title: Family conflict and somatic symptoms over 10 years: a growth mixture model analysis.
abstract: OBJECTIVE
  While family conflict and somatic symptoms are mutually associated, few longitudinal studies have examined multiple (heterogeneous) trajectory subgroups for family conflict and somatic symptoms and their covariation over time. The aim of this study was to identify heterogeneous trajectory subgroups for family conflict and somatic symptoms and their joint trajectories.
  
  
  METHODS
  A representative sample of 424 community participants completed surveys at baseline and 1-, 4-, and 10-year follow-ups. Family conflict and somatic symptoms were assessed at each wave. Covariates (age, gender, marital status, education, and medical conditions) were assessed at baseline. Growth mixture modeling (GMM) was used to identify heterogeneous trajectory subgroups for family conflict and somatic symptoms. A parallel process GMM was used to examine joint trajectory subgroup membership between family conflict and somatic symptoms.
  
  
  RESULTS
  There were three trajectory subgroups for family conflict: stable low; worsening; and improving, and three somewhat similar trajectory subgroups for somatic symptoms: stable low; stable moderate; and improving. Family conflict and somatic symptom trajectory subgroup memberships were jointly associated. Individuals who had stable low family conflict were most likely to follow a stable low somatic symptom trajectory. Individuals who improved in family conflict were most likely to continue to have stable low somatic symptoms or improve in somatic symptoms. Moreover, individuals who had stable moderate somatic symptoms were most likely to show worsening family conflict.
  
  
  CONCLUSIONS
  This study demonstrates heterogeneous family conflict and somatic symptom trajectories and indicates that these trajectories covary over time.
authors: Center for Innovation to Implementation, Health Services Research and Development (HSR&D), VA Palo Alto Health Care System, Menlo Park, CA, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA. Electronic address: Xiaoyu.bi@va.gov.
authors: Xiaoyu
authors: X
authors: Bi
authors: Center for Innovation to Implementation, Health Services Research and Development (HSR&D), VA Palo Alto Health Care System, Menlo Park, CA, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA. Electronic address: rmoos@stanford.edu.
authors: Rudolf H
authors: RH
authors: Moos
authors: Center for Innovation to Implementation, Health Services Research and Development (HSR&D), VA Palo Alto Health Care System, Menlo Park, CA, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA. Electronic address: ctimko@stanford.edu.
authors: Christine
authors: C
authors: Timko
authors: Center for Innovation to Implementation, Health Services Research and Development (HSR&D), VA Palo Alto Health Care System, Menlo Park, CA, USA; Department of Sociology, Stanford University, Stanford, CA, USA; Center for Primary Care and Outcomes Research, Stanford University, Stanford, CA, USA. Electronic address: cronkite@stanford.edu.
authors: Ruth C
authors: RC
authors: Cronkite
mesh_terms: D000328:Adult; D018450:Disease Progression; D054541:Family Conflict / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D013001:Somatoform Disorders / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Family conflict; Growth mixture model; Heterogeneous trajectory subgroups; Longitudinal; Somatic symptoms