THE ORIGIN OF PSYCHOSOMATIC DISORDERS IN CHILDREN: EARLY RELATIONAL TRAUMA AND THE BRAIN MECHANISM OF AFFECT REGULATION DISORDERS

Recent advances in the research on etiology and developmental context of psychosomatic disorders in children are being presented. The author shows their origin in the context of Bowlby attachment theory and the research on brain basis of somatization, conversion and dissociation. Research investigating the relation between attachment classification and predisposition to somatization has indicated that unsecure attachment is an important factor in the origin of unexplained somatic symptoms and in long-term perspective might result in psychiatric symptoms with psychiatric type of presentation. Early relational trauma is one of the main causes of chronic somatization. The following mechanism of the origin of psychosomatic disorders is being proposed: (1) early relational trauma contributes to distortions in development of brain areas involved in emotion regulation, (2) prolonged trauma experiences contribute to chronic dissociation, and further on, facilitate occurrence of unexplained somatic symptoms. The long-term consequence of relational trauma is (3) the prolonged disturbance in selfregulation (esp. in emotional functioning), which is a factor contributing to emergence of many other psychiatric disorders in adult life, such as depression and PTSD.