Illness Behavior and Somatization in Children

儿童的疾病行为和躯体化

• 批准号: 6636826
• 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/6636826
• 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）：该计划的长期目标 研究是了解与儿童相关的生物心理社会过程 疾病行为（即躯体投诉，残疾，卫生服务 利用率）。我们特别关心维护的孩子 广泛的疾病行为与医学发现不符。 复发性腹痛（RAP）的儿童是我们研究的原型 与疾病行为高的儿童无关 重要的有机疾病。我们最近的工作表明，主题 每日压力源与躯体抱怨之间的相关性显着 对于说唱儿童而言，比儿童更强大，这表明儿童 用RAP可以通过对压力做出反应的趋势来区分他们的同龄人 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 是确定将环境压力和躯体压力源连接到的机制 疾病行为。具体而言，使用实验室中的实验方法 设置，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，选择性关注躯体线索以及 症状报告； （目标2）评估内脏刺激的影响和 父母对儿童疼痛抱怨的反应。此外，我们将创建 基于实验室表现的压力反应性指数，并将评估 该指数在预测健康结果中的实用性。我们的第二个主要目标 是确定可能有不同治疗需求的RAP亚组。 具体而言，我们将：（目标3）确定患者患者的诊断子组 在症状，社会心理学方面进行说唱和比较 特征和疾病的特征和病程在3个月内，（目标4） 对RAP患者和 评估这些概况在预测健康结果中的效用。这 拟议的项目结合了自我报告和心理生理措施， 实验实验室方法和纵向设计。参与者 基线评估将包括396例RAP患者和842名健康儿童 （8-15岁）。从这些团体中，将招募孩子及其父母 对于实验室计算机任务（n = 200）和实验室水负荷任务（n = 220）。研究结果有可能洞悉机制 将压力与说唱中的疾病行为联系起来，此外， 干预目标使孩子及其父母更好地管理 说唱。