Physical symptoms in children and adolescents.

This chapter summarizes and critiques research on physical symptoms in children and adolescents from a developmental science perspective. Studies conducted by researchers from various disciplines, primarily after 1990, were identified through searches of MEDLINE, CINAHL, and Psyc INFO. This review focuses on two areas: the prevalence of common physical symptoms--headache, abdominal pain or discomfort, musculoskeletal pain and fatigue--in pediatric populations and the developmental issues associated with these symptom experiences. Developmental factors were organized into two overarching categories, individual and environmental factors. Findings indicate that demographic factors, including age, pubertal development, gender, and race or ethnicity; psychological factors, particularly self-esteem, depression, and anxiety; and behavioral factors have varying relationships to the report of physical symptoms in children and youth. In addition, family and parents, peers, and the broader school and community ecology of children have an influence on physical symptom complaints. There is a need for further studies that are strengthened by the use of developmentally sensitive theoretical frameworks and methodologies that address complicated developmental issues.