The Relation of Negative Life Events to Symptoms and Functioning in

Adolescents and Young Adults with a Childhood History of Chronic

Abdominal Pain

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

Presentation by: Gerianna Kneeland

Chronic abdominal painChronic 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

• 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

HypothesesHypotheses

• 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

• 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

MethodMethod

• Recruited from research database

• Telephone Interview

• Online Surveys

• Data analysis assessed by health interview and online surveys

• Recruited from research database

• Telephone Interview

• Online Surveys

• Data analysis assessed by health interview and online surveys

MeasuresMeasures

• 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

• 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.)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

• 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

ResultsResults

• 218 CAP patients

• 12-32 years

• 57.8% female

• 40.7% male

• 90.8% Caucasian

• 7.8% other

• 218 CAP patients

• 12-32 years

• 57.8% female

• 40.7% male

• 90.8% Caucasian

• 7.8% other

ResultsResultsHypothesis #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

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

ResultsResultsFigure 1. The two-way interaction effect of stress and competence on CSI scores

Figure 1. The two-way interaction effect of stress and competence on CSI scores

0

0.05

0.1

0.15

0.2

0.25

0.3

0.35

Low IV1 High IV1

High IV3

High IV2

Low IV2

Low stress

Low stress high stress

High competenceLow competence

CSI

SCORES

LimitationsLimitations

• Competence is a self-report measure

• Cross-sectional study

• Life events were assessed for year preceding interview

• Limited generalizability

• Competence is a self-report measure

• Cross-sectional study

• Life events were assessed for year preceding interview

• Limited generalizability

Future directionsFuture directions

• Other factors moderating effect of life stress

• Turn towards a prospective design

• Other factors moderating effect of life stress

• Turn towards a prospective design

AcknowledgementsAcknowledgements

• Dr. Lynn Walker

• Grace Shelby, doctoral student assistant

• Dr. Craig Smith

• Dr. Lynn Walker

• Grace Shelby, doctoral student assistant

• Dr. Craig Smith