Somatic Symptom and Related Disorders

  • Sara E. WilliamsEmail author
  • Nicole E. Zahka
  • Kristin A. Kullgren
Part of the Issues in Clinical Child Psychology book series (ICCP)


Somatic symptoms and related disorders (SSRD) share the hallmark feature of the presence of physical symptoms in the absence of identifiable disease, accompanied by associated psychological distress and impairment. As somatic symptoms are common among children and adolescents, a consultation-liaison (CL) psychologist is likely to encounter SSRD in practice. Studies on the etiology of SSRD point to contributions of biological, psychological, and social factors; as such, biopsychosocial diagnosis, assessment, and treatment are most effective. For CL psychologists, collaborative communication with healthcare providers is essential to present a coordinated diagnostic and treatment message. Psychological assessment should balance medical and psychological information while setting the stage for a functional approach to symptom management. Cognitive behavioral therapy (CBT) is the recommended intervention, with a focus on understanding how maladaptive thoughts, feelings, and actions influence symptoms and biological processes and how changing those patterns can regulate the autonomic nervous system, improve function, and reduce impairment. The core features of CBT for SSRD are psychoeducation, establishing a functional routine, behavioral strategies (e.g., distraction, relaxation), and cognitive strategies (e.g., emotion identification, thought reframing, problem-solving). Evidence-based CBT for SSRD can be modified to fit the treatment setting, from a clinician having one point of contact during a medical clinic visit, to multiple visits during a hospitalization, to seeing patients on an ongoing outpatient basis. Guidelines for adults and schools supporting children with SSRD are important resources to provide during treatment.


Somatic symptoms Somatic symptom disorder Functional neurological symptom disorder Conversion disorder  Biopsychosocial model Interdisciplinary treatment Cognitive behavioral therapy 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Sara E. Williams
    • 1
    • 2
    Email author
  • Nicole E. Zahka
    • 2
  • Kristin A. Kullgren
    • 3
  1. 1.Department of PediatricsUniversity of Cincinnati College of MedicineCincinnatiUSA
  2. 2.Division of Behavioral Medicine and Clinical PsychologyCincinnati Children’s Hospital Medical CenterCincinnatiUSA
  3. 3.Department of PediatricsC.S. Mott Children’s Hospital, Michigan MedicineAnn ArborUSA

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