Background In line with a consistent literature, somatic symptom disorders (having pronounced somatic symptoms without objective somatic signs) in childhood and adolescence have experienced traumatic events, such as physical or sexual abuse, major loss, natural disasters or who have been witnesses to violence. Recent studies are focusing the attention on the role of attachment and post-traumatic symptomatology for a better evaluation of this disorder.

Objective The following objectives are set by the present study: 1) to evaluate the post-traumatic stress and related psychological symptomatology in a group of children diagnosed with somatic symptom disorders; 2) to evaluate their attachment models; 3) to test the extent of the association between post-traumatic symptomatology and attachment organisation in somatic symptom disorders.

Method Twenty consecutive Italian patients aged from 8 to 15 (m = 11,9; ds = 1,48), previously diagnosed with somatic symptom disorders, were administered the Trauma Symptom Checklist for Children (TSCC-A) and the Child Attachment Interview (CAI).

Results Post-traumatic symptomatology, evaluated in 9 subscales, showed clinically significant scores about anxiety, depression and post-traumatic stress; dissociation symptomatology was seen only in 5% of the patients. Insecure attachment was found in more than half of the patients diagnosed with somatic symptom disorders.

Conclusions This study suggests that attachment organisation may be a fundamental element to be assessed in the evaluation of somatic symptom disorders in children and adolescents. Finally, methodological limitations restricting causal inferences between attachment and dissociation are discussed.