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确定社会心理 与发展相关的因素和社会认知过程 维持儿童的疾病行为（即躯体不适、 功能障碍和卫生服务利用）。 调查人员 特别旨在了解似乎不合常理的疾病行为 与医学检查结果成比例，因此他们专注于儿科患者 没有明确的器质性病因的复发性腹痛 (RAP) 夸大疾病行为的原型。 他们包括患有以下疾病的患者 将腹痛的器质性诊断作为对照组 评估其概念模型在解释疾病方面的普遍性 器质性疾病患者的行为。 该研究计划是 以压力和应对的概念模型为指导。 它检查 假设儿童具有某些心理社会特征（例如， RAP，低社会或学术能力，低社会支持）评估 压力源（包括生活压力源和疼痛发作）更严重， 评估他们的应对潜力较低，并以特定的应对方式做出反应 策略（例如被动和缺乏主动解决问题的能力） 假设会导致更高水平的疾病行为。 下一个 该研究计划的一步是探索解释的机制 消极生活事件、能力和疾病行为之间的联系 他们在之前的工作中发现了。 拟议的研究使用了一种关注儿童日常生活的方法 及时评估儿童对压力源的评价和反应 到这些事件实际发生的时间。 具体目的是：（1）调查 日常生活中压力与疾病行为之间的关系 生活压力源； (2) 在特定压力源的背景下进行检查 疼痛发作，压力和应对关系的潜在过程 对儿科疾病行为的反应； (3) 检验之间的联系 儿童应对疼痛的方式以及他们对特定情况的应对反应 疼痛发作； (4) 评估过程的程度 导致 RAP 患者过度患病行为也与此相关 患者的患病行为有器质性基础的腹痛。 这些目标将在孩子的日常生活中通过 儿童报告每日日记电话访谈方法 他们的经验以及应对常见压力源以及疼痛发作的经验 在几天的时间里。 受试者将是患有以下疾病的儿科患者 RAP 和腹痛的器质性诊断，以及健康的儿童， 8 至 15 岁之间。