ILLNESS BEHAVIOR AND SOMATIZATION IN CHILDREN

儿童的疾病行为和躯体化

• 批准号: 2888949
• 负责人: Lynn D. Walker
• 金额: $ 14.1万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-08-01 至 2001-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2888949
• 关键词: adolescence (12-20); behavioral /social science research tag; behavioral medicine; child behavior; clinical research; coping; disease /disorder model; health behavior; health care service utilization; human subject; interview; longitudinal human study; middle childhood (6-11); pain; pain threshold; pediatrics; physiologic stressor; psychological stressor; psychosomatic disorders; social behavior; stomach disorder; stress; stress management

DESCRIPTION: The central goal of this project is to identify psychosocial factors and social-cognitive processes associated with the development and maintenance of children's illness behavior (i.e., somatic complaints, functional disability, and health service utilization). The investigators aim particularly to understand illness behavior that appears to be out of proportion to medical findings, and thus they focus on pediatric patients with recurrent abdominal pain (RAP) without identifiable organic etiology as a prototype of exaggerated illness behavior. They include patients with organic diagnosis for abdominal pain as a comparison group in order to assess the generalizability of their conceptual model in explaining illness behavior in patients with organic disease. This program of research is guided by a conceptual model of stress and coping. It examines the hypothesis that children with certain psychosocial characteristics (e.g., RAP, low social or academic competence, low social support) appraise stressors (including life stressors and pain episodes) as more severe, appraise their coping potential as lower, and respond with particular coping strategies (such as passivity and lack of active problem-solving) that are hypothesized to contribute to higher levels of illness behavior. The next step in this program of research is to explore mechanisms explaining the links between negative life events, competence, and illness behavior that they have found in previous work. The proposed study uses a methodology that focuses on children's daily life and assesses children's appraisals and responses to stressors close in time to when these events actually occur. Specific aims are: (1) to investigate the relation between stress and illness behavior within the context of daily life stressors; (2) to examine, within the context of specific stressors and pain episodes, the processes underlying the relation of stress and coping responses to pediatric illness behavior; (3) to examine the links between children's styles of coping with pain and their coping responses to specific pain episodes; and, (4) to assess the degree to which the processes contributing to excessive illness behavior in RAP patients are also relevant to illness behavior in patients with an organic basis of abdominal pain. These aims will be pursued in the context of the child's daily life, using a daily diary telephone interview methodology in which children report on their experience and coping with common stressors as well as pain episodes over the course of several days. Subjects will be pediatric patients with RAP and with organic diagnosis for abdominal pain, and well children, between 8 and 15 years of age.

描述：该项目的中心目标是识别心理社会 与发展和发展有关的因素和社会认知过程 维持儿童的患病行为(即，躯体症状， 功能残疾和卫生服务利用)。调查人员 尤其是要了解看似不健康的疾病行为 与医学发现的比例，因此他们专注于儿科患者 无可识别的器质性病因的复发性腹痛(RAP) 夸大疾病行为的原型。他们包括患有 腹痛器质性诊断为对照组 评估他们的概念模型在解释疾病方面的概括性 器质性疾病患者的行为。这项研究计划是 以压力和应对的概念模型为指导。它检查 假设具有某些心理社会特征的儿童(例如， 说唱、低社会或学术能力、低社会支持)评价 应激源(包括生活应激源和疼痛发作)更严重， 评估他们的应对能力较低，并采取特别的应对措施 策略(如被动和缺乏主动解决问题) 假设会导致更高水平的患病行为。下一个 这一研究计划的一步是探索解释 负性生活事件、能力和患病行为之间的联系 他们在以前的工作中发现了。 这项拟议的研究使用了一种关注儿童日常生活的方法 并及时评估儿童对压力源的评估和反应 直到这些事件真正发生的时间。具体目标是：(1)调查 日常生活背景下应激与患病行为的关系 生活压力源；(2)在特定压力源和 疼痛发作，压力和应对关系的基础过程 对儿科疾病行为的反应；(3)检查两者之间的联系 儿童应对疼痛的方式及其应对方式的研究 疼痛发作；以及，(4)评估过程的程度 导致RAP患者过度患病的行为也是相关的 以患病行为为基础的患者有器质性腹痛。 这些目标将在儿童日常生活的背景下实现，使用 每日日记电话访谈法，儿童报告 他们的经历和应对常见的压力源以及疼痛发作 在几天的时间里。受试者将是患有 说唱音乐和腹痛的有机诊断，以及健康的儿童， 8至15岁之间。