Mentalisation in Parents and Adolescents With Somatic Symptom Disorder: A Cross-Sectional Case-Control Study

Somatic symptom disorder (SSD) is increasingly prevalent in youth and is associated with impaired later health and social functioning. SSD in youth is linked to emotional awareness and mentalising deficits; however, these factors, together with parental mentalising, have rarely been examined together. This cross-sectional case-control study aims to investigate these key factors in early adolescents with SSD and their mothers, compared with a community sample. The sample included 360 participants: a clinical group (n = 112) of 56 adolescents with SSD (M_age = 12.98, SD = 1.72) and their mothers, recruited from two paediatric hospitals; and a comparison group (n = 248) of 124 adolescents (M_age = 13.04, SD = 1.21) and their mothers from the general population. The adolescents completed the Emotional Awareness Questionnaire (EAQ) and the Reflective Functioning Questionnaire for Youth (RFQ-Y), and their mothers completed the Parental Reflective Functioning Questionnaire for Adolescents (PRFQ-A). A logistic regression predicting clinical (vs. comparison) group membership (R² = 0.24; p < 0.001) revealed that greater adolescent verbal emotion sharing (OR = 0.41, p = 0.015), higher RFQ-Y curiosity (OR = 0.45, p = 0.014) and higher RFQ-Y certainty (OR = 0.53, p = 0.011) were associated with reduced odds of belonging to the clinical group. Additionally, higher maternal PRFQ certainty was linked to lower odds of clinical group membership (OR = 0.56, p = 0.003). These findings inform interventions to enhance mentalising and emotional awareness in adolescents with SSD and their mothers, particularly deficits concerning others' mental and affective states.