A Mixed‐Methods Analysis of Trauma‐Exposed Adolescents' Gastrointestinal Symptoms as Captured in Online Social Communication

BACKGROUND: Traumatic stress can disrupt the adolescent gut-brain axis, and unintentional social reinforcement can lead to highly impairing disorders of gut-brain interaction (DGBI). However, social support is critical during the peritraumatic period, highlighting a unique challenge for caregivers and practitioners. The current study examined the ways in which post-trauma gastrointestinal concerns were discussed via online social messaging (e.g., texting, social media) among a sample of trauma-exposed adolescent patients. METHODS: One hundred ninety-one trauma-exposed adolescents were recruited from a US children's hospital emergency department. Topic modeling and key-word identification were used to examine naturalistic online communication (e.g., text messages), yielding a subsample of youth who used online social messaging to communicate about their gastrointestinal symptoms. Inductive content analysis was used to characterize communication about GI symptoms during the nine-month period immediately following presentation for a potentially traumatic event. KEY RESULTS: Youth were most likely to share about symptoms with peers (i.e., friends, romantic partners) rather than adults. Responses were usually caring/affirming or offered practical support; dismissive responses were rare. GI symptoms and life stressors were often mentioned in the same conversation. Themes of avoidance and impairment were also identified. CONCLUSIONS AND INFERENCES: Findings demonstrate the role of digital social attention in illness reinforcement, which complicates social support during the peritraumatic period. This avenue for peer reinforcement should be considered in treatment planning and discussions of family guidelines for managing symptoms.