title: Somatic complaints in children and community violence exposure.
abstract: Somatic complaints of children in primary care settings often go unexplained despite attempts to determine a cause. Recent research has linked violence exposure to stress symptomatology and associated somatic problems. Unknown, however, is whether specific physical symptom complaints can be attributed, at least in part, to violence exposure. Urban African-American 6- and 7-year-old children (N = 268), residing with their biological mothers, recruited before birth, and without prenatal exposure to hard illicit drugs participated. Children and mothers were evaluated in our hospital-based research laboratory, with teacher data collected by mail. Community violence exposure (Things I Have Seen and Heard), stress symptomatology (Levonn), and somatic complaints (teacher-and self-report items) were assessed. Additional data collected included prenatal alcohol exposure, socioeconomic status, domestic violence, maternal age, stress, somatic complaints and psychopathology, and child depression, abuse, and gender. Community violence witnessing and victimization were associated with stress symptoms (r = .26 and .25, respectively, p < .001); violence victimization was related to decreased appetite (r = .16, p < .01), difficulty sleeping (r = .21, p < .001), and stomachache complaints (r = .13, p < .05); witnessed violence was associated with difficulty sleeping (r = .13, p < .05) and headaches (r = .12, p < .05). All associations remained significant after control for confounding. Community violence exposure accounted for 10% of the variance in child stress symptoms, and children who had experienced community violence victimization had a 28% increased risk of appetite problems, a 94% increased risk of sleeping problems, a 57% increased risk of headaches, and a 174% increased risk of stomachaches. Results provide yet another possibility for clinicians to explore when treating these physical symptoms in children.
authors.affiliation: Department of Family Medicine, East Tennessee State University, Johnson City, Tennessee 37614, USA. nordstro@mail.etsu.edu
authors.forename: Beth Nordstrom
authors.initials: BN
authors.lastname: Bailey
authors.forename: Virginia
authors.initials: V
authors.lastname: Delaney-Black
authors.forename: John H
authors.initials: JH
authors.lastname: Hannigan
authors.forename: Joel
authors.initials: J
authors.lastname: Ager
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Sokol
authors.forename: Chandice Y
authors.initials: CY
authors.lastname: Covington
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009035:Mothers; D012111:Residence Characteristics; D012720:Severity of Illness Index; D012931:Social Environment; D013001:Somatoform Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology; D011795:Surveys and Questionnaires; D014505:Urban Population / Q000706:statistics & numerical data; D014754:Violence / Q000523:psychology* / Q000706:statistics & numerical data*