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）：本计划的长期目标是 研究的目的是了解与儿童心理健康相关的生物心理社会过程。 疾病行为（即，躯体疾病，残疾，卫生服务 利用）。我们特别关注那些 与医学发现不成比例的广泛疾病行为。 我们的研究以反复发作性腹痛（RAP）的儿童为原型 高水平的疾病行为的儿童， 严重的器质性疾病。我们最近的研究表明， 日常应激源与躯体化症状相关显著 RAP儿童比健康儿童更强，这表明儿童 RAP患者与同龄人的区别可能在于他们对压力的反应倾向 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 是确定环境和躯体压力之间的联系机制， 疾病行为。具体来说，在实验室中使用实验方法 设置，我们将：（目标1）评估具有挑战性的认知任务的影响 对儿童的生理活动，选择性注意身体线索， 症状报告;和（目的2）评估内脏刺激的影响， 父母对孩子疼痛的反应。此外，我们将创建 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 是识别可能有不同治疗需求的RAP亚组。 具体而言，我们将：（目的3）确定诊断亚组的患者， RAP并将其与生殖医学、心理社会学 特征和病程超过3个月，以及（目标4） 交叉验证RAP患者的疼痛应对特征类型， 评估这些特征在预测健康结果方面的实用性。的 建议的项目结合了自我报告和心理生理措施， 实验室方法和纵向设计。参与者 基线评估将包括396名RAP患者和842名健康儿童 (ages 8-15）。从这些团体中，儿童及其父母将被招募 实验室计算机任务（n =200）和实验室水负荷任务（n = 220）。研究结果有可能产生对机制的见解 在RAP中将压力与疾病行为联系起来，此外， 干预目标，使儿童及其父母做好准备， RAP。