Psychological comorbidity and stress reactivity in children and adolescents with recurrent abdominal pain and anxiety disorders

被引:149
作者
Dorn, LD
Campo, JC
Thato, S
Dahl, RE
Lewin, D
Chandra, R
Di Lorenzo, C
机构
[1] Univ Pittsburgh, Pittsburgh, PA 15261 USA
[2] Sch Med, Pittsburgh, PA USA
[3] Western Psychiat Inst & Clin, Pittsburgh, PA USA
[4] Childrens Hosp Pittsburgh, Pittsburgh, PA 15213 USA
[5] Chulalongkorn Univ, Sch Nursing, Bangkok, Thailand
[6] Mercy Hosp, Div Pediat Gastroenterol, Pittsburgh, PA 15219 USA
关键词
recurrent abdominal pain; anxiety; stress reactivity; cortisol; blood pressure;
D O I
10.1097/00004583-200301000-00012
中图分类号
B844 [发展心理学(人类心理学)];
学科分类号
040202 ;
摘要
Objective: To compare clinical symptoms, diagnoses, and physiological measures in children and adolescents with recurrent abdominal pain (RAP) (n = 14), to a group with anxiety disorders (ANX) (n = 14) and a physically and psychiatrically healthy control group (HC) (n = 14) Method: The cross-sectional study examined group differences in clinical symptoms of anxiety, somatic complaints, depression, and behavior problems. Physiological measures included heart rate, systolic and diastolic blood pressure, and salivary cortisol in response to the Trier Social Stress Test for Children (TSSTC). Subjects were between the ages of 8 and 16 years. Results: RAP and ANX subjects had comparable scores on most psychological measures, and their scores were higher (p <.05) than those of the HQ The ANX and RAP groups exhibited physiological findings that had more shared similarities than either group with the HC group. Few statistically significant group differences were noted in physiological measures, yet the pattern of findings in blood pressure and cortisol supported the use of the TSST-G and the direction of the findings was consistent with expectations. Conclusions: Understanding more about comorbidity between RAP and anxiety could have important management implications, with observed congruities between the disorders suggesting treatments already demonstrated to be efficacious for pediatric anxiety and depression might be applied productively to RAP.
引用
收藏
页码:66 / 75
页数:10
相关论文
共 48 条
[1]  
Achenbach T.M., 1992, Manual for the Child Behavior Checklist/ 2-3 and 1992 Profile
[2]   THE COVARIATION OF COMMON PSYCHOSOMATIC SYMPTOMS AMONG CHILDREN FROM SOCIO-ECONOMICALLY DIFFERING RESIDENTIAL AREAS - AN EPIDEMIOLOGIC-STUDY [J].
ALFVEN, G .
ACTA PAEDIATRICA, 1993, 82 (05) :484-487
[3]   DEPRESSED CONCENTRATIONS OF OXYTOCIN AND CORTISOL IN CHILDREN WITH RECURRENT ABDOMINAL-PAIN OF NONORGANIC ORIGIN [J].
ALFVEN, G ;
DELATORRE, B ;
UVNASMOBERG, K .
ACTA PAEDIATRICA, 1994, 83 (10) :1076-1080
[4]  
Apley J., 1975, CHILD ABDOMINAL PAIN, V2nd
[5]   PUPILLARY REACTIVITY IN CHILDREN WITH RECURRENT ABDOMINAL-PAIN [J].
BATTISTELLA, PA ;
CARRA, S ;
ZANINOTTO, M ;
RUFFILLI, R ;
DADALT, L .
HEADACHE, 1992, 32 (02) :105-107
[6]   Somatic symptoms in anxious-depressed school refusers [J].
Bernstein, GA ;
Massie, ED ;
Thuras, PD ;
Perwien, AR ;
Borchardt, CM ;
Crosby, RD .
JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY, 1997, 36 (05) :661-668
[7]   A 3-YEAR FOLLOW-UP OF CHILDREN WITH AND WITHOUT BEHAVIORAL-INHIBITION [J].
BIEDERMAN, J ;
ROSENBAUM, JF ;
BOLDUCMURPHY, EA ;
FARAONE, SV ;
CHALOFF, J ;
HIRSHFELD, DR ;
KAGAN, J .
JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY, 1993, 32 (04) :814-821
[8]   Psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED): A replication study [J].
Birmaher, B ;
Brent, DA ;
Chiappetta, L ;
Bridge, J ;
Monga, S ;
Baugher, M .
JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY, 1999, 38 (10) :1230-1236
[9]   The screen for child anxiety related emotional disorders (SCARED): Scale construction and psychometric characteristics [J].
Birmaher, B ;
Khetarpal, S ;
Brent, D ;
Cully, M ;
Balach, L ;
Kaufman, J ;
Neer, SM .
JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY, 1997, 36 (04) :545-553
[10]   Childhood and adolescent depression: A review of the past 10 years .2. [J].
Birmaher, B ;
Ryan, ND ;
Williamson, DE ;
Brent, DA ;
Kaufman, J .
JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY, 1996, 35 (12) :1575-1583