained by a medical condition. Between twenty and thirty-five percent of children and adolescents experience psychosomatic symptoms. Literature highlights a poorly defined etiology. While much research has focused on the role of adolescents’ internalizing symptoms, family functioning, and dynamics, less attention has been given to the emotional functioning of adolescents and their parents. This pilot study aims to bridge this gap by investigating the role of specific parental and adolescent variables, including reflective functioning, emotional regulation, and awareness in increasing the risk of having psychosomatic disorders. These were assessed through self and informant reports in a clinical group (CG) consisting of 36 mothers (mean age = 47.21; SD = 5.80) and adolescents (69.4% female; mean age = 12.94; SD = 0.86) with psychosomatic disorders, hospitalized in two different Italian hospitals, and in a healthy control group (HG) comprising 36 mothers (mean age = 44.78; SD = 4.06) and adolescents (52.8% female; mean age = 13; SD = 1.69) recruited from the general population and randomly selected from a larger database. The results of Mann-Whitney analysis showed that adolescents of the CG reported higher scores of internalizing symptoms (CBCL-Int) (U = 264.50; p<.001) and lower scores of reflective functioning (RFQ-Y) (U = 517.02; p<.001) than HG. Mothers of CG referred lower scores of parental reflective functioning (PRF) than mothers of HG. Two different logistic regression models were separately conducted for adolescents' and mothers' features. These analyses showed that higher CBCL Somatic Symptoms (OR = 1.63; 95% CI = 1.17 – 2.26; β = .486; p<.01) and lower RFQ (OR = .330; 95% CI = 129 – 845; β = -1.11; p<.01) scores in adolescents increase the risk of psychosomatic disorders. Regarding maternal dimensions, greater uncertainty about the children’s mental states (PRF-CM) (OR = .445; 95% CI = 262 – .756; β = -0.81; p<.01), it seems to elevate the odds ratio of being part of the CG. These findings emphasize the need to assess not just symptoms, parenting, and family dynamics but also the reflective functioning of both adolescents and their mothers. This approach aids in understanding disorder vulnerabilities and designing more tailored preventive interventions.