Psychobiological Processes in Pediatric Pain and Anxiety

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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.