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  • Textbook
  • Open Access
  • © 2020

Functional Somatic Symptoms in Children and Adolescents

A Stress-System Approach to Assessment and Treatment

Palgrave Macmillan
  • This is an Open Access title

  • Provides a ground-breaking approach to working with complex psychosomatic symptoms

  • Examines the neurobiology underlying FSS in a clear and accessible manner

  • Advances a unique model based on understanding neurobiology and stress

  • Offers a valuable new resource for researchers and clinicians across pediatrics, psychiatry, neurology, psychology, social work, and allied rehabilitation disciplines

Part of the book series: Palgrave Texts in Counselling and Psychotherapy (PTCP)

Buying options

Softcover Book USD 49.99
Price excludes VAT (USA)

Table of contents (17 chapters)

  1. Front Matter

    Pages i-xxxi
  2. A Brief Introduction

    • Kasia Kozlowska, Stephen Scher, Helene Helgeland
    Pages 1-16Open Access
  3. Children with Functional Somatic Symptoms: The Clinical Encounter

    1. Front Matter

      Pages 17-18
    2. Going to See the Paediatrician

      • Kasia Kozlowska, Stephen Scher, Helene Helgeland
      Pages 19-36Open Access
    3. The Family Assessment Interview: The Narrative, Formulation, and Discussion of Treatment Options

      • Kasia Kozlowska, Stephen Scher, Helene Helgeland
      Pages 37-63Open Access
  4. Mind, Body, and the Science of Functional Somatic Symptoms

    1. Front Matter

      Pages 65-67
    2. The Stress-System Model for Functional Somatic Symptoms

      • Kasia Kozlowska, Stephen Scher, Helene Helgeland
      Pages 69-95Open Access
    3. The Circadian Clock and Functional Somatic Symptoms

      • Kasia Kozlowska, Stephen Scher, Helene Helgeland
      Pages 97-118Open Access
    4. The Autonomic Nervous System and Functional Somatic Symptoms

      • Kasia Kozlowska, Stephen Scher, Helene Helgeland
      Pages 119-136Open Access
    5. The Skeletomotor System and Functional Somatic Symptoms

      • Kasia Kozlowska, Stephen Scher, Helene Helgeland
      Pages 137-160Open Access
    6. The HPA Axis and Functional Somatic Symptoms

      • Kasia Kozlowska, Stephen Scher, Helene Helgeland
      Pages 161-173Open Access
    7. The Immune-Inflammatory System and Functional Somatic Symptoms

      • Kasia Kozlowska, Stephen Scher, Helene Helgeland
      Pages 175-201Open Access
    8. The Role of the Gut in the Neurobiology of Functional Somatic Symptoms

      • Kasia Kozlowska, Stephen Scher, Helene Helgeland
      Pages 203-219Open Access
    9. The Brain Stress Systems I: The Implicit Level of Brain Operations

      • Kasia Kozlowska, Stephen Scher, Helene Helgeland
      Pages 221-249Open Access
    10. The Brain Stress Systems II: The Mind Level of Brain Operations

      • Kasia Kozlowska, Stephen Scher, Helene Helgeland
      Pages 251-272Open Access
  5. The Treatment of Functional Somatic Symptoms

    1. Front Matter

      Pages 273-274
    2. Principles of Assessment and Treatment

      • Kasia Kozlowska, Stephen Scher, Helene Helgeland
      Pages 275-291Open Access
    3. Treatment Interventions I: Working with the Body

      • Kasia Kozlowska, Stephen Scher, Helene Helgeland
      Pages 293-321Open Access
    4. Treatment Interventions II: Working with the Mind

      • Kasia Kozlowska, Stephen Scher, Helene Helgeland
      Pages 323-337Open Access
    5. Treatment Interventions III: Working with the Family and Implementing Behavioural Interventions

      • Kasia Kozlowska, Stephen Scher, Helene Helgeland
      Pages 339-357Open Access

About this book

This open access book sets out the stress-system model for functional somatic symptoms in children and adolescents. The book begins by exploring the initial encounter between the paediatrician, child, and family, moves through the assessment process, including the formulation and the treatment contract, and then describes the various forms of treatment that are designed to settle the child’s dysregulated stress system. This approach both provides a new understanding of how such symptoms emerge – typically, through a history of recurrent or chronic stress, either physical or psychological – and points the way to effective assessment, management, and treatment that put the child (and family) back on the road to health and well-being.

Keywords

  • Functional Somatic Symptoms
  • neurological symptoms
  • medically unexplained symptoms
  • FSS
  • psychogenic non-epileptic seizures (PNES)
  • stress-based model
  • neurobiology
  • child and adolescent psychiatry
  • Child and Adolescent Health
  • pediatrics
  • paediatrics
  • Neuropsychology
  • Clinical Psychology
  • open access

Reviews

"Functional Somatic Symptoms in Children and Adolescents, at the intersection of mind-body medicine, is a must-read for clinicians across pediatrics, psychiatry, neurology, psychology, social work, and allied rehabilitation disciplines involved in diagnosing and treating children and adolescents with functional symptoms. The authors have done a masterful job of linking together emerging cutting-edge biology with case-based discussions and practical treatment suggestions to aid the development of a mind-body program. Functional disorders are common in pediatrics, and this book is a major advance in bringing this set of conditions out of the shadows and into mainstream educational and clinical initiatives."

(David L. Perez, MD, MMSc; Massachusetts General Hospital, Harvard Medical School, USA)


"A uniquely creative, well-informed, and authoritative account that uses the latest scientific and clinical research to inform clinical assessment and treatment of functional symptoms and syndromes in children and young people. The authors’ stress-system model for understanding these experiences is complemented by the extensive use of clinical vignettes that are integrated into an overarching clinical framework that will prove useful for trainees and the broad range of clinicians addressing these problems in their own practices."

(Elena Garralda, MD, MPhil, FRCPsych, FRCPCH, Emeritus Professor of Child and Adolescent Psychiatry, Imperial College London, UK)


"This is the book that clinicians, researchers and educators concerned with children and adolescents with functional somatic symptoms have been waiting for. For clinicians treating these children – both paediatricians and mental health professionals – this is a ‘must-have’ book. Until very recently, research in this field has been sparse, and in the absence of a clear understanding of these symptoms, it has been difficult for clinicians to provide good, persuasive explanations to children and their distressed parents. The frequent result has been extensive medical assessments, trips to doctor after doctor, and an increasing likelihood that the symptoms would become chronic. Advances in research methodologies now set a neuroscience basis for functional somatic symptoms as reflecting disturbances of neurophysiological regulation. In this context, the book sets forth the important and clinically useful stress-system model for functional somatic symptoms. It also provides the knowledge and skills for clinicians understand both the complexities in the neurophysiological dysregulation and how to communicate this understanding to patients and families. Functional Somatic Symptoms is an impressive and important book that should become a basic work of reference for multidisciplinary health professionals concerned with the role of disturbances of neurophysiological regulation in children and adolescents with functional somatic symptoms."

(Trond H. Diseth, MD, Professor of Child and Adolescent Psychiatry, University of Oslo, Norway)


"In this superb book Kozlowska and colleagues have provided a much-needed roadmap for accelerating our understanding of functional somatic symptoms. It describes important scientific developments while also maintaining a strong clinical focus relevant to medicine, nursing, social work, psychology, psychiatry, and other fields of health care."

(Leanne Williams, PhD, Professor of Psychiatry and Behavioral Sciences, Director of Center for Precision Mental Health and Wellness, Stanford University, USA)


"Help is on the way for stressed and traumatized children suffering from functional somatic symptoms and their families, thanks to this great book for pediatricians, medical specialists, and mental health providers still confused by those children’s “medically unexplained” symptoms and unable to help them heal. In this brilliant, compassionate, and eminently practical resource, Kozlowska and her colleagues have distilled decades of clinical experience and integrated many areas of research – from attachment relationships and adverse childhood experiences to the neurobiology of the stress-system encompassing the circadian clock, autonomic nervous system, inflammatory/immune system, and hypothalamic-pituitary-adrenal axis. They explain the “unexplained” and provide the map and toolbox for professionals to effectively apply their stress-system approach as individuals and teams. Everyone who works with children presenting with functional somatic symptoms, from pain and fatigue to non-epileptic seizures, will greatly benefit from reading this landmark book and putting its wisdom and practices into action."

(James W. Hopper, PhD, Independent Consultant & Cambridge Health Alliance, Harvard Medical School, USA)

Authors and Affiliations

  • The Children’s Hospital at Westmead Disciplines of Child & Adolescent Health, and of Psychiatry, University of Sydney Medical School, Sydney, Australia

    Kasia Kozlowska

  • McLean Hospital, Department of Psychiatry, Harvard Medical School, Belmont, USA

    Stephen Scher

  • Department of Child and Adolescent Mental Health in Hospitals, Oslo University Hospital, Oslo, Norway

    Helene Helgeland

About the authors

Kasia Kozlowska is a child and adolescent psychiatrist at The Children’s Hospital at Westmead and Clinical Associate Professor of Psychiatry and of Child and Adolescent Health at the University of Sydney Medical School, Australia. 

Stephen Scher is Senior Editor, Harvard Review of Psychiatry, and Lecturer in Psychiatry, McLean Hospital, Harvard Medical School, USA, and the University of Sydney Medical School, Australia.

Helene Helgeland is a child and adolescent psychiatrist at Oslo University Hospital. She is the head of Norway’s National Advisory Unit on Complex Psychosomatic Disorders in Children and Adolescents.

Bibliographic Information

Buying options

Softcover Book USD 49.99
Price excludes VAT (USA)