Appraisal and coping with daily stressors by pediatric patients with chronic abdominal pain.
OBJECTIVE
To test the hypothesis that pain patients differ from well children in their appraisal and coping with daily stressors and to test a model of the relation of stress appraisal and coping to symptoms and disability.


METHODS
Pediatric patients with chronic abdominal pain (n = 143) and well children (n = 104) completed a 5-day diary study regarding their appraisal and coping with daily stressors. Somatic symptoms, depressive symptoms, and functional disability were assessed 2 months later.


RESULTS
Compared to well children, pain patients were less confident of their ability either to change or to adapt to stress and were less likely to use accommodative coping strategies. Different patterns of stress appraisal were associated with active, passive, and accommodative coping. Both appraisals and coping were significantly related to symptoms and disability.


CONCLUSIONS
The relation between stress and symptoms in pediatric pain patients may be explained in part by their appraisal and coping with stressors. The relation between appraisal and coping was consistent with Lazarus, R. S., & Folkman, S. (1984). Stress, Appraisal, and Coping. New York: Springer.
Walker
Lynn S
LS
Division of Adolescent Medicine and Behavioral Science, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee 37232-9060, USA. lynn.walker@vanderbilt.edu
Smith
Craig A
CA
Garber
Judy
J
Claar
Robyn Lewis
RL
D015746:Abdominal Pain / Q000523:psychology*; D000203:Activities of Daily Living / Q000523:psychology; D000223:Adaptation, Psychological; D000293:Adolescent; D002648:Child; D002908:Chronic Disease; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008499:Medical Records; D010147:Pain Measurement; D013001:Somatoform Disorders / Q000175:diagnosis / Q000523:psychology; D013315:Stress, Psychological / Q000150:complications*