Adolescents at risk for chronic pain

描述(由申请人提供)：K23候选人是俄勒冈健康与科学大学(OHSU)麻醉学和围术期医学系助理教授。这一奖项有望帮助转移候选人的研究重点，并提供儿童和青少年慢性疼痛风险方面的额外培训。候选人的职业目标是发展一项与识别和预防高危青年慢性疼痛相关的独立研究事业。职业发展和研究培训计划的具体目标是获得必要的培训，以评估高危青少年中疼痛和躯体症状的个人和家庭预测因素，并使用实验室疼痛反应性数据来测试有关风险和复原力因素的假设，这些因素与儿童随着时间的推移发展慢性疼痛有关。候选人提出了一个为期五年的培训计划，由来自强大麻醉系的教师指导。她的赞助人是一位非常有经验的儿科疼痛研究人员，他的工作重点是了解和治疗儿童慢性疼痛的功能后果。其他导师是实验室疼痛方法、高危青少年健康促进和预防以及儿童纵向研究方面的专家。OHSU是这一奖项的理想机构，因为有广泛的可用资源(例如，俄勒冈州临床和翻译研究所的培训机会)。除了由全国知名的以患者为导向的研究人员进行密集指导外，职业发展计划还包括慢性疼痛治疗、实验室疼痛方法学、拨款撰写技能和研究伦理方面的课程作业和教学培训。该计划的其他活动包括统计方法方面的研究培训，以及为独立研究支助准备赠款提案的监督经验。这位候选人提出的研究涉及三个具体目标。第一个目的是在两组人中检查疼痛与躯体症状、身体功能和心理功能的个体和父母的相关性：1)患有慢性疼痛的成年照顾者的孩子，以及2)没有慢性疼痛的健康父母的孩子。第二个目标是在青春期对这群儿童进行为期一年的跟踪调查，以确定纵向上预测疼痛和躯体症状的风险和保护因素，并检查儿童性行为的作用。将检查与父母、心理和健康相关的风险因素。第三个目的是比较两组父母在实验室疼痛任务中的反应，以更好地了解父母行为对儿童疼痛体验的影响。这项创新的研究利用临床和实验室疼痛评估技术来提供有关高危人群的新信息，并将为预防干预措施的发展提供信息。从候选人的职业发展和研究计划中获得的综合技能和经验将为候选人提供必要的早期职业支持，以建立一个成功的独立研究职业生涯，重点是在有慢性疼痛风险的青年中预防和治疗慢性疼痛和相关残疾。 公共卫生相关性：慢性疼痛家族史增加了儿童和青少年发生慢性疼痛的风险。这项研究将确定与疼痛反应性和躯体症状相关的风险和保护因素，这些儿童与患有慢性疼痛的成年照顾者生活在一起。长期目标是预防成人慢性疼痛和相关残疾的发展。

DESCRIPTION (provided by applicant): The K23 candidate is an assistant professor in the Department of Anesthesiology and Perioperative Medicine at Oregon Health & Science University (OHSU). This award is expected to help transition the focus of the candidate's research and to provide additional training in risk for chronic pain in children and adolescents. The candidate's career goals are to develop an independent research career related to identification and prevention of chronic pain in at risk youth. Specific objectives of the career development and research training plan are to obtain the necessary training to evaluate individual and family predictors of pain and somatic symptoms among at-risk youth, and to use laboratory pain reactivity data to test hypotheses about risk and resilience factors related to the development of chronic pain in children over time. The candidate proposes a five-year training program with faculty mentors from a strong anesthesiology department. Her sponsor is a very experienced pediatric pain researcher whose work has focused on understanding and treating the functional consequences of chronic pain in children. Additional mentors are experts in laboratory pain methods, health promotion and prevention in at risk youth, and longitudinal studies with children. OHSU is an ideal institution for this award owing to the breadth of resources available (e.g., Oregon Clinical and Translational Research Institute training opportunities). In addition to intensive mentoring by nationally renowned patient-oriented researchers, the career development plan includes coursework and didactic training in chronic pain treatment, laboratory pain methodology, grant writing skills, and research ethics. Other activities in the plan include research training in statistical methods and supervised experience in preparation of grant proposals for independent research support. The candidate's proposed research involves three specific aims. The first aim is to examine individual and parental correlates of pain and somatic symptoms, physical functioning, and psychological functioning within two groups: 1) children of adult caregivers with chronic pain, and 2) children of healthy parents without chronic pain. The second aim is to follow this cohort of children over a one-year period in adolescence to identify risk and protective factors that predict pain and somatic symptoms longitudinally and examine the role of child sex. Parental, psychological, and health-related risk factors will be examined. The third aim is to compare parental responses during laboratory pain tasks in the two groups to better understand the influence of parent behaviors on children's pain experiences. This innovative study utilizes clinical and laboratory pain assessment techniques to provide new information about an at risk population, and will inform the development of preventive interventions. The combined skill set and experience gained from the candidate's career development and research plan will provide the necessary early career support for the candidate to establish a successful independent research career focused on prevention and treatment of chronic pain and related disability among youth at risk for chronic pain. Public Health Relevance: Family history of chronic pain increases the risk for the development of chronic pain in children and adolescents. This study will identify risk and protective factors associated with pain reactivity and somatic symptoms in children who are living with an adult caregiver with chronic pain. The long-term goal is to prevent the development of adult chronic pain and related disability.