Abstract
Parents make important treatment decisions for their children based on symptoms they perceive their child to be experiencing. Multiple psychological factors are associated with subjective symptom perception, but factors affecting perception of symptoms in others have been explored less. We systematically reviewed the literature to identify parent and child psychological factors associated with parental report of physical symptoms in their child. We searched Embase, Ovid, PsycINFO, and Scopus for studies that investigated associations between psychological factors and parental report of symptoms in their child. Thirty-six citations reporting on 34 studies that assessed the association between parent or child psychological factors and parental report of physical symptoms in the child were included in the review. Three main factors were identified as being associated with parental symptom report. First, there was evidence for an association between parental symptom report and affect, in particular parent and child anxiety. Second, child behavioral and conduct problems, and temperament-related challenges (problems with feeding and sleeping) were associated with parental symptom report. Third, parental expectations and beliefs that symptoms would occur were associated with parental symptom report, although few studies investigated these associations. Parent and child affect, and parental expectations and beliefs may influence parents' cognition, causing them to pay more attention to their child, interpret their child's behavior as symptomatic, and recall symptoms in the child. Given the importance of parental perception of symptoms in driving decisions around care, additional research in this field is needed.
Highlights
Two studies investigated the incidence of symptoms in response to vaccination, one investigated symptoms attributed to food allergy, and one investigated symptoms attributed by parents to various ailments such as the common cold
Psychological factors from three categories were found to be associated with parental report of symptoms: affect; behavior; and expectations, attitudes, and beliefs
Factors most often associated with parental report of symptoms were parent anxiety and stress, and child anxiety, emotional problems, and attention-deficit/hyperactivity disorder (ADHD)
Summary
Models of subjective symptom perception postulate that bodily sensations lead to symptom experience through cognitive processing such as attention to the bodily sensation and interpretation of the sensation as a symptom (see Van den Bergh et al (2) for summary). Psychological factors such as trait negativity, health anxiety, and learning are proposed to moderate these processes. One-third of parents believe that their child has food sensitivity (3). Most of these children do not undergo any formal testing of food allergy such as skin prick tests or oral food challenges. When formal testing does occur, the actual prevalence of food hypersensitivity is much lower (approximately 1.9%–4.5%) (3,4)
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