Developmental Outcomes of Pediatric Chronic Abdominal Pain

小儿慢性腹痛的发育结局

• 批准号: 7417953
• 负责人: Lynn D. Walker
• 金额: $ 43.58万
• 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 2012-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7417953
• 关键词: Abdominal Pain; Acute; Address; Adolescence; Adolescent; Adult; Age; Anxiety Disorders; Behavioral; Belief; Characteristics; Child; Childhood; Chronic; Classification; Competence; Control Groups; Daily; Databases; Development; Diagnostic; Disease; Emotional; Evaluation; Family; Functional Gastrointestinal Disorders; Gastrointestinal Diseases; Goals; Grant; Headache; Headache Disorders; Health; Health Services; Impairment; Individual; Laboratories; Life Stress; Link; Maintenance; Measures; Medical; Mental Depression; Mental Health; Mental disorders; Methods; Moods; Newsletter; Outcome; Outcome Assessment; Pain; Pain Disorder; Parents; Participant; Pathology; Patient Self-Report; Patients; Physiological; Prevention; Process; Prospective Studies; Psyche structure; Public Health; Questionnaires; Reporting; Research; Research Personnel; Resolution; Risk; Risk Factors; Sampling; Sampling Studies; Self Efficacy; Severities; Stress; Symptoms; Telephone; Thinking; Title; Visceral; Walkers; Youth; acute stress; analog; biopsychosocial; chronic pain; cohort; comparison group; coping; depressive symptoms; diaries; disability; follow-up; functional disability; functional outcomes; gastrointestinal; indexing; programs; prototype; psychologic; psychosocial; response; social; social skills; stressor; trait; young adult

DESCRIPTION (provided by applicant): This revised application is for renewal of R01 HD23264 with a new title that reflects the evolving focus of our research program. Our goal is to understand bio-psychosocial processes associated with pediatric chronic pain with the aim of informing prevention and treatment. Youth with chronic abdominal pain (CAP) have served as a prototype in our study of pain not associated with significant medically explained pathology. These youth are thought to be at risk for functional gastrointestinal disorders (FGIDs), headache, other chronic pain disorders, and psychiatric disorders as adolescents and adults. However, no prospective studies have systematically assessed these outcomes. Additional information is needed to characterize physical, emotional, and functional outcomes of CAP, discover risk factors for adverse outcomes, and identify psychological, behavioral, and physiological factors that may influence the course of CAP from childhood to adolescence and young adulthood. This application capitalizes on our existing landmark database of more than 800 patients evaluated for CAP at ages 8 through 15 years and a similar age control group of 350 well children. Our sample presents a unique opportunity to identify predictors of long-term health and psychosocial outcomes of pediatric onset CAP for individuals in our database who will be adolescents and young adults (ages 13-28 years) at follow-up. Former study participants with pediatric onset-CAP and those previously serving as well controls will be contacted for detailed psychosocial and laboratory follow-up assessment. Thus, we will evaluate CAP patients as they pass through the "age of risk" for several disorders associated with considerable impairment and health service use. We aim to (1) examine health and functional outcomes (including diagnostic criteria for FGIDs, chronic pain disorders, and psychiatric disorders) in adolescents and adults with pediatric onset CAP compared to well controls, (2) assess the relation between baseline risk factors and long-term outcomes and, (3) as a follow-up to our diary study that linked acute stress to CAP symptoms, use laboratory methods to examine experimentally the impact of acute stressors on symptom exacerbation and physiological reactivity across CAP and well controls, and identify potential moderators of the response to stressors. Relevance of this project to public health: The study will identify characteristics of youth with CAP who are most likely to develop psychiatric disorders and chronic pain as adolescents and young adults and will suggest factors that should be addressed in prevention and treatment efforts.

描述（由申请人提供）：此修订的应用程序用于续签R01 HD23264，其新标题反映了我们研究计划的不断发展的重点。我们的目标是了解与小儿慢性疼痛相关的生物心理社会过程，以便为预防和治疗提供信息。慢性腹痛（CAP）的青年在我们对疼痛的研究中已成为原型，与大量医学解释的病理学无关。这些年轻人被认为处于功能性胃肠道疾病（FGID），头痛，其他慢性疼痛障碍和精神疾病的风险中，作为青少年和成人。但是，没有前瞻性研究系统地评估了这些结果。需要其他信息来表征CAP的身体，情感和功能结果，发现不良结果的风险因素，并确定可能影响从童年到青春期和年轻成年的CAP进程的心理，行为和生理因素。该应用程序大写了我们现有的地标数据库，该数据库的800多名患者在8至15岁时评估了CAP，以及类似的350个井子女的年龄对照组。我们的样本提供了一个独特的机会，可以为我们的数据库中的个体中的长期健康和心理社会心理结局的预测指标，他们将在随访中成为青少年和年轻人（13-28岁）。将与小儿发病率和先前服务的对照组的前研究参与者联系，以进行详细的社会心理和实验室随访评估。因此，我们将评估CAP患者经历与大量障碍和健康服务使用相关的几种疾病的“风险年龄”时。我们的目的是（1）检查青少年和成年人的健康和功能结果（包括fGID，慢性疼痛障碍和精神疾病的诊断标准），与井对照组相比，儿科发作限额和成年人与井对照组相比，（2）评估基线风险因素与长期疾病的关系和（3）的疾病，并（3）使用疾病的疾病，（3）链接，（3）链接的方法，（3）在实验上，急性应激源对跨CAP和井对照的症状加剧和生理反应性的影响，并确定对应激源反应的潜在调节剂。该项目与公共卫生的相关性：这项研究将确定CAP青年的特征，这些年轻人最有可能作为青少年和年轻人发展精神疾病和慢性疼痛，并提出预防和治疗工作中应解决的因素。