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.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
5R01HD023264-20
Application #
7799195
Study Section
Special Emphasis Panel (ZRG1-RPHB-K (03))
Program Officer
Haverkos, Lynne
Project Start
1997-08-01
Project End
2012-03-31
Budget Start
2010-04-01
Budget End
2011-03-31
Support Year
20
Fiscal Year
2010
Total Cost
$455,123
Indirect Cost
Name
Vanderbilt University Medical Center
Department
Pediatrics
Type
Schools of Medicine
DUNS #
004413456
City
Nashville
State
TN
Country
United States
Zip Code
37212
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Russell, Alexandra C; Stone, Amanda L; Walker, Lynn S (2017) Nausea in Children With Functional Abdominal Pain Predicts Poor Health Outcomes in Young Adulthood. Clin Gastroenterol Hepatol 15:706-711
Stone, Amanda L; Walker, Lynn S; Laird, Kelsey T et al. (2016) Pediatric Pain Beliefs Questionnaire: Psychometric Properties of the Short Form. J Pain 17:1036-44
Laird, Kelsey T; Sherman, Amanda L; Smith, Craig A et al. (2015) Validation of the Abdominal Pain Index using a revised scoring method. J Pediatr Psychol 40:517-25
Sherman, Amanda L; Morris, Matthew C; Bruehl, Stephen et al. (2015) Heightened Temporal Summation of Pain in Patients with Functional Gastrointestinal Disorders and History of Trauma. Ann Behav Med 49:785-92
Noel, Melanie; Palermo, Tonya M; Essner, Bonnie et al. (2015) A developmental analysis of the factorial validity of the parent-report version of the Adult Responses to Children's Symptoms in children versus adolescents with chronic pain or pain-related chronic illness. J Pain 16:31-41
Laird, Kelsey T; Preacher, Kristopher J; Walker, Lynn S (2015) Attachment and adjustment in adolescents and young adults with a history of pediatric functional abdominal pain. Clin J Pain 31:152-8
Morris, Matthew C; Walker, Lynn; Bruehl, Stephen et al. (2015) Race Effects on Conditioned Pain Modulation in Youth. J Pain 16:873-80
Horst, Sara; Shelby, Grace; Anderson, Julia et al. (2014) Predicting persistence of functional abdominal pain from childhood into young adulthood. Clin Gastroenterol Hepatol 12:2026-32
Ewart, Craig K; Elder, Gavin J; Laird, Kelsey T et al. (2014) Can agonistic striving lead to unexplained illness? Implicit goals, pain tolerance, and somatic symptoms in adolescents and adults. Health Psychol 33:977-85

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