Models of anxiety, depression, somatization, and coping as predictors of abdominal pain in a community sample of school-age children

Objective To examine whether somatization mediates the relationship of coping styles and internalizing problems with abdominal pain. Methods 230 school children (M age = 11.80 years; 43.8% male; 21.3% White) completed measures of coping style, anxiety, and depression early in the school year, and subsequently reported abdominal pain symptoms weekly. Results The results showed (a) the association of anxiety and depression with abdominal pain may be mediated by somatization; (b) there are similarities and differences in the association of coping styles with pain for models including anxiety versus depression. Significant indirect effects showed higher levels of passive coping were associated with more pain via somatization and either anxiety or depression. For active coping, results differed for models including anxiety versus depression. Accommodative coping showed no independent relationship with abdominal pain. Conclusions Somatization may mediate the relationship of internalizing symptoms and coping styles with pain. Treatment implications are discussed.