title: Patterns of physical symptoms and relationships with psychosocial factors in adolescents.
abstract: OBJECTIVE
  Physical symptoms are common in otherwise healthy adolescents. This study sought to identify meaningful patterns of multiple physical symptoms and to examine relationships between the patterns and psychosocial factors. One-year stability of symptom patterns and factors contributing to stability were also examined.
  
  
  METHODS
  This secondary data analysis used longitudinal data from a nationally representative sample of adolescents in grades 7 through 12 (n = 9,141) who participated in the National Longitudinal Study of Adolescent Health during 1994 to 1996. Ten selected physical symptoms (i.e., headache, stomachaches, fatigue) were used to construct clusters. Each cluster was compared in regard to demographic factors, psychological adjustment and interpersonal relationships.
  
  
  RESULTS
  K-means in combination with Ward method clustered the sample into 4 groups according to the overall patterns of the 10 symptoms: nonsymptom (41%), moderate symptom (38%), high symptom (19%) and extreme symptom (2%). Adolescents in higher symptom clusters were more likely to be girls, nonwhites, or from families on welfare and reported high depressive symptoms, low self-esteem, and poor perceptions of parental affection and friendship quality. About 16% in clusters with lower symptom patterns develop somatizing patterns in Wave II; new onset was predicted by gender, younger age, and depressive symptoms.
  
  
  CONCLUSIONS
  Symptom patterns characterized by overall high frequencies of multiple symptoms may indicate somatization. This study also suggests that adolescents with a somatizing tendency are more likely to experience psychological and interpersonal difficulties, and girls and younger adolescents are more vulnerable. Targeted prevention programs are needed for these vulnerable individuals by addressing their psychosocial functioning.
authors.affiliation: School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. hr3k@virgnia.edu
authors.forename: Hyekyun
authors.initials: H
authors.lastname: Rhee
authors.forename: Diane
authors.initials: D
authors.lastname: Holditch-Davis
authors.forename: Margaret S
authors.initials: MS
authors.lastname: Miles
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D016000:Cluster Analysis; D005190:Family / Q000523:psychology; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007398:Interpersonal Relations; D008137:Longitudinal Studies; D008297:Male; D000297:Psychology, Adolescent; D012649:Self Concept; D012737:Sex Factors; D012946:Social Welfare / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D013001:Somatoform Disorders / Q000175:diagnosis* / Q000453:epidemiology; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology; D013334:Students / Q000706:statistics & numerical data*