Parents’ Reflective Functioning, Emotion Regulation, and Health: Associations with Children’s Functional Somatic Symptoms
Functional somatic symptoms (FSSs) in children—such as headaches, stomachaches, and muscle pain without clear medical explanations—pose a significant clinical challenge, often leading to repeated healthcare visits and impairments in daily functioning. While the role of parental psychological factors...
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2025-04-01
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| author | Aikaterini Fostini Foivos Zaravinos-Tsakos Gerasimos Kolaitis Georgios Giannakopoulos |
| author_facet | Aikaterini Fostini Foivos Zaravinos-Tsakos Gerasimos Kolaitis Georgios Giannakopoulos |
| author_sort | Aikaterini Fostini |
| collection | DOAJ |
| description | Functional somatic symptoms (FSSs) in children—such as headaches, stomachaches, and muscle pain without clear medical explanations—pose a significant clinical challenge, often leading to repeated healthcare visits and impairments in daily functioning. While the role of parental psychological factors in shaping children’s FSSs has been suggested, empirical evidence remains limited and fragmented. This study addresses this gap by systematically examining the associations between parents’ reflective functioning, emotion regulation, alexithymia, and physical and mental health, and the frequency and severity of children’s FSSs. A total of 339 parents of children aged 6–12 completed surveys assessing their capacity to understand mental states, regulate emotions, and identify or describe feelings, as well as their self-reported physical and mental health. They also indicated whether their child experienced FSSs (e.g., headaches, stomachaches) more than once per week. Results revealed that parents of children with FSSs reported significantly lower levels of reflective functioning (lower certainty, higher uncertainty), higher alexithymic traits, and greater emotion regulation difficulties, alongside poorer physical and mental health indices. Logistic regression analyses demonstrated that emotion regulation difficulties and poorer mental health significantly increased the likelihood of a child exhibiting FSSs, while lower reflective functioning also emerged as a significant predictor. Furthermore, multiple linear regression indicated that emotion regulation challenges and poor mental health predicted greater severity of FSSs. These findings offer novel insights into how parents’ psychological and health characteristics can shape children’s somatic symptom expression, highlighting the need for family-focused interventions. By identifying and addressing parental emotional and cognitive difficulties, clinicians may be able to mitigate the intergenerational transmission of maladaptive stress responses, ultimately reducing the burden of FSSs in children. |
| format | Article |
| id | doaj-art-e8d76e5836594d13bce979e44d656d90 |
| institution | Kabale University |
| issn | 2813-9844 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | MDPI AG |
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| series | Psychology International |
| spelling | doaj-art-e8d76e5836594d13bce979e44d656d902025-08-20T03:29:35ZengMDPI AGPsychology International2813-98442025-04-01723110.3390/psycholint7020031Parents’ Reflective Functioning, Emotion Regulation, and Health: Associations with Children’s Functional Somatic SymptomsAikaterini Fostini0Foivos Zaravinos-Tsakos1Gerasimos Kolaitis2Georgios Giannakopoulos3School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, GreeceDepartment of Child Psychiatry, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, GreeceDepartment of Child Psychiatry, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, GreeceDepartment of Child Psychiatry, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, GreeceFunctional somatic symptoms (FSSs) in children—such as headaches, stomachaches, and muscle pain without clear medical explanations—pose a significant clinical challenge, often leading to repeated healthcare visits and impairments in daily functioning. While the role of parental psychological factors in shaping children’s FSSs has been suggested, empirical evidence remains limited and fragmented. This study addresses this gap by systematically examining the associations between parents’ reflective functioning, emotion regulation, alexithymia, and physical and mental health, and the frequency and severity of children’s FSSs. A total of 339 parents of children aged 6–12 completed surveys assessing their capacity to understand mental states, regulate emotions, and identify or describe feelings, as well as their self-reported physical and mental health. They also indicated whether their child experienced FSSs (e.g., headaches, stomachaches) more than once per week. Results revealed that parents of children with FSSs reported significantly lower levels of reflective functioning (lower certainty, higher uncertainty), higher alexithymic traits, and greater emotion regulation difficulties, alongside poorer physical and mental health indices. Logistic regression analyses demonstrated that emotion regulation difficulties and poorer mental health significantly increased the likelihood of a child exhibiting FSSs, while lower reflective functioning also emerged as a significant predictor. Furthermore, multiple linear regression indicated that emotion regulation challenges and poor mental health predicted greater severity of FSSs. These findings offer novel insights into how parents’ psychological and health characteristics can shape children’s somatic symptom expression, highlighting the need for family-focused interventions. By identifying and addressing parental emotional and cognitive difficulties, clinicians may be able to mitigate the intergenerational transmission of maladaptive stress responses, ultimately reducing the burden of FSSs in children.https://www.mdpi.com/2813-9844/7/2/31functional somatic symptomsreflective functioningalexithymiaemotion regulationparental healthchild well-being |
| spellingShingle | Aikaterini Fostini Foivos Zaravinos-Tsakos Gerasimos Kolaitis Georgios Giannakopoulos Parents’ Reflective Functioning, Emotion Regulation, and Health: Associations with Children’s Functional Somatic Symptoms Psychology International functional somatic symptoms reflective functioning alexithymia emotion regulation parental health child well-being |
| title | Parents’ Reflective Functioning, Emotion Regulation, and Health: Associations with Children’s Functional Somatic Symptoms |
| title_full | Parents’ Reflective Functioning, Emotion Regulation, and Health: Associations with Children’s Functional Somatic Symptoms |
| title_fullStr | Parents’ Reflective Functioning, Emotion Regulation, and Health: Associations with Children’s Functional Somatic Symptoms |
| title_full_unstemmed | Parents’ Reflective Functioning, Emotion Regulation, and Health: Associations with Children’s Functional Somatic Symptoms |
| title_short | Parents’ Reflective Functioning, Emotion Regulation, and Health: Associations with Children’s Functional Somatic Symptoms |
| title_sort | parents reflective functioning emotion regulation and health associations with children s functional somatic symptoms |
| topic | functional somatic symptoms reflective functioning alexithymia emotion regulation parental health child well-being |
| url | https://www.mdpi.com/2813-9844/7/2/31 |
| work_keys_str_mv | AT aikaterinifostini parentsreflectivefunctioningemotionregulationandhealthassociationswithchildrensfunctionalsomaticsymptoms AT foivoszaravinostsakos parentsreflectivefunctioningemotionregulationandhealthassociationswithchildrensfunctionalsomaticsymptoms AT gerasimoskolaitis parentsreflectivefunctioningemotionregulationandhealthassociationswithchildrensfunctionalsomaticsymptoms AT georgiosgiannakopoulos parentsreflectivefunctioningemotionregulationandhealthassociationswithchildrensfunctionalsomaticsymptoms |