This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Rhee, H. Articles by Miles, M. S. Search for Related Content PubMed PubMed Citation Articles by Rhee, H. Articles by Miles, M. S. Related Collections Pediatrics Somatoform

Patterns of Physical Symptoms and Relationships With Psychosocial Factors in Adolescents

From the School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

Address correspondence and reprint requests to Hyekyun Rhee, Department of Family, Community and Mental Health Systems, School of Nursing, University of Virginia, McLeod Hall, PO Box 800782, Charlottesville, VA 22908. E-mail: hr3k{at}virgnia.edu

Objectives: Physical symptoms are common in otherwise healthy adolescents. This study sought to identify meaningful patterns of multiple physical symptoms and to examine relationships between the patterns and psychosocial factors. One-year stability of symptom patterns and factors contributing to stability were also examined.

Methods: This secondary data analysis used longitudinal data from a nationally representative sample of adolescents in grades 7 through 12 (n = 9,141) who participated in the National Longitudinal Study of Adolescent Health during 1994 to 1996. Ten selected physical symptoms (i.e., headache, stomachaches, fatigue) were used to construct clusters. Each cluster was compared in regard to demographic factors, psychological adjustment and interpersonal relationships.

Results: K-means in combination with Ward method clustered the sample into 4 groups according to the overall patterns of the 10 symptoms: nonsymptom (41%), moderate symptom (38%), high symptom (19%) and extreme symptom (2%). Adolescents in higher symptom clusters were more likely to be girls, nonwhites, or from families on welfare and reported high depressive symptoms, low self-esteem, and poor perceptions of parental affection and friendship quality. About 16% in clusters with lower symptom patterns develop somatizing patterns in Wave II; new onset was predicted by gender, younger age, and depressive symptoms.

Conclusion: Symptom patterns characterized by overall high frequencies of multiple symptoms may indicate somatization. This study also suggests that adolescents with a somatizing tendency are more likely to experience psychological and interpersonal difficulties, and girls and younger adolescents are more vulnerable. Targeted prevention programs are needed for these vulnerable individuals by addressing their psychosocial functioning.

Key Words: multiple symptoms • clusters • psychological adjustment • interpersonal relationships • stability

Abbreviations: Add Health = the National Longitudinal Study of Adolescent Health; CES-D = the Center for Epidemiological Studies-Depression Scale; SES = socioeconomic status; ANOVA = analysis of variance; OR = odds ratio; 95CI = 95% confidence interval; NS = nonsymptom; MS = moderate symptom; HS = high symptom; ES = extreme symptom.

This article has been cited by other articles:

				G. S. Goldfield, R. Mallory, T. Parker, T. Cunningham, C. Legg, A. Lumb, K. Parker, D. Prud'homme, and K. B. Adamo Effects of Modifying Physical Activity and Sedentary Behavior on Psychosocial Adjustment in Overweight/Obese Children J. Pediatr. Psychol., August 1, 2007; 32(7): 783 - 793. [Abstract] [Full Text] [PDF]