Cross-national daily associations of sadness, sadness dysregulation, and somatic symptoms in typical and atypical adolescents

Somatic symptoms are bodily experiences that occur without apparent organic pathological basis, and common during childhood and adolescence (Beck, 2008). Somatic symptoms burden health systems beacause their treatment often requires prolonged health-care (Bohman et al. 2018). In adolescence somatic symptoms have been linked to poor life quality and to academic and social difficulties (Meyer et al. 2020; Domenech-Llaberia et al., 2004). Researchers have already shown the association between depressive mood and somatic symptoms (Janssens et al, 2010) and between sadness experience and somatization (Fushuber et al.2019). Despite this, little is known about the underling mechanisms of emotion dysregulation that may work as predictors of the onset of somatic symptoms. Moreover, recent findings highlighted the importance of studying the day-to-day variability (e.g. instability) of youths’ emotional experiences in order to tap the within-person pattern of frequency and intensity of a specific negative emotion associated with youths’ maladjustment (e.g.,Cole & Hall, 2008; Maciejewski et al., 2015). This study examines the associations between three different facets of sadness (experienced sadness, sadness dysregulation, and self-efficacy in sadness regulation) and the somatic symptoms in three sample of adolescents. This study includes two normative samples of adolescents (103 Italians; 53% males; M age = 15.56, SD = .77; 64 Colombians; 44% male, M age =16.56, DS=.77) that are part of an ongoing international longitudinal study (Lansford et al., 2018) and a clinical sample of 80 Italian adolescents (53% males; M age =15.84; SD = 2.30). Data were gathered with ecological momentary assessment. For 15 days, adolescents were prompted via mobile-phones to respond to questions about whether they were feeling sad, whether they were using specific strategies to handle that emotion (sadness dysregulation; Gratz & Romer, 2004; Zeman et al., 2002), and how much they believed they were capable of regulating that emotion (self-efficacy in sadness regulation; Bandura et al., 2003) in that moment. Instability scores for each of the aforementioned constructs were examined with the root mean square of successive differences (Ebner-Priemer & Trull, 2012; high score refers to high instability). Somatic symptoms were measured using the somatic symptoms sub-scale from Youth Self-Report (Achenbach, 1991). In all samples, higher sadness was associated with higher somatic symptoms. Only among Italians, higher sadness dysregulation was associated with higher somatic symptoms. Only in normative samples self-efficacy in sadness regulation was associated with lower somatic symptoms. Preliminary analyses conducted only on the Italian normative sample showed an association between sadness instability and higher somatic symptoms. These results contribute to knowledge about the role of discrete emotions, and in particular of sadness, in somatic complaints in typical and atypical adolescents in cross-cultural contexts, and suggest the importance of taking into account the level of instability of the emotional experience as an important facet of emotion regulation.