Intergenerational transmission of gastrointestinal illness behavior.
OBJECTIVE
Previous research, based on retrospective reporting, suggests that parental reinforcement and modeling may be important mechanisms in the development of gastrointestinal illness behavior in children and adults. The aim of this study was to determine the relationship between the illness behavior of parents, in the form of health care use for irritable bowel symptoms, and the illness behavior of their children, without relying on retrospective recall.


METHODS
A comparison of two matched groups was made. Groups included 631 children of parents who were diagnosed with irritable bowel syndrome during 1 calendar yr and 646 children of parents matched by parental age, gender, and number of children in the family who did not receive an IBS diagnosis during the same 1 yr. Health care use and costs over a 3-yr calendar period for all children and their parents collected from the health care database of a large health maintenance organization were evaluated.


RESULTS
Case children had significantly more ambulatory care visits for all causes (mean 12.26 vs. 9.81, p = 0.0001) and more ambulatory visits for gastrointestinal symptoms (0.35 vs. 0.18, p = 0.0001). Outpatient health care costs over the 3-yr period were also significantly higher for case than control children ($1979 vs. $1546, p = 0.0001). Controlling for the total number of ambulatory visits of the parents, excluding gastrointestinal visits, did not alter the findings. Gender of the IBS parent was not related to children's gastrointestinal visits.


CONCLUSIONS
This study extends previous research by showing that specific types of illness behavior may be learned through modeling.
Levy
R L
RL
University of Washington, Seattle 98105, USA.
Whitehead
W E
WE
Von Korff
M R
MR
Feld
A D
AD
D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care / Q000191:economics / Q000706:statistics & numerical data; D016022:Case-Control Studies; D002648:Child; D003109:Colonic Diseases, Functional / Q000523:psychology*; D019992:Databases as Topic; D005260:Female; D017048:Health Care Costs; D006279:Health Maintenance Organizations; D006801:Humans; D007100:Imitative Behavior; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D010287:Parent-Child Relations; D012054:Reinforcement, Psychology; D012737:Sex Factors; D012803:Sick Role