ILLNESS BEHAVIOR AND SOMATIZATION IN CHILDREN

儿童的疾病行为和躯体化

基本信息

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
项目类别：
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

项目摘要

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：该项目的核心目标是识别社会心理与发展相关的因素和社会认知过程维持儿童疾病行为（即躯体投诉，功能残疾和健康服务利用）。调查人员旨在特别了解似乎不在的疾病行为与医疗发现比例，因此他们专注于小儿患者复发性腹痛（RAP），没有可识别的有机病因为夸张的疾病行为的原型。他们包括患者有机诊断腹痛作为比较组评估其概念模型在解释疾病方面的普遍性有机疾病患者的行为。该研究计划是在压力和应对的概念模型的指导下。它检查了假设具有某些社会心理特征的儿童（例如，说唱，社会或学术能力低，社会支持低）评估压力源（包括生命压力源和疼痛发作）更为严重，评估他们的应对潜力较低，并以特定的应对做出回应策略（例如被动性和缺乏积极的解决问题）是假设有助于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负面生活事件，能力和疾病行为之间的联系他们在以前的工作中找到了。拟议的研究使用了一种专注于儿童日常生活的方法并评估儿童的评估和对压力源的回应这些事件实际发生的时候。具体目的是：（1）调查每天的压力与疾病行为之间的关系生活压力；（2）在特定的压力源和疼痛发作，压力和应对关系的基础的过程对小儿疾病行为的反应；（3）检查儿童应对疼痛的方式及其对特定的应对反应疼痛发作；以及（4）评估过程的程度 RAP患者中导致过度疾病行为的原因也很重要在腹痛有机基础的患者中疾病行为。这些目标将在孩子的日常生活中追求每日日记电话采访方法，儿童报告他们的经验和应对常见压力源以及疼痛发作在几天的时间里。受试者将是儿科患者说唱和有机诊断腹痛和健康的孩子，在8至15岁之间。