PSYCHOPATHOLOGY AND COURSE OF RECURRENT ABDOMINAL PAIN

本指导患者导向研究职业发展奖申请中概述的职业发展和研究计划旨在使候选人能够独立设计和开展儿科当前腹痛（RAP），其病程以及与未来临床干预设计相关的相关精神病理学的研究。RAP的定义是在至少三个月的时间内至少发生三次医学上无法解释的腹痛，严重程度足以影响儿童的活动。RAP是一种常见的、有损健康的做法，并使儿童面临危险、昂贵和不必要的医疗程序的风险。先前关于RAP和相关精神病理学的研究没有采用标准化的精神病学访谈和纵向设计，并且被三级转诊偏倚所混淆。了解RAP及其病程与焦虑、抑郁和其他危险因素的关系，将为制定有效的干预和预防策略以及家庭和心理生物学研究铺平道路。提出的RAP研究是第一个在儿科初级保健中采用标准化精神病学访谈和纵向设计的研究，并将RAP报告者与未受影响的儿童在精神病理学、气质、其他躯体症状、生活事件、父母精神病理学、健康和鼓励疾病行为等方面进行比较，为候选人提供纵向研究和使用现代研究评估的经验。候选人获得儿科，精神病学，儿童和青少年精神病学认证，具有近十年的研究生临床经验。大卫·布伦特博士将担任导师。流行病学、生物统计学、数据管理、研究伦理学、脑肠相互作用的神经生物学、神经药理学、药物开发、精神药理学和心理治疗临床试验的设计等方面的课程作业和指导阅读将补充研究训练。

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.