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Relationship Between the Decision to Take a Child to the Clinic for Abdominal Pain and Maternal Psychological Distress
Rona L. Levy, MSW, PhD, MPH;
Shelby L. Langer, PhD;
Lynn S. Walker, PhD;
Lauren D. Feld;
William E. Whitehead, PhD
Arch Pediatr Adolesc Med. 2006;160:961-965.
Background Among adults with functional gastrointestinal disorders, psychological distress influences who consults a physician, but little is known about predictors of consultation when the patient is a child.
Objective To determine the relative contributions of psychological symptoms of the mother, psychological symptoms of the child, severity of child abdominal pain, and family stress to consultation.
Design Observational study.
Setting Health maintenance organization.
Participants Two hundred seventy-five mothers of 334 children who had abdominal pain in the past 2 weeks, as per child self-report.
Main Outcome Measures Mothers completed questionnaires about themselves (Symptom Checklist 90–Revised) and their children (school absences, medication use, and the Child Behavior Checklist). Children completed the Pain Beliefs Questionnaire to assess perceived pain severity.
Results Thirty-nine children had been taken to the clinic for abdominal pain symptoms at least once in the past 3 months (consulters), whereas 295 were nonconsulters. Logistic regression analyses revealed that both the child's self-report of perceived pain severity (P<.001) and maternal psychological symptoms (P = .006) predicted consultation. Although children who visited physicians had significantly more psychological symptoms, this was not a significant predictor of consultation after adjusting for maternal psychological symptoms. Family stress did not predict consultation.
Conclusion The decision to take a child to the clinic for abdominal pain is best predicted by maternal psychological distress and the child's perceived pain severity.
Author Affiliations: School of Social Work (Drs Levy and Langer) and School of Medicine and Department of Psychology (Dr Levy), University of Washington, and Lakeside School (Ms Feld), Seattle; Department of Adolescent Medicine and Behavioral Science, Vanderbilt University Medical Center, Nashville, Tenn (Dr Walker); and Center for Functional GI and Motility Disorders, University of North Carolina at Chapel Hill (Dr Whitehead).
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