Psychophysiological Disorders in Childhood and Adolescence

  • Robert Simmons


A psychophysiological disorder is present when a child, exposed to a stressful or upsetting situation, responds simultaneously along two dimensions:
  1. 1.

    At the psychological level, he reacts subjectively, feeling upset, tense, anxious, or angry.

  2. 2.

    At the physiological level, the stress activates the autonomic nervous system, causing an alteration of functioning (e.g. spasm, oversecretion, overbreathing) which, if it persists, may lead to changes in structure (e.g. ulceration, obesity).



Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Recommended for Further Reading

  1. 2.
    BARBERO, G. J. “Ulcerative Colitis”, in Vaughan, V. C.; McKay, R. J.; and Nelson, W. E., eds., Nelson Textbook of Pediatrics. 10th ed. Philadelphia, W. B. Saunders, 1975. —a good description of the medical picture in ulcerative colitis.Google Scholar
  2. 4.
    BRUCH, H. Eating Disorders. New York, Basic Books, 1973. —the most comprehensive book on the subject.Google Scholar
  3. 8.
    LIEBMAN, R.; MINUCHIN, S.; and BAKER, L. “An Integrated Treatment Program for Anorexia Nervosa”. Amer. J. Psych. 131: 432–36, 1974. —presents the case for a family approach to management.Google Scholar
  4. 9.
    LIEBMAN, R.; MINUCHIN, S.; and BAKER, L. “The Use of Structural Family Therapy in the Treatment of Intractable Asthma”. Amer. J. Psychiat. 131: 535–40, 1974. —discusses characteristics of family organization and functioning associated with psychosomatic illness (e.g. chronic relapsing asthma) and reports the goals, process, and technique of a successful therapeutic approach to changing these.Google Scholar
  5. 10.
    LIVINGSTON, S. “Breath-Holding Spells in Children: Differentiation from Epileptic Attacks”. J. A. M. A. 212: 2231–35, 1970. —differentiates breath-holding from seizure disorders and discusses management of spells.CrossRefGoogle Scholar
  6. 12.
    McNICHOL, K. N.; WILLIAMS, H. E.; ALLAN, J.; and Mc ANDREW, I. “Spectrum of Asthma in Children: 1. Clinical and Psychological Components; 2. Allergic Components; 3. Psychological and Social Components”. Brit. Med. J. 4: 7–20, 1973. —the most comprehensive study available today looking at all factors contributing to asthma.CrossRefGoogle Scholar
  7. 15.
    MILLER, N.E. “Learning of Visceral and Glandular Responses”. Science 163: 434–45, 1969. —preliminary report that the autonomic nervous system is influenced by experience.CrossRefGoogle Scholar
  8. 16.
    MINUCHIN, S.; BAKER, L.; ROSMAN, B. L.; LIEBMAN, R.; MILMAN, L.; and TODD, T. C. “A Conceptual Mode of Psychosomatic Illness in Children: Family Organization and Family Therapy”. Arch. Gen. Psychiat. 32: 1031–33, 1975. —provides a useful family model in approaching psychophysiological disorders.CrossRefGoogle Scholar
  9. 17.
    MOLDOFSKY, H., and GARFINKEL, P. E. “Problems of Treatment of Anorexia Nervosa”. Canad. Psychiat. Assoc. J. 19: 169–75, 1974. —a good discussion of problems in clinical management.Google Scholar
  10. 18.
    O’CONNOR, J. F.; DANIELS, G.; KARUSH, A.; FLOOD, G.; and STERN, L O. “Prognostic Implications of Psychiatric Diagnosis in Ulcerative Colitis”. Psychosomat. Med. 28: 375–81, 1966. —an adult study, examining the relation of psychiatric disorder to the course of ulcerative colitis.CrossRefGoogle Scholar
  11. 19.
    POS, R. “Psychological Assessment of Factors Affecting Pain”. Canad. Med. Assoc. J. 111: 1213–15, 1974. —assessment of patients with chronic pain should focus on both the organic factors and the psychological process contributing to the pain. The traditional tendency to see organic and psychogenic pain as distinct entities leads to physician confusion and interferes with patient care.Google Scholar
  12. 21.
    REINHART, J. B.; KENNA, M. D.; and SUCCOP, R. A. “Anorexia Nervosa in Children: Outpatient Management”. J. Amer. Acad. Child Psychiat. 11: 114–31, 1972. —describes a method of managing children with anorexia nervosa and their families, stressing particularly the importance of the psychological conflict. Helpful case reports.CrossRefGoogle Scholar
  13. 23.
    SPERLING, M. “Asthma in Children: An Evaluation of Concepts and Therapies”. J. Amer. Acad. Child Psychiat. 7: 44–58, 1968. —strongly psychoanalytical in its approach: points out the chief contributing psychological patterns.CrossRefGoogle Scholar
  14. 24.
    TOLSTRUP, K. “The Treatment of Anorexia Nervosa in Childhood and Adolescence”. J. Child Psychol. Psychiat. 16: 75–78, 1975. —brief review of various approaches to treatment and a brief evaluation of results obtained.CrossRefGoogle Scholar
  15. 25.
    TUDOR, R. “Peptic Ulcer in Childhood”, in Sleisenger, M. H., and Fordtran, J. S., eds., Gastrointestinal Disease. Philadelphia, W.B.Saunders, 1973. —very comprehensive article dealing with medical aspects of peptic ulcer.Google Scholar

Additional Reading

  1. 1.
    APLEY, J. “The Child with Recurrent Abdominal Pain”. Pediat. Clin. N. Amer. 14,1: 63–72, 1967.Google Scholar
  2. 3.
    BRUCH, H. “Obesity in Adolescence”, in Howells, J. G., ed., Modern Perspectives in Psychiatry. Vol. 4: 254–73, Brunner/Mazel, New York, 1971.Google Scholar
  3. 5.
    HOLLAND, B. C., and WARD, R. S. “Homeostasis and Psychosomatic Medicine”, in Arieti, S., ed., American Handbook of Psychiatry. Vol. 3: 344–62. New York, Basic Books, 1966.Google Scholar
  4. 6.
    KARLSTROM, F. “Peptic Ulcer in Children in Sweden During the Years 1953–1962”. Ann. Paediat (Basel). 202: p. 218, 1964.Google Scholar
  5. 7.
    KHAN, A. U. “Present Status of Psychosomatic Aspects of Asthma”. Psychosomat 14: 195–200, 1973.CrossRefGoogle Scholar
  6. 11.
    MASON, J. W. “Organization of the Multiple Endocrine Responses to Avoidance in the Monkey”. Psychosomat. Med. 30: 774–90, 1968.CrossRefGoogle Scholar
  7. 13.
    MERCER, R. D. “Constipation”. Pediat. Clin. N. Amer. 14: 175–84, 1967.Google Scholar
  8. 14.
    MILLAR, T. P. “Peptic Ulcers in Children”, in Howells, J. G., ed., Modern Perspectives in International Child Psychiatry. Vol. 3: 471–93. Modern Perspectives in Psychiatry, Edinburgh, Oliver and Boyd, 1969.Google Scholar
  9. 20.
    PRUGH, D. G., and JORDON, K. “The Management of Ulcerative Colitis in Childhood” in Howells, J. G., ed., Modern Perspectives in International Child Psychiatry. Modern Perspectives in Psychiatry. Edinburgh, Oliver and Boyd, Vol. 3: 494–530, 1969.Google Scholar
  10. 22.
    SINGLETON, E. B., and FAYKUS, M. H. “Incidence of Peptic Ulcer as Determined by Radiologic Examination in the Pediatric Age Group” J. Pediat. 65: 858–62, 1964.CrossRefGoogle Scholar
  11. 26.
    WAHL, C. W. “Commonly Neglected Psychosomatic Syndromes—Hyperventilation Syndrome”, in Arieti, S., ed., American Handbook of Psychiatry. Vol. 3: 158–65. New York, Basic Books, 1966.Google Scholar
  12. 27.
    WOLF, S. G. and WOLFE, H. G. Human Gastric Function. New York, Oxford Univ. Press, 1947.Google Scholar

Copyright information

© Macmillan Publishers Limited 1977

Authors and Affiliations

  • Robert Simmons

There are no affiliations available

Personalised recommendations