Somatic Symptoms Before Menarche: The Role of Parents and Pain Sensitivity

Abstract

Somatic symptoms are common in adolescence and can predict later emotional distress, academic challenges, and chronic health problems. Their developmental origins, particularly before menarche, remain poorly understood. This cross-sectional study examined associations between psychological distress, parental modeling of pain behavior, pain sensitivity, and somatic symptom burden in premenarchal adolescents. A community sample of 228 adolescents (Age M = 11.3, SD = 0.9) completed standardized measures of anxiety, depression, stress, somatic symptoms, and parent-reported pain modeling. Participants also underwent laboratory-based bladder and pressure pain threshold testing. In multivariable regression, Tanner stage (β = .11), anxiety (.31), depression (.23), parental pain modeling (.15), and visceral pain sensitivity (.13) were independently associated with greater somatic symptoms. Results highlight a constellation of psychological, familial, and physiological factors related to somatic symptoms in early adolescence, suggesting that early identification of these risks could inform prevention strategies before puberty, when more persistent symptom patterns may emerge.