Somatoform Symptoms and Functional Impairments During Middle Childhood Associations With Insecure Attachment Dimensions and Emotion Regulation Strategies

Theoretical Background: Studies have shown that attachment is associated with somatoform symptoms in childhood, yet factors that mediate the association need to be explored. Objective: To examine emotion regulation strategies as a mediator between insecure attachment dimensions and somatoform symptoms and symptom-related impairments in quality of life (QoL). Method: A total of 221 fourth-grade school children in Germany completed the SOMS-KJ, FEEL-KJ, and ECR-RC. Results: In the path model, attachment-related anxiety was positively associated with social support seeking and emotional expression, while attachment-related avoidance was negatively associated with these, yet positively associated with emotional suppression. Both emotional suppression and social support seeking were positively associated with somatoform symptoms and symptom-related impaired QoL. Discussion and Conclusion: Differential pathways exist from insecure attachment dimensions to increased somatoform symptoms, indicating that children require specialized emotion competence training.