Functional abdominal pain in childhood: from etiology to maladaptation.

OBJECTIVE

To review the extant literature on functional abdominal pain in childhood through the lens of the developmental psychopathology perspective and to systematize research results by means of a two-stage pathway model in which the emergence of functional abdominal pain and its potential transition into a somatoform adjustment disorder is outlined.

METHODS

Using electronic searches for published studies and previous reviews about functional abdominal pain.

RESULTS

An association of functional abdominal pain with internalizing symptoms, poor well-being of family members, major life events and daily stressors is found. The impact of stress on pain seems to be moderated by the children's coping style and their perceived competence and self-efficacy to manage the pain experience. There is evidence for the influence of modeling and operant mechanisms on pain experiences. A new term, 'somatoform adjustment disorder', and its relation to functional abdominal pain is discussed.

CONCLUSIONS

It seems that those children with functional abdominal pain who cannot adapt to the pain indeed run the risk of developing a somatoform adjustment disorder.