Feelings/Body Investigators:Interoceptive Exposure for Children w/Abdominal Pain

感受/身体调查员：腹痛儿童的内感受暴露

基本信息

批准号：
8512185
负责人：
HELEN L. EGGER
金额：
$ 25.66万
依托单位：
DUKE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-09-26 至 2015-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8512185
关键词：
8 year old Abdominal Pain Adaptive Behaviors Address Adult Aftercare Age Anxiety Awareness Basic Science Behavior Behavior Therapy Behavioral Brain Butterflies Caregivers Caring Child Childhood Clinic Curiosities Development Diagnostic tests Disease Distress Early Intervention Eating Educational Intervention Educational process of instructing Emotions Enrollment Epidemiologic Methods Esthesia Evaluation Facial Affective Scale Family Feeling Fright Future Health Home environment Homeostasis Hunger Impairment Internet Intervention Label Laboratories Lead Learning Link Longevity Medical Mental Health Mental disorders Mission Modification Moods Neurosciences Neurosciences Research Nursery Schools Pain Pain Disorder Pain management Parent-Child Relations Parenting Education Parents Participant Pattern Phase Prevention Primary Health Care Psychopathology Psychophysiologic Disorders Public Health Randomized Recurrence Recurrent pain Regulation Research Research Personnel Research Support Risk Safety Sampling Schools Signal Transduction Social Environment Solutions Stress Symptoms Syndrome Testing Time Training Translating Translational Research Viscera Visceral Visceral pain Weight Work active control base chronic abdominal pain chronic pain clinically significant cost design diaries early childhood emotion regulation emotional experience experience fascinate fundamental research group intervention health care service utilization improved improved functioning innovation neural circuit neurodevelopment novel physical conditioning prevent public health relevance research and development response role model satisfaction success therapy development treatment program

项目摘要

DESCRIPTION (provided by applicant): This application, Feelings and Body Investigators (FBI): Interoceptive Exposure for Child Abdominal Pain is in response to PA-11-177, Translational Research for the Development of Novel Interventions for Mental Disorders (R21/R33). We propose development and pilot-testing of an acceptance- based behavioral treatment for young children (5-8 years old) with functional abdominal pain (FAP; R21, n=26, R33, n=100). FAP is one of the most frequent somatic syndromes in young children, causes significant impairment, and is predictive of psychiatric and pain disorders later in childhood and in adulthood. No treatments exist for very young children with FAP. Research supports that FAP is influenced by: (1) early pain on the neurodevelopment of the gut-brain axis and (2) maladaptive interactions with the social environment that inadvertently increase somatic fear. These vulnerabilities provide targets for early intervention. OBJECTIVE: To develop and pilot an intervention for FAP based on fundamental neuroscience research on the aberrant neurodevelopment of the gut-brain axis and subsequent modification by the social environment. Our treatment 1) links intervention strategies to unique patterns of neural circuit maturation associated with early visceral pain on the gut-brain axis, 2) adapts acceptance-based behavioral strategies used to address psychopathology in older children to younger children, and 3) incorporates caregivers as role models and facilitators based on attachment research. METHODS: Our ten session intervention trains children to be "Feeling and Body Investigators". Half of the sessions will be done in clinic and half at home via web-camera to facilitate generalization. During the treatment child/caregiver dyads will 1) gather body clues (Learn), 2) investigate (Experience: perform interoceptive mystery missions to explore a body sensation), 3) organize body clues (Contextualize: recall other contexts that evoke similar sensations), and 4) go on increasingly daring missions (Challenge: decrease avoidance and safety behaviors). In the R21 phase we will develop and refine the FBI intervention in 26 child- caregiver dyads. In the R33 phase we will randomize 100 children with FAP to FBI or an active control (parent education with standard medical care) to conduct a pilot-test of the feasibility, acceptability, an clinical significance of FBI compared with an active control treatment. We will use epidemiological methods to screen all eligible children attending primary care practices so that our sample will be representative of young children with FAP, not simply a convenience sample. If we are successful, young children with FAP who complete our FBI early intervention will learn to experience changes in the viscera as fun and fascinating, rather than scary, and will develop new capacities for pain management, adaptive functioning, and emotion regulation. The success of our early intervention for FAP in young children will also have broad implications for the treatment and prevention of mental illness and chronic abdominal pain.

描述（由申请人提供）：此应用，感觉和身体研究人员（FBI）：儿童腹部疼痛的感受性暴露是对PA-11-177的反应，这是针对精神疾病新干预措施发展的转化研究（R21/R33）。我们提出了对腹部疼痛（FAP; R21，n = 26，r33，n = 100）的基于接受行为治疗的开发和试验测试。 FAP是幼儿中最常见的体细胞综合症之一，会引起重大损害，并且可以预测儿童后期和成年期的精神病和疼痛障碍。对于有FAP的非常小的孩子，没有治疗。研究支持FAP受：（1）肠道轴神经发育的早期疼痛以及（2）与社会环境的不良相互作用，而社会环境无意中增加了体细胞的恐惧。这些漏洞为早期干预提供了目标。目的：基于对肠脑轴异常神经发育的基本神经科学研究以及随后对社会环境的修改，开发和试行了FAP的干预措施。我们的治疗方法1）将干预策略与与肠道轴上的早期内脏疼痛相关的神经回路成熟的独特模式联系起来，2）适应基于依恋研究的榜样和辅助因子，适用于年龄较大儿童的基于接受的行为策略，以解决年龄较大的儿童的精神病理学。方法：我们的十次课程干预训练儿童成为“感觉和身体调查员”。一半的课程将在诊所进行，一半是通过网络摄像机在家中进行的，以促进概括。在治疗期间，儿童/照料者的二元组将1）收集身体线索（学习），2）调查（经验：执行感官面的神秘任务以探索身体感觉），3）组织身体线索（情境化：回忆其他相似感觉的上下文），而4）进行越来越多的挑战（挑战：挑战：降低回避和安全行为）。在R21阶段，我们将在26个儿童护理人员二元组中开发和完善FBI干预。在R33阶段，我们将对100名FBI的FBI或主动控制（具有标准医疗护理的父母教育）随机，以进行可行性，可接受性，FBI的临床意义的试验测试，与主动对照治疗相比。我们将使用流行病学方法来筛查所有参加初级保健实践的合格儿童，以便我们的样本代表有FAP的幼儿，而不仅仅是方便样本。如果我们取得了成功，那么有FAP的幼儿完成了我们的联邦调查局早期干预措施，将学会体验内脏的变化，而不是令人着迷，而不是恐怖，并将为疼痛管理，适应性功能和情感调节增长新的能力。我们对幼儿FAP的早期干预的成功也将对治疗和预防精神疾病和慢性腹部疼痛具有广泛的影响。