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Entwicklungspsychopathologie

Entwicklungspsychopathologie rekurrierender Bauchschmerzen und somatoformer Störungen

Published Online:September 01, 2006https://doi.org/10.1026//0942-5403.11.3.152

Abstract

Zusammenfassung. Der Beitrag untersucht aus einer entwicklungspsychopathologischen Perspektive die störungs- und entwicklungsbezogenen Assoziationen zwischen rekurrierendem Bauchschmerz und somatoformer Störung sowie komorbiden Angststörungen bzw. Depression. Dazu werden eingangs Pfade des Übergangs von Störungsbildern der Eltern auf das Kind (Transmission) sowie die Stabilität bzw. Variabilität rekurrierender Bauchschmerzen und somatoformer Störungen vom Kindesalter zum Erwachsenenalter untersucht. Ein entwicklungspsychopathologisches Phasenmodell zeigt eine Sequenz von vier Etappen der Störungsentwicklung auf. Als Mediatoren eines ungünstigen Verlaufs werden Lernprozesse, Faktoren der kognitiv-behavioralen Schmerz- und Beschwerdeverarbeitung, beschwerdebezogene Copingstrategien sowie dysfunktionale Interaktionsmuster innerhalb der Familie sowie in der Arzt-Patient-Beziehung analysiert. Entwickelt sich eine Komorbidität mit einer Angststörung oder Depression, so zeigen diese Patienten störungsbedingt ein zusätzlich erhöhtes Risiko der verzerrten Verarbeitung abdomineller Beschwerden und Schmerzen.


Developmental psychopathology in recurrent abdominal pain and somatoform disorder

Abstract. From the point of view of developmental psychopathology the etiological associations between recurrent abdominal pain, somatoform disorder, and disorders of psychopathological comorbidity (anxiety, depression) are examined. Starting point is the identification of pathways and transitions from parental disorders to manifestations in the child and the analysis of the stability vs. variability of disorders from childhood into adult age. A developmental psychopathology framework is introduced that delineates a sequence of four stages of increasing disorder development and chronification. Mediators enhancing and maintaining a negative course are identified, including learning principles, cognitive-behavioral processing, appraisal and coping strategies, patterns of dysfunctional family interaction, and patient-physician relationship. Comorbidity with anxiety disorder or depression enhances the risk of distorted appraisal processes concerning the abdominal pain experience, thus worsening the individual prognosis also of the somatoform disorder.

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