Julia Jäkel

Psychosomatic risk and resilience from birth to adulthood

Humans are a social species. In our work, we assess how social interactions affect the body, to understand the aetiology of psychosomatic symptoms and how to prevent them. We apply theoretical models of early life risk and resilience to assess trajectories of social problems and a broad range of psychosomatic symptoms.

In early childhood, mothers and fathers are foundational for the developing neurobiological and emotional systems (1, 2). Around age 6 years, once children enter formal schooling, social relationships with peers and friends become increasingly important. Feeling socially accepted in a peer network and having close friends is crucial for socioemotional development, mental health, and quality of life (3-5). Specifically, studies have shown that social support from family members and peers is associated with decreased risk for psychosomatic problems in childhood and adolescence (6, 7). Psychosomatic symptoms include subjective physical complaints such as headaches, stomach aches, or other chronic pain as well as psychological complaints such as irritability and difficulty falling asleep that are not fully explained by an underlying physical disease (8, 9). Psychosomatic disorders are a growing health concern worldwide and associated with adverse mental health outcomes such as mood disorders, personal impairments, and occupational limitations (10-12). However, to date, we know surprisingly little about the specific aetiology and trajectories of psychosomatic symptoms from childhood throughout adolescence and into adulthood.

With funding from the Signe and Ane Gyllenberg Foundation, we have initiated several systematic literature reviews. We found, for example, that research on psychosomatic symptoms among individuals born preterm (<37 weeks gestational age) has been neglected. Similarly, studies on associations between immigrant background and psychosomatic symptoms are scarce. We hope that our contributions will trigger new research on these topics in the future.

We are also investigating dyadic social interactions between children and their mothers and fathers and early regulatory problems (i.e., multiple or persistent crying, sleeping, or feeding problems in infancy and early childhood) (13). Regulatory problems represent another early-life risk that may be associated with psychosomatic symptoms. As part of a life-course model, we found that children with multiple/persistent early regulatory problems had a higher risk of any mood disorder (odds ratio (OR) = 1.81 [95% confidence interval = 1.01–3.23]) and of not having any social support from peers and friends (OR = 1.67 [1.07–2.58]) in adulthood than children who never had regulatory problems (14). Social support from peers and friends provided protection from mood disorders, but only among adults who never had regulatory problems in their early life (14). This finding provides important pointers for health services screening and prevention, to promote health and wellbeing for the whole population. Social integration and support from peers and friends are important protective factors that should be fostered more in day-to-day life.

Julia Jäkel

Professor of Clinical and Developmental Psychology

University of Oulu

References
1. A. A. Hane et al., The Welch Emotional Connection Screen: validation of a brief mother-infant relational health screen. Acta Paediatr 108, 615-625 (2019).
2. R. J. Ludwig, M. G. Welch, Darwin’s other dilemmas and the theoretical roots of emotional connection. Frontiers in Psychology 10, (2019).
3. L. M. Reyes, J. Jaekel, K. M. Heuser, D. Wolke, Developmental cascades of social inhibition and friendships in preterm and full-term children. Infant and Child Development 28, e2165 (2019).
4. K. M. Heuser, J. Jaekel, D. Wolke, Origins and predictors of friendships in 6- to 8-year-old children born at neonatal risk. The Journal of Pediatrics 193, 93-101.e105 (2018).
5. R. K. Narr, J. P. Allen, J. S. Tan, E. L. Loeb, Close Friendship Strength and Broader Peer Group Desirability as Differential Predictors of Adult Mental Health. (2017).
6. V. Ottova et al., The Role of Individual- and Macro-Level Social Determinants on Young Adolescents’ Psychosomatic Complaints. The Journal of Early Adolescence 32, 126-158 (2012).
7. S. R. Sumter, S. E. Baumgartner, Psychosomatic complaints in adolescence: Untangling the relationship between offline and online peer victimization, psychosomatic complaints and social support. European Journal of Developmental Psychology 14, 399-415 (2017).
8. APA, Diagnostic and Statistical Manual of Mental Disorders (DSM-5). A. P. Association, Ed., (American Psychiatric Association (APA), Arlington, VA, 2013).
9. O. Gureje, G. M. Reed, Bodily distress disorder in ICD-11: problems and prospects. World Psychiatry 15, 291-292 (2016).
10. C. R. Chandrashekar, S. B. Math, Psychosomatic disorders in developing countries: current issues and future challenges. Current Opinion in Psychiatry 19, 201-206 (2006).
11. T. Huurre, O. Rahkonen, E. Komulainen, H. Aro, Socioeconomic status as a cause and consequence of psychosomatic symptoms from adolescence to adulthood. Social Psychiatry and Psychiatric Epidemiology 40, 580-587 (2005).
12. A. M. Soehner, A. G. Harvey, Prevalence and Functional Consequences of Severe Insomnia Symptoms in Mood and Anxiety Disorders: Results from a Nationally Representative Sample. Sleep 35, 1367-1375 (2012).
13. J. Jaekel et al., Infant regulatory problems and the quality of dyadic emotional connection – a proof-of-concept study in a multilingual sample. Frontiers in Child and Adolescent Psychiatry, (2024, in press).
14. J. Jaekel et al., Associations of crying, sleeping, and feeding problems in early childhood and perceived social support with emotional disorders in adulthood. BMC Psychiatry 23, 394 (2023).