Psychobiological Processes in Pediatric Pain and Anxiety

描述（由申请人提供）：复发性腹痛（RAP）是儿童时期最常见的复发性疼痛主诉。通常，患有RAP的儿童除了疼痛外，还表现出高比率的焦虑和内化症状。以下提出的研究探讨了RAP和儿童焦虑之间的共同或区别的潜在共享潜在机制。本研究旨在通过测量应激反应、应激恢复、应对和注意力，更好地了解应激反应及其与压力和焦虑的关系。RAP儿童、焦虑儿童和健康儿童将对使用点探针范式的自动和受控注意过程的实验室测量做出反应。此外，儿童参与者还将参与社会压力源（Ewart社会能力访谈）和疼痛任务（冷压力范式），并测量他们对压力的自主反应和从压力中恢复。预测RAP患儿在注意测量（RAP患儿对疼痛和社会威胁词均有注意偏倚）、疼痛敏感性和耐受性方面与焦虑患儿存在差异。此外，RAP患儿和焦虑症患儿在应激反应性和恢复（心率、迷走神经张力、血压和GSR）方面与正常儿童存在差异，但彼此之间没有差异。应对方式、注意偏差和对压力的自主反应之间的联系也将被检查。这项研究的结果将有助于我们进一步了解RAP和焦虑之间的联系，并可能因此为治疗这种疾病提供信息。

DESCRIPTION (provided by applicant): Recurrent Abdominal Pain (RAP) is the most common recurrent pain complaint of childhood. Often, children with RAP present with high rates of anxiety and internalizing symptoms in addition to their pain. The following proposed study examines the potential shared underlying mechanisms that are either common to or discriminate between RAP and anxiety in children. The proposed research is designed to better understand RAP and its relationship with stress and anxiety by measuring stress reactivity, stress recovery, coping, and attention in these two populations. Children with RAP, children with anxiety, and well children will respond to a laboratory measure of automatic and controlled attentional processes using the dot-probe paradigm. In addition, child participants will also participate in a social stressor (the Ewart Social Competency Interview) and pain task (the cold pressor paradigm), and their autonomic responses to and recovery from stress will be measured. Children with RAP are predicted to differ from children with anxiety on measures of attention (children with RAP will have an attentional bias to both pain and social threat words) and pain sensitivity and tolerance. Moreover, children with RAP and children with anxiety disorders are expected to differ from well children, but not with each other, on measures of stress reactivity and recovery (heart rate, vagal tone, blood pressure, and GSR). The associations between coping style, attentional bias, and autonomic responses to stress will also be examined. Results from this study will help further our understanding of the links between RAP and anxiety, and may thus inform treatment of the disorder.