Illness Behavior and Somatization in Children

儿童的疾病行为和躯体化

• 批准号: 6520829
• 负责人: Lynn D. Walker
• 金额: $ 33.98万
• 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 2006-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6520829
• 关键词: adolescence (12-20); behavioral /social science research tag; behavioral medicine; child behavior; clinical research; coping; human subject; interview; longitudinal human study; middle childhood (6-11); pain; pain threshold; pediatrics; psychophysiology; psychosomatic disorders; social behavior; stomach disorder; stress; stress management

DESCRIPTION (provided by applicant): The long term goal of this program of research is to understand biopsychosocial processes associated with children's illness behavior (i.e., somatic complaints, disability, health service utilization). We are particularly concerned with children who maintain extensive illness behavior that is out of proportion to medical findings. Children with recurrent abdominal pain (RAP) serve as a prototype for our study of children with high levels of illness behavior not associated with significant organic disease. Our recent work showed that the within-subject correlation between daily stressors and somatic complaints was significantly stronger for children with RAP than for Well children, suggesting that children with RAP may be distinguished from their peers by a tendency to react to stress with somatic symptoms. In the next stage of this research, our first major goal is to identify mechanisms linking environmental and somatic stressors to illness behavior. Specifically, using experimental methods in a laboratory setting, we will: (Aim 1) assess the influence of a challenging cognitive task on children's physiological activity, selective attention to somatic cues, and symptom reporting; and (Aim 2) assess the influence of visceral stimulation and parental responses on children's pain complaints. In addition, we will create an index of stress reactivity based on laboratory performance and will assess the utility of that index in predicting health outcomes. Our second major goal is to identify subgroups of RAP that may have different treatment needs. Specifically, we will: (Aim 3) identify diagnostic subgroups of patients with RAP and compare these with respect to symptomatology, psychosocial characteristics, and course of illness over 3 months, and (Aim 4) cross-validate a typology of pain coping profiles for patients with RAP and assess the utility of these profiles in predicting health outcomes. The proposed project combines self-report and psychophysiological measures, experimental laboratory methods, and a longitudinal design. Participants in the Baseline Assessment will include 396 patients with RAP and 842 Well children (ages 8-15). From these groups, children and their parents will be recruited for the Laboratory Computer Task (n =200) and the Laboratory Water Load Task (n = 220). Study results have the potential to yield insights into mechanisms linking stress to illness behavior in RAP and, in addition, to identify intervention targets that prepare children and their parents to better manage RAP.

描述(由申请人提供)：本项目的长期目标是 研究旨在了解与儿童的生物心理社会过程有关的 患病行为(即躯体症状、残疾、健康服务 利用率)。我们特别关注的是那些 与医学发现不成比例的广泛的疾病行为。 反复腹痛(RAP)的儿童作为我们研究的原型 与疾病行为无关的高水平患病儿童 严重的器质性疾病。我们最近的研究表明，受试者内部的 日常应激源与躯体主诉之间的相关性显著 对于有说唱的孩子来说比对健康的孩子更强烈，这表明孩子们 说唱歌手与同龄人的不同之处在于对压力的反应倾向 有躯体症状。在这项研究的下一阶段，我们的第一个主要目标 是确定将环境和躯体应激源与 疾病行为。具体地说，使用实验室中的实验方法 背景，我们将：(目标1)评估具有挑战性的认知任务的影响 关于儿童的生理活动，对躯体暗示的选择性注意，以及 症状报告；和(目标2)评估内脏刺激和 父母对儿童疼痛投诉的反应。此外，我们还将创建 基于实验室表现的应激反应指数，并将评估 该指数在预测健康结果方面的效用。我们的第二个主要目标 确定可能有不同治疗需求的RAP亚群。 具体来说，我们将：(目标3)确定患有以下疾病的患者的诊断亚群 说唱并从症状、心理社会等方面进行比较 特征、病程超过3个月，以及(目标4) 交叉验证RAP和RAP患者疼痛应对特征的类型 评估这些概况在预测健康结果方面的效用。这个 拟议的项目结合了自我报告和心理生理措施， 实验采用实验室方法，并采用纵向设计。参赛者： 基线评估将包括396名RAP患者和842名健康儿童 (8-15岁)。从这些小组中，将招募儿童及其父母 实验室计算机任务(n=200)和实验室水负荷任务(n =220)。研究结果有可能对机制有深入的了解 在说唱中将压力与疾病行为联系起来，此外，为了识别 干预目标，使儿童及其父母做好准备，更好地管理 说唱。