title: Relationship between the decision to take a child to the clinic for abdominal pain and maternal psychological distress.
abstract: 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.
  
  
  METHODS
  Observational study.
  
  
  METHODS
  Health maintenance organization.
  
  
  METHODS
  Two hundred seventy-five mothers of 334 children who had abdominal pain in the past 2 weeks, as per child self-report.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: School of Social Work and School of Medicine and Department of Psychology, University of Washington, and Lakeside School, Seattle, USA. rlevy@u.washington.edu
authors.forename: Rona L
authors.initials: RL
authors.lastname: Levy
authors.forename: Shelby L
authors.initials: SL
authors.lastname: Langer
authors.forename: Lynn S
authors.initials: LS
authors.lastname: Walker
authors.forename: Lauren D
authors.initials: LD
authors.lastname: Feld
authors.forename: William E
authors.initials: WE
authors.lastname: Whitehead
mesh_terms: D015746:Abdominal Pain / Q000523:psychology*; D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D016009:Chi-Square Distribution; D002648:Child; D003657:Decision Making; D006801:Humans; D016015:Logistic Models; D009035:Mothers / Q000523:psychology*; D010147:Pain Measurement; D011795:Surveys and Questionnaires