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Journal of Pediatric Psychology Advance Access originally published online on May 22, 2006
Journal of Pediatric Psychology 2007 32(2):206-216; doi:10.1093/jpepsy/jsj124
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© The Author 2006. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Appraisal and Coping with Daily Stressors by Pediatric Patients with Chronic Abdominal Pain

Lynn S. Walker, PhD1, Craig A. Smith, PhD2, Judy Garber, PhD2 and Robyn Lewis Claar, PhD3

1 Vanderbilt University School of Medicine, 2 Vanderbilt University, and, 3 Children’s Hospital Boston and Harvard Medical School

All correspondence concerning this article should be addressed to Lynn S. Walker, PhD, Division of Adolescent Medicine and Behavioral Science, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee 37232-9060. E-mail: lynn.walker{at}vanderbilt.edu.


   Abstract

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.

Key words: abdominal pain; accommodative coping; appraisal; passive coping; stress.

Received October 22, 2004; revision received November 28, 2005; revision received March 9, 2006; accepted April 12, 2006


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