In Brief

Mothers who are depressed and anxious are twice as likely to consult physicians when their children complain of stomach aches as mothers with less mental stress, according to research funded by the National Institute of Child Health and Human Development (NICHD) and presented at the Society of Behavioral Medicine annual meeting this spring.

The findings raise concerns that many well children may be making unnecessary physician visits, which could lead to problems down the road, says study researcher and psychologist Rona Levy, PhD, of the University of Washington School of Social Work.

"Children tend to have a lot of disability due to illness--they miss school, they spend a lot of time in physicians' offices and they miss out on life's activities," Levy explains. "So the question is, 'What's going on--do they need to be disabled to the extent that they are?'"

The findings are part of a large-scale study of the intergenerational transmission of illness--the first of its size to examine the relationship between parents' illness behavior and children's well-being--funded by the NICHD. Levy, along with psychologists Lynn Walker, PhD, of Vanderbilt University, and William Whitehead, PhD, of the University of North Carolina at Chapel Hill, looked at 326 families in a Seattle health maintenance organization with children 8-16 years old who had recently reported abdominal pain. The researchers then looked at which of these children visited a pediatrician or family physician with their mother for abdominal pain in the past three months.

Mothers completed questionnaires on their own levels of anxiety, depression and psychosomatic symptoms, on their children's behavior and on how they responded when their children reported feeling ill. Children completed a questionnaire on how they behaved when ill and how their mothers reacted. The mothers' psychological state was a key determinant--but not the child's--of which children saw physicians, even when the researchers controlled for the children's level of pain, says Levy, who along with her collaborators, posits that anxious, depressed mothers may "fear the worst," or "catastrophize things," and schedule needless check-ups.

The findings suggest that parents--while not ignoring their children's health--need to watch how they teach their children to respond to physical sensations, Levy believes. And, she says, they include an important message for health professionals: Don't treat the child in isolation. Instead, consider family interaction during treatment and train patients and parents to appropriately respond to illness.

--J. CHAMBERLIN