PSYCHOPATHOLOGY AND COURSE OF RECURRENT ABDOMINAL PAIN

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The career development and research plans outlined in this Mentored Patient-Oriented Research Career Development Award application are designed to enable the candidate to independently design and conduct studies of pediatric current abdominal pain (RAP), its course, and associated psychopathology relevant to the design of future clinical interventions. RAP is defined as at least three episodes of medically unexplained abdominal pain occurring over a period of at least three months that are severe enough to affect the activities of the child. RAP is common, impairing, and puts children at risk for dangerous, costly, and unnecessary medical procedures. Previous studies of RAP and associated psychopathology have not employed standardized psychiatric interviews and longitudinal designs, and are confounded by tertiary referral bias. Understanding the relationship of RAP and its course with anxiety, depression, and other risk factors will prepare the way for the development of effective intervention and prevention strategies, as well as family and psychobiological studies. The proposed study of RAP is the first to employ standardized psychiatric interviews and a longitudinal design in pediatric primary care, and will compare RAP presenters with unaffected children on measures of psychopathology, temperament, other somatic symptoms, life events, and parental psychopathology, health, and encouragement of illness behavior, providing the candidate experience in the conduct of longitudinal studies and the use of modern research assessments. The candidate is certified in pediatrics, psychiatry, and child and adolescent psychiatry, with nearly ten years of post-graduate clinical experience. Dr. David Brent will serve as preceptor. Course work and directed readings in epidemiology, biostatistics, data management, research ethics, the neurobiology of brain-gut interactions, neuropharmacology, drug development, and the design of psychopharmacologic and psychotherapeutic clinical trials will complement the research training.