The association between parental chronic physical illness and adolescent functional somatic symptoms 2023 Koen et al

[Andy]

Background
Previous studies have found that adolescents with a chronically ill parent may experience more internalizing problems. It is less clear if this association is sex-related, and whether it is specific for functional somatic symptoms (FSSs) or concerns other internalizing or externalizing problems.

Methods
In a prospective cohort of adolescents, oversampled on emotional and behavioral problems (n = 841; mean age 14.9 years), we examined the association between parental chronic illness and adolescent's FSSs, and internalizing and externalizing problems. Adolescent's internalizing and externalizing symptoms were measured using the Youth Self Report; parental chronic physical illness was reported during an interview. Associations were tested using linear regression analyses taking into account socio-demographic confounders. We also explored gender-interaction effects.

Results
Having a chronically ill parent (n = 120; 14.3 %) was associated with more FSS in girls (B = 1.05, 95%CI = [0.23, 1.88], p = .013), but not in boys (sex-interaction: p = .013). In girls, an association was also found between parental chronic illness and more internalizing problems (B = 2.68, 95%CI = [0.41, 4.95], p = .021), but this association disappeared when FSSs were excluded from the Internalizing problem scores.

Limitations
The current study has a cross-sectional design and relied on self-reported parental chronic physical illness what may have induced misclassification.

Conclusion
Findings suggest that having a chronically ill parent is associated with more FSSs in adolescent girls and that this association is specific for FSSs instead of general internalizing problems. Girls with a chronically ill parent may profit from interventions to prevent the development of FSSs.

Paywall but with section 'snippets', https://www.sciencedirect.com/science/article/abs/pii/S0165032723007681

 

[SNT Gatchaman]

The current study has a cross-sectional design and relied on self-reported parental chronic physical illness what may have induced misclassification.

 

[SNT Gatchaman]

Functional somatic symptoms (FSSs) are persistent somatic complaints that affect daily functioning but do not have sufficient medical explanation. These symptoms are also referred to as medically unexplained symptoms or persistent physical symptoms.

Several theories have provided an explanation for the association between parental chronic illness and FSSs in their offspring. The Social learning theory proposes that through social learning mechanisms such as modeling and social reinforcement, an individual may learn to imitate illness behavior from their chronically ill parent. This notion is supported by studies that have found that somatic complaints of adolescents and the symptoms that are expressed by their chronically ill parents are of a similar nature.

It's like they've never heard of genes or environment.

The stress-system model is a more biological framework to explain the association between parental chronic illness and adolescent FSSs. According to this model, the neurobiological stress system is built out of multiple components (e.g., the hypothalamic-pituitary-adrenal axis, the autonomic nervous system) that ensure effective energy regulation and protect an individual from various threats. When the stress system is activated for too long, for instance when a parent is chronically ill, FSSs may arise.

We say "biological" but we mean "psychosomatic".

It has been found that adolescents with a chronically ill parent indeed report more stress than their counterparts without a chronically ill parent.

It is known.

It has been found that girls and women across several populations report more somatic symptoms than their male peers. However, this does not explain why girls’ FSSs seem to be stronger related to having chronically ill parents than FSSs in boys. A more plausible explanation may be that girls are more prone than boys to social learning behaviors that are associated with somatic symptoms, or that parents encourage illness behavior in girls more than in boys.

Oh yes definitely - totally plausible that teenage girls, who famously do so much less work supporting the household than teenage boys, should be encouraged to be adopt illness behaviour.

It has also been argued that girls with a chronically ill parent have more FSSs than their male counterparts because of their more pronounced biological somatic and affective responses to stressors, such as having a chronically ill parent.

There's that word "biological" again.

 

[RedFox]

The only correlation they found was that girls with a chronically ill parent are more likely to have symptoms they classify as "functional," which are often caused by autoimmune or post-infectious disease that more women get. Thus the only thing they found is health problems run in families.

 

[SNT Gatchaman]

FSSs were measured using the Somatic Complaints subscale from the Youth Self Report (YSR), a self-report questionnaire for adolescents aged 11-18 years about emotional and behavioral problems they have experienced during the last 6 months. The Somatic Complaints subscale measures FSSs, i.e. physical symptoms with no medical cause, with 8 items: headache, nausea, eye problems, skin problems, stomach pain, vomiting, other forms of pain, and fatigue.

Internalizing and externalizing problems were measured using the Internalizing and Externalizing Problems subscales from the YSR. The Internalizing Problems subscale consists of 31 items about depressive symptoms, anxiety, somatic complaints, and other internalizing problems. The Externalizing Problems subscale consists of 32 items about rule-breaking behavior, aggressive behavior, and other externalizing problems.

Illness of mother 66.7%
Illness of father 29.2%
Illness of both 4.2%

Parental chronic illness was associated with internalizing problems in girls (B = 2.68, t(424) = 2.32, p = .021), but not in boys (B = -0.88, t(393) = -0.83, p = .406). [...] Parental chronic illness was not associated with internalizing problems when FSSs were removed from the scale in both adolescent boys and girls

Other studies point out that from the start of adolescence, the girls’ stress system is more reactive than that of boys. It is thus possible that the girls’ larger amount of FSSs is related to their more reactive stress system, which gets activated when they have a chronically ill parent.

an education program could be designed to educate chronically ill parents about the potential effects of their illness on their children, or these adolescents could follow a program that provides them with support and coping skills in order to prevent the development of FSSs. Another possibility is to apply interventions, such as cognitive behavioral therapy, too ill* parents and their children to address parental reinforcement and modeling of symptoms.

Or you could circle back to your opening two sentences and recommend we get to work on the "not medically understood" part. All of which was more succinctly posted by @RedFox.

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* I was going to write that as "too sic ill" but that was worse than the original !

 

[obeat]

A teenage girl in the UK is dying from bone cancer because the teenager had her back pain dismissed as mimicking her mother's back pain.

 

[Arnie Pye]

A teenage girl in the UK is dying from bone cancer because the teenager had her back pain dismissed as mimicking her mother's back pain.

If you do a web search for "teenager pain dismissed" the links that get returned are almost all relating to girls and young women.

 

[rvallee]

Really sick beyond measure of this "look what they were wearing" research where they try to find any single tiny straw they can grasp on to blame anything, anything, but what's actually happening. It's every bit as bad as the most excessively bigoted profiling on any other basis.

Good research accounts for all other things being equal. This isn't even close. This is ridiculous.

All they have to support this is "women be hysterical":

A more plausible explanation may be that girls are more prone than boys to social learning behaviors that are associated with somatic symptoms, or that parents encourage illness behavior in girls more than in boys.

Same as Wessely's recent sadistic outing about illnesses in Iran. Those old bigoted ideas dominate psychosomatic medicine.

I completely fail to see how this is different than most racist arguments about this or that ethnic group being less civilized or intelligent, based entirely on comparing to their own society as it is right now and as far as they can see. It's pure bigotry, it's all they have.