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Health Psychology / Behavioral Medicine - Child

Examination of somatic symptom trajectories in US adolescents: differences based on sex and race.

(PS6-C64) Examination of Somatic Symptom Trajectories in US Adolescents: Differences Based on Sex and Race

Friday, November 17, 2023

4:00 PM – 5:00 PM PST

Location: Regency Ballroom, Level 7

Author(s)

MW

Marcus G. Wild, Ph.D.

Postdoctoral Fellow
VISN 17 Center of Excellence for Research on Returning War Veterans
Waco, Texas
BN

Bridget A. Nestor, Ph.D.

Postdoctoral Fellow
Boston Children’s Hospital/Harvard Medical School
Boston, Massachusetts

Adolescence is a critical period in the development of psychological disorders and distress. Somatic symptoms, or physical symptoms that cause significant psychological distress, are common in adolescents. Cross-sectional disparities in somatic symptoms, including pain, have been identified for adolescents of color and female adolescents. However, it is currently unknown how racism and sexism impact the development and experience of somatic symptoms across development. The goal of the present study was to examine how racial and sex identities modify the trajectory of somatic symptom severity over the course of adolescence. To address this goal, data from 11876 adolescent participants in the Adolescent Brain and Cognitive Development (ABCD) study were used to develop latent growth curve models of the somatic symptom syndrome subscale of the Child Behavior Checklist (CBCL), with racial identity and sex included as factors. Results of the model indicated somatic symptom scores decreased over time for the sample as a whole by an average of 0.58 points across each timepoint (95% CI: 0.40 - 0.76), with participants starting at higher levels of somatic symptoms decreasing in somatic symptom severity more rapidly than participants with lower starting somatic symptom severity (intercept-slope covariance = -1.48, 95% CI: -1.83 to -1.12). Further, individual differences were highly significant in both baseline somatic symptom scores (variance estimate = 21.71, 95% CI: 20.76-22.65) and in the magnitude and direction of the somatic symptom growth curve (variance estimate = 0.84, 95% CI: 0.66-1.03). Related to specific identities, White American (intercept = 1.05, 95% CI: 0.70-1.41), Black American (intercept = 0.66, 95% CI: 0.31-1.02), American Indian (intercept = 1.13, 95% CI: 0.56-1.70), and Other Race (intercept = 1.19, 95% CI: 0.72-1.65) racial identity, and female sex (intercept = 0.45, 95% CI: 0.25-0.66) participants reported greater somatic symptoms at baseline than participants who did not endorse those identities. Participants with White American (slope = 0.22, 95% CI: 0.07-0.37) and American Indian (0.27, 95% CI: 0.03-0.50) racial identity and male sex (slope = 0.12, 95% CI: 0.03-0.20) had more positive slopes (i.e., less reduction in somatic symptoms over time) than participants who did not endorse those identities. These results indicate that 1) there is tremendous individual variation in somatic symptom severity and trajectory across adolescence, 2) disparities exist in somatic symptom severity in early adolescence, and 3) somatic symptom severity may decrease over the course of adolescence, with that reduction attenuated in individuals with White American and American Indian racial, and male sex identities. Examination of the impact of cultural biases on the conceptualization and assessment of somatic symptoms is warranted. Further work on prevention of somatic symptoms in early adolescence may benefit from a focus on female patients from underrepresented racial identities, while treatment efforts in middle adolescence may benefit from adaptations for White American and American Indian males.