Physical symptoms of stress, depression and suicidal ideation in high school students.

Herman, Sandra L. ; Lester, David

There are many theories as to the etiology of psychosomatic disorders. The somatic-weakness theory proposes that each person's body has genetically determined weak systems which break down when the person is under stress. The specific-attitudes theory proposes that particular childhood experiences arouse specific psychological conflicts and that the symptoms reflect these conflicts. For example, hypertension may be related to the person's attitude that he or she must continually be on guard and prepared to deal with threats of danger (Grace & Graham, 1952). Often personality traits are associated with psychosomatic disorders. For example, hypertensive patients have been described as hostile but unable to express anger in a constructive way (Zax & Cowen, 1972).

It is possible that psychosomatic stress symptoms are adaptive in that they lead the person to be less preoccupied with their psychological conflicts, and worry about physical ailments instead. The present study of teenagers sought to answer two questions: (1) Are those with psychosomatic stress symptoms more depressed or less depressed than those without such symptoms? and (2) Does the presence of psychosomatic stress symptoms increase preoccupation with suicide or decrease such preoccupation?

METHOD

A questionnaire was completed anonymously by 52 male and 45 female 10th- and 11th-grade high school students containing the Beck Depression Inventory (Beck et al., 1961), a belief in locus of control scale (Rotter, 1966), and a 37-item symptom checklist (Goldberg, 1978). The depression inventory contains one item concerning current suicidal ideation, and the students were also asked whether they had ever thought about, threatened or attempted suicide. On the symptom checklist, respondents indicated whether they suffered from the symptom never, occasionally, frequently, or constantly.

RESULTS AND DISCUSSION

The results of a multiple regression analysis using sex, age, depression score and locus of control score to predict each symptom is shown in Table 1. Overall, the total symptom occurrence score was significantly predicted by sex and depression score, with a multiple R of 0.65. Females and those more depressed reported more symptoms.

TABULAR DATA OMITTED

Depression scores were significantly associated with 16 symptoms, including constipation, hyperventilation, nausea-vomiting, migraine headaches, aching neck and shoulder muscles, hear palpitations and tension headaches, but not the major psychosomatic disorders of asthma, high blood pressure, dermatitis, colitis, or ulcers. Locus of control scores were associated with constipation, worrisome thoughts, and angry feelings.

The total symptom score was associated with current suicidal ideation and a history of suicidal thoughts, threats, and attempts but, after controls for depression by means of partial correlation coefficents, these associations were no longer statistically significant.

The present results indicate that high school students with deeper depression are more likely to suffer minor physical symptoms of stress, but are not more likely to suffer the major psychosomatic disorders such as asthma and ulcers. The occurrence of stress symptoms, however, was not associated with suicidal preoccupation (past or present) once depression was taken into account.

REFERENCES

Beck, A. T., Ward, C. H., Mendelson, M., Mock, M., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561-571.

Goldberg, P. (1978). Executive health. New York: McGraw-Hill.

Grace, W. J., & Graham, D. T. (1952). Relationship of specific attitudes and emotions to certain bodily diseases. Psychosomatic Medicine, 14, 243-251.

Rotter, J. (1966). Generalized expectancies for internal versus external reinforcement. Psychological Monographs, 80(1).

Zax, M., & Cowen, E. L. (1972). Abnormal psychology. New York: Holt, Rinehart & Winston.