The proposed study will use both qualitative and quantitative methodologies to evaluate a multidisciplinary Pain Clinic at UCLA for the treatment of chronic pain in children, a problem which affects some 10-20% of children under 17, is often co-morbid with anxiety and depression disorders, and may establish behaviors which increase the risk of chronic pain syndrome and pain-associated disability in adulthood. The UCLA Pediatric Pain Clinic uses a biopsychosocial model to treat chronic pain in children and to promote behavioral and therapeutic change through enhancement of the child's sense of self-efficacy. The study will use oral history master narratives; validated quantitative measures of patient self-efficacy, self-management (an indicator of function); validated quantitative measures of pain level, co-morbid anxiety and depression; and conversation analysis of physician-patient interactions to study the trajectory of change in the Pain Clinic patients and in patients with the same diagnosis drawn from two pediatric subspecialty clinics. Narratives of change drawn from the oral histories will be co-analyzed with scores on the pre and post-treatment quantitative measures and with observations of practitioner strategy and behavior in patient interactions.
Our specific aims are: 1) to make a quantitative and qualitative comparison of the PPC treatment model with that used to treat persistent pain in two pediatric subspecialty clinics, comparing changes in patient pain level, anxiety, depression, self-efficacy and functioning; 2) to examine in depth the children's cognitive beliefs and affective reactions to pain, the sources of these beliefs and reactions, and the process of changes in cognition, anxiety and depression, and behavior during Clinic treatment; and 3) to use the quantitative and qualitative data gathered to identify specific factors within the PPC treatment model which may be further evaluated in the next phase, a controlled clinical trial of this model for the treatment of pain and co-morbid anxiety and depression.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH063779-04
Application #
6998983
Study Section
Special Emphasis Panel (ZRG1-RPHB-3 (01))
Program Officer
Muehrer, Peter R
Project Start
2002-12-01
Project End
2007-11-30
Budget Start
2006-12-01
Budget End
2007-11-30
Support Year
4
Fiscal Year
2007
Total Cost
$377,103
Indirect Cost
Name
University of California Los Angeles
Department
Miscellaneous
Type
Schools of Arts and Sciences
DUNS #
092530369
City
Los Angeles
State
CA
Country
United States
Zip Code
90095
Evans, Subhadra; Djilas, Vesna; Seidman, Laura C et al. (2017) Sleep Quality, Affect, Pain, and Disability in Children With Chronic Pain: Is Affect a Mediator or Moderator? J Pain 18:1087-1095
Clemente, Ignasi; Heritage, John; Meldrum, Marcia L et al. (2012) Preserving the child as a respondent: initiating patient-centered interviews in a US outpatient tertiary care pediatric pain clinic. Commun Med 9:203-13
Allen, Laura B; Tsao, Jennie C I; Seidman, Laura C et al. (2012) A Unified, Transdiagnostic Treatment for Adolescents With Chronic Pain and Comorbid Anxiety and Depression. Cogn Behav Pract 19:56-67
von Baeyer, Carl L; Lin, Vivian; Seidman, Laura C et al. (2011) Pain charts (body maps or manikins) in assessment of the location of pediatric pain. Pain Manag 1:61-68
Evans, Subhadra; Taub, Rebecca; Tsao, Jennie Ci et al. (2010) Sociodemographic factors in a pediatric chronic pain clinic: The roles of age, sex and minority status in pain and health characteristics. J Pain Manag 3:273-281
Buchbinder, Mara (2010) Giving an account of one's pain in the anthropological interview. Cult Med Psychiatry 34:108-31
Evans, Subhadra; Meldrum, Marcia; Tsao, Jennie Ci et al. (2010) Associations between parent and child pain and functioning in a pediatric chronic pain sample: A mixed methods approach. Int J Disabil Hum Dev 9:11-21
Tsao, Jennie C I; Evans, Subhadra; Meldrum, Marcia et al. (2009) Sex differences in anxiety sensitivity among children with chronic pain and non-clinical children. J Pain Manag 2:151-161
Meldrum, Marcia L; Tsao, Jennie C-I; Zeltzer, Lonnie K (2009) ""I can't be what I want to be"": children's narratives of chronic pain experiences and treatment outcomes. Pain Med 10:1018-34
Waterhouse, Michael; Tsao, Jennie C I; Zeltzer, Lonnie K (2009) Commentary on the use of acupuncture in chronic pediatric pain. J Dev Behav Pediatr 30:69-71

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