Transcript Kneeland

The Relation of Negative Life Events
to Symptoms and Functioning in
Adolescents and Young Adults with
a Childhood History of Chronic
Abdominal Pain
Presentation by: Gerianna
Kneeland
Chronic abdominal pain
• Defined as intermittent or constant abdominal
•
•
•
pain of at least 3 months duration (American
Academy of Pediatrics, 2005)
Psychosocial factors influence illness in CAP
patients
Negative life events
Competence may serve as moderator
Hypotheses
• 1) higher levels of personal stress will be
•
associated with poorer patient outcomes at
follow-up including more emotional symptoms,
somatic symptoms, and disability
2) personal competence will moderate the effect
of life stress on patient outcomes, such that life
stress will be associated with poorer outcomes
in patients with low competence compared to
those with high competence
Method
•
•
•
•
Recruited from research database
Telephone Interview
Online Surveys
Data analysis assessed by health
interview and online surveys
Measures
• SF-36 Health Survey- assesses functioning
and emotions of participants
• Child/adult Somatization Inventory•
assesses the severity of nonspecific somatic
symptoms most commonly reported by children
with chronic abdominal pain
Functional Disability Inventory- assesses the
extent to which functional disability limits a child
in different activities
Measures (cont.)
• Life Events Questionnaire (LEQ)•
assesses negative life events in the past
year
Self-Perception Profile For
Adults/Adolescents- assesses perceived
global and domain-specific competence
Results
•
•
•
•
•
•
218 CAP patients
12-32 years
57.8% female
40.7% male
90.8% Caucasian
7.8% other
Results
Hypothesis #1 (Life stress predicts poor outcomes)
• SF-36 p-value of .001* and ß of -.292
• CSI- p-value of .007* and ß of .188
• FDI- p-value of .074
Hypothesis #2 (Competence moderates effect of life stress)
• CSI- p-value of .035*
• SF-36 p-value of .236
• FDI- p-value of .148
*p<.05
Results
Figure 1. The two-way interaction effect of stress and competence on CSI scores
C
S
I
S
C
O
R
E
S
0.35
0.3
0.25
0.2
0.15
0.1
Low
stress
Low
stress
0.05
0
Low IV1
High competence
Low competence
Hig
Low
high stress
High IV1
High IV3
Limitations
• Competence is a self-report measure
• Cross-sectional study
• Life events were assessed for year
preceding interview
• Limited generalizability
Future directions
• Other factors moderating effect of life
stress
• Turn towards a prospective design
Acknowledgements
• Dr. Lynn Walker
• Grace Shelby, doctoral student assistant
• Dr. Craig Smith