University of Washington
Friday, March 28, 2003
Children whose mothers are the most depressed, anxious, and report high levels of psychosomatic symptoms are twice as likely to be taken to a doctor when they complain of a stomach ache or abdominal pain than are children whose mothers report the least amount of such mental stress.
"A parent's psychological state is a significant factor in who goes to the doctor," Rona Levy, a University of Washington School of Social Work professor and psychologist, reported last weekend at the annual meeting of the Society of Behavioral Medicine in Salt Lake City.
The finding by Levy and her collaborators, Dr. Lynn Walker, a Vanderbilt University professor of pediatric and adolescent medicine, and Dr. William Whitehead, a University of North Carolina at Chapel Hill professor of medicine, is part of a larger study examining family and social factors that influence children's illness behavior. One important aspect of the research, funded by the National Institute of Child Health and Human Development, focuses on irritable bowel syndrome, a chronic condition that primarily affects women, and how the symptoms of the gastrointestinal disorder may be transmitted from mothers to their children.
In the study the researchers looked at 326 families in a Seattle health maintenance organization with children ages 8 to 16. The researchers checked to see which youngsters had been taken to the doctor for gastrointestinal problems in the past three months. Mothers filled out several questionnaires. One allowed Levy and her colleagues to measure the mothers' levels of anxiety, depression and psychosomatic symptoms. Another asked how they responded when their children were sick and whether their children had any behavior problems. A third questionnaire, given to the children, asked about how they behaved when they became ill and what their mothers did when they had stomach problems.
Even when the researchers controlled for the level of pain experience by the children, a key factor in which youngsters were taken to the doctor was their mothers' psychological state. Behavior problems had nothing to do with which children were taken to the doctor. Anxious parents may be super-vigilant about children's symptoms and fear the worst, according to Levy, while depressed people "may catastrophize things" and so there is less ignoring of small complaints.
"This study shows that a mother's attitudes about health can be transmitted to another generation," said Levy. "Parents should be sensitive to how they teach their children to deal with and respond to physical sensations. We are not telling them to ignore their children's health. We are trying to encourage parents to respond when it is appropriate and not to when it is inappropriate. If parents can improve the way children learn to respond to their physical condition, their physical state may not unnecessarily become the central focus of their life or their child's life."
She added that physicians treating children with these kinds of health problems also need to assess and treat other family factors and not just focus on the child.
"They need to work with the parents or they will be ineffective in treating the child." Levy said.