Journal of Child and Family Studies

, Volume 27, Issue 5, pp 1473–1481 | Cite as

Linking Family Functioning and Self-Discrepancies among Children with Functional Somatic Symptoms

  • Tamar Silberg
  • Hila Drucker-Bezalel
  • Maya Gerner
  • Tal Krasovsky
  • Ety Berant
  • Amichai Brezner
  • Jana Landa
Original Paper


Functional somatic symptoms (FSS), defined as physical symptoms of unknown pathology, are common among children and adolescents and are often associated with high levels of functional impairment. Self-discrepancy theory (SDT) suggests that discrepancies between one’s ideal, ought, or undesired self-states and one’s actual self-representation may lead to emotional distress. Among families with dysfunctional patterns, such emotional distress may result in FSS. The current study examined the relationship between familial patterns and children’s levels of self-discrepancies, among children with and without FSS. Twenty-three children diagnosed with FSS and 23 children with orthopedic problems (non-FSS) and their mothers participated in the study. Mothers and children completed the Child Somatization Inventory and the Integrated Self-Discrepancies Index. Mothers also completed the general scale of the Family Assessment Device. Higher levels of symptom intensity were found in the FSS group than in the non-FSS group. Dysfunctional familial patterns were significantly higher in the FSS group, and higher levels of discrepancies were reported in the FSS group, compared with the non-FSS group. No significant relationship was found in the FSS group between level of self-state discrepancies and level of family functioning. Higher levels of dysfunctional patterns are observed among families of children with FSS. Furthermore, children with FSS and their mothers hold relatively high levels of self-state discrepancies. However, these elevated discrepancies are not significantly related to familial dysfunctional patterns. Viewing self-state discrepancies together with family maladaptive patterns might help address both inter- and intrapersonal conflicts within the family and reduce children’s symptoms.


Self-concept Childhood FSS Family assessment Emotional distress Family communication 



The present work is part of Hilla Drucker’s MA thesis done under the supervision of Ety Berant (PhD) and Tamar Silberg (PhD). We wish to thank the children and their mothers who agreed to participate in this study. We thank Amos Schindler (MD) and Ronit Regev (MA) for their assistance in recruiting the study participants.

Author Contributions

T. S. designed the study, assisted with the data analyses, and wrote the paper. H. D. collected data and assisted with the design and writing of the study. M. G. reviewed and critically revised the article for content and approved the final version. T. K. analyzed the data and wrote part of the results. E. B. collaborated in the conception and design of the paper and approved the final version. A. B. and J. L. collaborated in the writing and editing of the final manuscript.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no competing interests.

Ethical Approval

All procedures performed in the study involving human participants were in accordance with the ethical standards of the Sheba Medical Center research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Tamar Silberg
    • 1
    • 2
  • Hila Drucker-Bezalel
    • 1
  • Maya Gerner
    • 2
  • Tal Krasovsky
    • 2
  • Ety Berant
    • 3
  • Amichai Brezner
    • 2
  • Jana Landa
    • 2
  1. 1.Department of PsychologyBar Ilan UniversityRamat-GanIsrael
  2. 2.Department of Pediatric Rehabilitation, the Edmond and Lily Safra Children’s HospitalTel Hashomer Medical CenterRamat-GanIsrael
  3. 3.The Baruh Ivcher School of PsychologyInterdisciplinary Center (IDC)HerzliyaIsrael

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