The literature on somatic complaints in children without a clear physical medical cause often demonstrates connections with various psychological factors, such as negative emotions and problems handling them, poor self-image, and coping potential. We entered these elements into a structural model to elucidate the relationships among them and tested it on 330 children (mean age 10 years and 9 months). The results showed that mood balance contributed most to the prediction of self-reported somatic complaints. Moreover, mood (in combination with anxiety and depression problems) had an indirect impact on children's somatic complaints by influencing self-esteem. The influence and position of coping was less clear. The results are discussed in terms of the 'symptom perception theory'. Copyright © 2006 John Wiley & Sons, Ltd.