This study investigated the etiology of preschoolers’ somatic symptoms and internalizing problems, using a twin sample. A specific focus was placed on the genetic (i.e., DRD4 and 5-HTTLPR) and environmental (i.e., SES, household chaos, family conflict, and maternal emotional stability) factors that were hypothesized to be associated with these problems. This project also explored the possible gene-environmental interactions (GxE) that may exist among these contributors. It was hypothesized that children who are at greatest risk due to their genotype, environment, or a combination of the two would display elevated somatic symptoms and internalizing problems, compared to children who were less at-risk due to these factors. Data from 252 families included in the Southern Illinois Twins/Triplets and Siblings Study (SITSS) at age 5 were examined. Results indicated a significant DRD4 x household chaos interaction predicting preschoolers’ somatic symptoms, demonstrating that children with the DRD4-7r genotype exhibited less somaticizing in highly chaotic homes. Additionally, 5-year-old internalizing problems were significantly predicted by the cumulative environmental risk factor created (i.e., top 15% of scores for each environmental variable in the current sample) and marginally by the additive genotypic risk factor (i.e., a summation of the DRD4 and 5-HTTLPR “risk” scores). These results provide additional insight into the factors that may place children at greater risk for somatic symptoms and internalizing problems.

A proposta desta dissertaÃÃo à compreender o cÃncer infantil entrelaÃado ao processo de constituiÃÃo subjetiva, tomando como referÃncia o estudo psicanalÃtico dos sintomas somÃticos em bebÃs e crianÃas pequenas a partir dos lugares simbÃlicos e imaginÃrios que os filhos ocupam no desejo dos pais. Abordamos esse tema articulando a constituiÃÃo do sujeito com o trabalho da pulsÃo, em que a mÃe â enquanto Outro â assume grande importÃncia por sua funÃÃo de para-excitaÃÃo e, portanto, na qualidade de organizadora do circuito pulsional. Ã, portanto, no tempo de constituiÃÃo subjetiva que acreditamos poder encontrar a chave para a compreensÃo do sintoma somÃtico, visto que à na pequena infÃncia que o corpo simbÃlico e imaginÃrio se forma nesse duplo com o corpo anatÃmico. Neste estudo, utilizamos como referenciais teÃricos a PsicossomÃtica psicanalÃtica e os textos de Assoun, ambos fundamentados na metapsicologia freudiana. O primeiro oferece compreensÃo acerca da constituiÃÃo dos sintomas somÃticos nas relaÃÃes primordiais que a crianÃa estabelece com seus pais. O segundo aborda o sintoma somÃtico com base em uma desfusÃo pulsional localizada na origem do eu-corporal, constituÃdo no laÃo com o Outro. Trata-se de uma pesquisa qualitativa, com realizaÃÃo de entrevistas semi-estruturadas com seis pais que estavam acompanhando os filhos durante o perÃodo de internaÃÃo num hospital pÃblico de referencia em Fortaleza/CE. Os dados foram submetidos ao mÃtodo de anÃlise de conteÃdo, cujas categorias temÃticas centrais foram a funÃÃo materna e o sintoma somÃtico. A anÃlise desses temas mostrou que a qualidade do laÃo pais/filhos recebe a influÃncia do desejo materno que, por sua vez, traz a marca da ambivalÃncia inerente a esta relaÃÃo, mediante o conflito psÃquico que, nÃo sendo resolvido em termos de uma elaboraÃÃo simbÃlica, recai sobre o corpo (da crianÃa) como inscriÃÃo, marca do poder do desejo do Outro. As elaboraÃÃes fantasmÃticas dos pais sobre a causa do cÃncer dos filhos foram outro dado relevante, possibilitando melhor compreensÃo do laÃo pais/filhos e do lugar que o filho ocupa na economia libidinal materna. Dessa forma, a compreensÃo dos sintomas somÃticos em bebÃs e crianÃas pequenas deve levar em consideraÃÃo nÃo apenas a realidade somÃtica desse corpo fÃsico, como tambÃm as vicissitudes do desejo materno, que operam por meio da corporizaÃÃo do fantasma, denunciando o efeito plÃstico ativo do processo inconsciente, ou seja, a corporizaÃÃo (no filho) do fantasma (materno). / We propose in this dissertation to understand the childhood cancer linked to the subjective constitution process, taking as a reference the psychoanalytic study of somatic symptoms in babies and small children from the symbolic and imaginary places that children have on parentâs desire. We address this issue articulating the process of the subject construction with the drive work, where the mother â as the Other - is of great importance for its function of excitement-shielding and, therefore, as an organizer of the drive circuit. It is, therefore, on the time of subjective constitution that we believe we can find the key to understanding the somatic symptoms, since it is in early childhood that the imaginary and symbolic body is formed in this double with the anatomical body. In this study, we used as the theoretical framework the psychoanalytic psychosomatic and AssounÂs texts, both based in Freudian metapsychology. The first one gives us an understanding about the formation of somatic symptoms from the primary relationships the child has with his parents. The second one, deals with somatic symptoms from a drive unmerge located in the origin of the I-body, forming the link with the Other. This is a qualitative research, with semi-structured interviews with six parents who were accompanying their children during hospitalization time in a known public hospital in Fortaleza-CE. The data were submitted to the method of content analysis, which center themes were maternal function and somatic symptoms. The analysis of these issues has shown us that the quality of the parents/children link suffer the effects of maternal desire that brings, itself, the mark of the inherent ambivalence in this relationship, through the psychic conflict, that when is not resolved in terms of symbolic development, falls on the body (of the child) as an affiliation, the mark of the Otherâs desire power. The parentâs phantasmagoric constructions about the cause of cancer of their children were another relevant thing, enabling us to have a better understanding of the parents / children link, and of the childâs place in maternal libidinal economy. Thus, the understanding of somatic symptoms in babies and small children should take into account not only the somatic reality of this physical body, but also the vicissitudes of maternal desire that act through the embodiment of the ghost, denouncing the plastic effect that is active in unconscious process, that is, the embodiment (in the son) of the ghost (maternal).

To date, not much is known about why past research has found that Latino youth report higher levels of internalizing symptoms than White non-Latino youth. At a more basic level, our current understanding of phenomenology of internalizing problems in Latino youth is limited. This study explored the relationship among anxiety, depression, and somatic symptoms and investigated the influence of cultural acceptability on somatic symptom expression within a school-based sample (5th through 8th grade) of Latino and White non-Latino youth. Anxiety and depression uniquely explained variability in somatic symptom expression. Contrary to past research, Latino and White non-Latino youth did not report different somatic symptoms levels. Cultural acceptability did not vary by ethnicity. Cultural acceptability also did not predict somatic symptoms. Exploratory analyses were conducted including African-American youth and with male only samples. Cultural acceptability predicted somatic symptoms among the male only samples. Future studies should further explore possible interactions between gender and culture on the expression of psychological distress. / acase@tulane.edu

Background: Mindfulness based interventions are becoming increasingly popular for use with children and adolescents, particularly within the school context. Objectives: The aim of the systematic review was to examine the effectiveness of school-based mindfulness interventions with particular reference to mental health and wellbeing. The main study aimed to determine if beliefs about emotions and mindfulness moderated the relationship between stressors and somatic symptoms in an adolescent population. Method: The literature was systematically searched for mindfulness interventions carried out with children and adolescents within the school context. A cross-sectional survey was carried out in a rural sample of 489 high school students to examine specific a priori anticipated relationships amongst beliefs about emotions, mindfulness, stressors, and somatic symptoms. Results: Six studies met the criteria for inclusion. The study demonstrated that school-based mindfulness interventions produce some evidence of effective outcomes for mental health and wellbeing in children and adolescents. Factors associated with improvements included that the intervention was delivered by an experienced mindfulness trainer, and that home practice formed part of the intervention. Somatic symptoms were significantly correlated with beliefs about emotions and were significantly inversely correlated with dispositional mindfulness. Lower levels of mindfulness were associated with stronger beliefs about the unacceptability of expressing or experiencing negative emotions. Beliefs about emotions and mindfulness did not significantly moderate the relationship between somatic symptoms and stressors within an adolescent population. Conclusion: Further research is necessary to determine if mindfulness as a construct or an intervention is effective in enhancing adolescents’ resilience to stressors by improving mental health and wellbeing.

This thesis examines the effectiveness of acupuncture therapy in the treatment of psychological and somatic distress in the context of medically unexplained symptoms (MUS). Also, it explores the role of psychological attachment and experiential avoidance in an effort to explain potential mechanisms of acupuncture’s effect. Existing literature demonstrates some level of effectiveness of acupuncture therapy for the treatment of depression, anxiety and somatic symptoms. However, a lack of experimental rigor in methodology means that existing results cannot be shown to be superior to a placebo and thus current treatment protocols for patients with MUS do not include a recommendation of acupuncture therapy. MUS are defined as any set of symptoms that cannot be explained by organic disease, these clusters of symptoms are theorised to be of psychological aetiology. Sufferers of MUS find themselves stuck in a perpetual loop of secondary care referrals with little or no treatment options being made available. Whilst there is some evidence that talking therapies, such as cognitive behavioural therapy, are effective, their availability, efficacy and stigma mean they are often not desired by patients who suffer with MUS. Previous research has shown that insecure attachment predicts higher instances of, psychological and somatic distress, as well as MUS. Previous work undertaken by the author of this thesis also suggests that there may be a moderating effect of attachment in acupuncture therapy outcomes. In order to investigate acupuncture’s efficacy a double-blind randomised control trial was undertaken; 63 participants were randomised to receive either five treatments of genuine acupuncture or a non-penetrating sham form of acupuncture using the Park sham acupuncture device. A rigorous procedure ensured participant and practitioner blinding to group allocation. Primary measures of psychological (GHQ) and somatic (BSI) distress were taken at pre, post and follow-up time points (8 weeks). Secondary measures included general attachment (RQ), experiential avoidance (MEAQ) and client attachment to therapist (CATS). Results showed a significant effect of acupuncture over placebo in the reduction of both psychological (GHQ) and somatic distress (BSI). This therapeutic effect was maintained at 8-week follow-up. Further results showed moderation effects of secure attachment on somatic symptoms in the treatment group but not placebo group. Experiential avoidance also moderated somatic symptom outcomes in the treatment but not placebo group. A subsequent study utilising a quasi-experimental multi-centre methodology, which used identical measures to the previous experiment, revealed the same significant reduction of both psychological and somatic distress. This study consisted of 184 participants across five clinics, each participant receiving five sessions of acupuncture. Similar results were observed regarding moderation effects of secure attachment on treatment outcomes of somatic symptoms. Results also showed differences in moderation effects between participant with a MUS diagnosis vs. those without. Findings of both studies suggest acupuncture is an effective treatment for psychological and somatic distress, as well as MUS. The differences in attachment moderation effects between treatment and placebo may indicate acupuncture’s ability to elicit endogenous opioid release in the brain. However, further neurological studies are required to confirm this hypothesis.

Research has documented the adverse health outcomes that may result from experiences of sexual trauma and medical mistrust. Stigmatization as a result of sexual trauma experience(s) may also cause significant distress. The current study examined the effect of sexual trauma stigma and the potential mediating role of medical mistrust on health. Resiliency was examined as a potential moderator, as it may buffer sexual trauma stigma’s effects on medical mistrust and health outcomes. A sample of 482 women with a sexual trauma history completed questionnaires regarding health and sexual trauma stigma. Study data was analyzed in SPSS v.25 and included correlations and moderated-mediational analyses. Results demonstrated that sexual trauma stigma and medical mistrust independently predicted somatic symptom burden but not BMI. Medical mistrust and resiliency did not emerge as significant mediators/moderators. Limitations include a homogenous sample and possible measurement error. Future research of other maintaining mechanisms is warranted.

The aim of this study was tome asure effects of domestic violence on children, both child abuse and exposure to marital violence. 300 families were randomly selected in Hermosillo, Sonora, a northwestern Mexican city. Two members of each family were interviewed: the mother anda minor randomly selected among all their children. The research instrument collected demographicinformation, and information regarding mother's and parent's alcohol consumption, marital violence,child abuse, and child misconduct. A structural model was tested which estimated the effects ofchild abuse and exposure to marital violence on child problems. Results showed that the two forms of violence had repercussions on delinquent and antisocial behavior, produced attention problems,depression, anxiety, sadness and the manifestation of somatic symptoms. In addition, mother's education a level had a significant and negative effect on children's behavioral and social problemsand father's educational level inhibited their aggression against their wives. Alcohol consumption was positively related to child abuse. These results seems to indicate that both child abuse andexposure to marital violence rcsult in harmful consequences on children's behavior and well-being. / Se examinan los efectos de la violencia doméstica en niños. Se seleccionaron 300 familias al azaren la ciudad de Hermosillo, Sonora, México. Se entrevistó a dos miembros de cada familia: la madre y un menor al azar. Se aplicó una batería de instrumentos de información demográfica: datos acerca del consumo de alcohol de los padres, agresiones del padre contra la madre, maltrato que recibían los menores de sus padres y los problemas de conducta infantiles. Al analizar estos datos se obtuvieron estadísticas univariadas. Posteriormente se examinaron las variables utilizando un modelo de ecuaciones estructurales. Los resultados mostraron que tanto el maltrato recibido como el ser testigo de la violencia que recibía la madre, tuvieron repercusiones en la conducta delictiva y antisocial de los menores. Los niños presentaron problemas de atención, ansiedad, depresión, timidez y somatización. El nivel educativo de la madre tuvo un efecto significativo en los problemas de conducta infantil. De la misma manera, la escolaridad de los maridos tuvo un efecto negativo en las agresiones que ellos dirigían contra sus esposas. El consumo de alcohol de los padres se relacion ópositivamente con el maltrato infantil.

Syftet med den föreliggande studien var att undersöka hur yogautövare, motionsutövare och kombinationsutövare skiljer sig åt i psykologiskt välbefinnande, stress, somatiska symtom och emotionsreglering. Vidare undersökte studien antal yoga tillfällen i veckan och dess samspel till de fyra variablerna (psykologiskt välbefinnande, stress, somatiska symtom och emotionsreglering). En kvantitativ design användes för att studera syftet och datainsamlingen genomfördes via webbenkät. Webbenkäten innehöll fyra olika frågeformulär: PSS-14, DERS, RPWB och SCL-90. Studien rekryterade totalt 152 deltagare, varav 98 kvinnor och 54 män. Av dem 152 deltagarna var 45 yogautövare, 56 motionsutövare och 51 kombinationsutövare. Studiens resultat visar att deltagare som utövar yoga tenderar att skatta sig lägre i upplevd stress, svårigheter av emotionsreglering och somatiska symtom samt högre i psykologiskt välbefinnande, i jämförelse med deltagare som endast utövar motion. Antal yoga tillfällen i veckan indikerade enbart ha ett positiv samband till psykologiskt välbefinnande, inget signifikant samband visades till resterande variabler stress, emotionsreglering och somatiska symtom. / The purpose of the present study was to investigate how yoga practitioners, exercisers andcombination practitioners differ in psychological well-being, stress, somatic symptoms andemotions regulation. Furthermore, the study examined the number of yoga sessions per weekand its interaction with the four variables (psychological well-being, stress, somaticsymptoms and emotions regulation). A quantitative design was used to study the purpose andthe data collection was carried out via a web survey. The web survey contained four differentquestionnaires: PSS-14, DERS, RPWB and SCL-90. The study recruited a total of 152participants, of which 98 were women and 54 men. Of these, 152 participants were 45 yogapractitioners, 56 exercisers and 51 combination practitioners. The results of the study showthat participants who practice yoga tend to rate themselves lower in perceived stress,difficulties of emotions regulation and somatic symptoms and higher in psychological wellbeing, in comparison with participants who only practice exercise. The number of yogasessions per week indicated only a positive association with psychological well-being, nosignificant association was shown with the remaining variables stress, emotions regulationand somatic symptoms.

An overview of the existing body of knowledge on the most widely researched areas of childhood leukaemia was presented and it was argued that a conceptual shift is required to achieve a more comprehensive understanding of the problem. This conceptual shift encompassed an ecosystemic approach. This study was conducted within a holistic systemic epistemology. A qualitative approach employing a case study method to provide rich descriptions of the context in which two leukaemia sufferer's symptoms were embedded. / Psychology / M.A. (Psyhcoloy)

Objective: Self-stigma in overweight and obese individuals has strong associations with impairment in mental and global health. This study sought to explore self-compassion as a psychological resource in the self-stigma process. Methods: In a 2012 representative German population survey of N = 1,158 overweight and obese individuals, self-compassion was examined as a mediator between self-stigma and mental and physical health outcomes, including BMI (kg/m 2 ), using structural equation modeling and controlling for sociodemographic factors. Results: Psychological variables were assessed using validated self-report questionnaires. Self-compassion partially mediated the relationships between self-stigma and depression, somatic symptoms, and health status / quality of life, lowering the predictive effect of self-stigma on the outcomes by approximately one-third. In contrast, self-compassion, because it was unrelated to BMI, did not mediate the association between self-stigma and BMI. Conclusion: Self-compassion has the potential to act as a buffer against the mental and global health detriments of self-stigma in overweight and obesity and could thus represent a target for interventions to reduce self-stigma and prevent these health impairments. In order to influence the association between self-stigma and BMI, self-compassion should conceptually be linked to weight management.