Beyond the "psychosomatic family": a biobehavioral family model of pediatric illness.

This article proposes a multilevel systems model of the interactive biological, psychological, and social processes in childhood illness. This heuristic model can organize the investigation of pathways and mechanisms by which these levels influence one another. A pivotal feature of this biobehavioral family model is the construct of responsivity, which is conceptualized at both family (interpersonal responsivity) and individual (biobehavioral reactivity) levels. Individual biobehavioral reactivity is proposed as a bidirectional pathway by which family patterns and disease processes influence one another. Illustrative clinical material and relevant research are presented with recommendations for future study. This model integrates individual and family-level theory and thus has the capacity to bridge the fields of psychosomatics, pediatrics, behavioral medicine, and family systems medicine.