Adolescent Somatic Symptoms Under Psychosocial Adversity: Differential Links of Risk and Protective Factors to Physical and Psychological Burden in Türkiye.

Background/Objectives: Adolescent somatic symptoms such as headache, irritability, and sleep difficulties are common and closely tied to adolescent mental health, yet they are typically studied as a single dimension and as individual complaints detached from the psychosocial adversity surrounding the adolescent. Drawing on the nationally representative 2022 Türkiye Child Survey (n = 3523, ages 13-17), we examined whether these symptoms are patterned by the psychosocial risk and support surrounding the adolescent. Methods: Measurement models, multiple correspondence analysis, survey-weighted ordinal regression, a mixed graphical model, and machine-learning algorithms were applied in sequence. Results: Somatic symptoms were organized around a dominant general factor, alongside closely correlated physical and psychological dimensions that showed differential external associations. The three relational microsystems formed a coherent psychosocial adversity gradient along which somatic burden increased. The two dimensions were linked to different factors: peer victimization, a risk factor, and parental support, a protective factor, were associated primarily with psychological burden (odds ratios per standard deviation 1.84 and 0.88), whereas female sex and chronic illness were linked more strongly to physical burden (2.35 and 1.61); body mass index, income strain, and housing problems showed no independent associations. Regression, network, and machine-learning analyses converged on this dissociation while indicating modest individual-level predictability. Conclusions: Adolescent somatic symptoms are thus systematically patterned by psychosocial risk and support at the population level, an association that may inform monitoring and psychosocially informed assessment rather than individual prediction, and that requires longitudinal work to interpret directionally.