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Exploring the Intergenerational Transmission of Illness Behavior: From Observations to Experimental Intervention

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Background

Functional abdominal pain (FAP) of childhood is characterized by, among other things, pain with no known physiological cause, and family patterns of related disorders have been reported.

Purpose

The purpose of this paper is to trace the development of one FAP research program and highlight some of its key findings from observations of interaction patterns to intervention studies designed to test outcomes of altering these patterns.

Methods

Studies summarized include observational and experimental research.

Results

Parental response to child pain behaviors appears to be a key factor in the development and maintenance of FAP, and intervention which includes targeting changes in parental responses can decrease reports of pain and other illness behaviors.

Conclusions

Research into FAP can provide valuable information for not only FAP and other unexplained pain conditions, but other medical conditions where environmental responses may play an important role in their etiology and maintenance.

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References

  1. Mechanic D. Sex, Illness, Illness Behavior, and the Use of Health Services. Madison, WI: University of Wisconsin—Madison; 1976

    Google Scholar 

  2. Drossman DA, Li Z, Andruzzi E, et al. U.S. householder survey of functional gastrointestinal disorders. Prevalence, sociodemography, and health impact. Dig Dis Sci. 1993; 38(9): 1569–1580.

    Article  PubMed  CAS  Google Scholar 

  3. Gerson MJ, Schonholtz J, Grega CH, Barr DR. The importance of the family context in inflammatory bowel disease. Mt Sinai J Med. 1998; 65(5–6): 398–403.

    PubMed  CAS  Google Scholar 

  4. Whitehead WE, Fedoravicius AS, Blackwell B, Wooley S. A behavioral conceptualization of psychosomatic illness: Psychosomatic symptoms as learned responses. In McNamara JR, ed. Behavioral Approaches in Medicine: Application and Analysis. New York: Plenum; 1979, 65–99.

    Google Scholar 

  5. Fordyce WE. Behavioral Methods for Chronic Pain and Illness. Saint Louis: Mosby, 1976.

    Google Scholar 

  6. Wooley SC, Blackwell B, Winget C. A learning theory model of chronic illness behavior: Theory, treatment, and research. Psychosom Med. 1978; 40(5): 379–401.

    PubMed  CAS  Google Scholar 

  7. Flor H, Kerns RD, Turk DC. The role of spouse reinforcement, perceived pain, and activity levels of chronic pain patients. J Psychosom Res. 1987; 31(2): 251–259.

    Article  PubMed  CAS  Google Scholar 

  8. Flor H, Turk DC, Rudy TE. Relationship of pain impact and significant other reinforcement of pain behaviors: The mediating role of gender, marital status and marital satisfaction. Pain. 1989; 38(1): 45–50.

    Article  PubMed  CAS  Google Scholar 

  9. Kerns RD, Southwick S, Giller EL, Haythornthwaite JA. The relationship between reports of pain-related social interactions and expressions of pain and affective distress. Behav Ther. 1991; 22(1): 101–111.

    Article  Google Scholar 

  10. Keefe FJ, Abernethy AP, Campbell LC. Psychological approaches to understanding and treating disease-related pain. Annu Rev Psychol. 2005; 56: 601–630.

    Article  PubMed  Google Scholar 

  11. Romano JM, Turner JA, Jensen MP, et al. Chronic pain patient–spouse behavioral interactions predict patient disability. Pain. 1995; 63(3): 353–360.

    Article  PubMed  CAS  Google Scholar 

  12. Drossman DA, Corazziari E, Delvaux M, Spiller R, Talley NJ. Rome III: The Functional Gastrointestinal Disorders. McLean, VA: Degnon Associates; 2006: 749

    Google Scholar 

  13. Wilcox-Gök VL. Sibling data and the family background influence on child health. Med Care. 1983; 21(6): 630–638.

    Article  PubMed  Google Scholar 

  14. Lewis CE, Lewis MA, Lorimer A, et al. Child initiated care; the use of school nursing services by children as an “adult free” system. Pediatrics. 1977; 60: 499–507.

    PubMed  CAS  Google Scholar 

  15. Schor E, Starfield B, Stidley C, Hankin J. Family health. Utilization and effects of family membership. Med Care. 1987; 25(7): 616–626.

    Article  PubMed  CAS  Google Scholar 

  16. Whitehead WE, Winget C, Fedoravicius AS, Wooley S, Blackwell B. Learned illness behavior in patients with irritable bowel syndrome and peptic ulcer. Dig Dis Sci. 1982; 27(3): 202–208.

    Article  PubMed  CAS  Google Scholar 

  17. Whitehead WE, Crowell MD, Heller BR, Courtland Robinson J. Modeling and reinforcement of the sick role during childhood predicts adult illness behavior. Psychosom Med. 1994; 56(6): 541–550.

    PubMed  CAS  Google Scholar 

  18. Lowman BC, Drossman DA, Cramer EM, McKee DC. Recollection of childhood events in adults with irritable bowel syndrome. J Clin Gastroenterol. 1987; 9(3): 324–330.

    Article  PubMed  CAS  Google Scholar 

  19. Levy RL, Whitehead WE, Von Korff MR, Feld AD. Intergenerational transmission of gastrointestinal illness behavior. Am J Gastroenterol. 2000; 95(2): 451-456.

    Article  PubMed  CAS  Google Scholar 

  20. Levy RL, Whitehead WE, Walker LS, et al. Increased somatic complaints and health-care utilization in children: Effects of parent IBS status and parent response to gastrointestinal symptoms. Am J Gastroenterol. 2004; 99(12): 2442–2451.

    Article  PubMed  Google Scholar 

  21. Levy RL, Jones KR, Whitehead WE, et al. Irritable bowel syndrome in twins: Heredity and social learning both contribute to etiology. Gastroenterology. 2001; 121(4): 799–804.

    Article  PubMed  CAS  Google Scholar 

  22. Kendler KS, Eaves LJ. The estimation of probandwise concordance in twins: The effect of unequal ascertainment. Acta Genet Med Gemellol (Roma). 1989; 38: 253–270.

    CAS  Google Scholar 

  23. Levy RL, Langer SL, Walker LS, Feld LD, Whitehead WE. Relationship between the decision to take a child to the clinic for abdominal pain and maternal psychological distress. Arch Pediatr Adolesc Med. 2006; 160(9): 961–965.

    Article  PubMed  Google Scholar 

  24. Garber J, Walker LS, Zeman J. Somatization symptoms in a community sample of children and adolescents: Further validation of the children’s somatization inventory. Psychol Assess. 1991; 3: 588–595.

    Article  Google Scholar 

  25. Walker LS, Garber J. Manual for the Children’s Somatization Inventory. Nashville, TN: Vanderbilt University Medical Center, Department of Pediatrics, 2003.

  26. Walker LS, Smith CA, Garber J, Claar RL. Testing a model of pain appraisal and coping in children with chronic abdominal pain. Health Psychology. 2005; 24(4): 364–374.

    Article  PubMed  Google Scholar 

  27. Derogatis LR, Fitzpatrick M. The SCL-90-R, the Brief Symptom Inventory (BSI), and the BSI-18. In Maruish ME, ed. The Use of Psychological Testing for Treatment Planning and Outcomes Assessment: Volume 3: Instruments for Adults. Mahwah, NJ: Lawrence Erlbaum Associates, 2004; 1–41.

    Google Scholar 

  28. Achenbach TM, Brown JS. Bibliography of Published Studies Using the Child Behavior Checklist and Related Material. Burlington: VT: University Associates in Psychiatry, 1988

    Google Scholar 

  29. Achenbach TM, Edelbrock C. Manual for the Child Behavior Checklist and Revised Child Behavior Profile. Burlington: University of Vermont, 1983.

    Google Scholar 

  30. McCubbin H, Patterson J, Wilson L. Family Inventory of Life Events and Changes (FILE). In McCubbin HI, Thompson AI, McCubbin MA, eds. Family Assessment: Resiliency, Coping and Adaptation—Inventories for Research and Practice. Madison: University of Wisconsin System, 1996; 103–178.

    Google Scholar 

  31. Walker LS, Zeman JL. Parental response to child illness behavior. J Pediatr Psychol. 1992; 17(1): 49–71.

    Article  PubMed  CAS  Google Scholar 

  32. Langer SL, Romano JM, Levy RL, Walker LS, Whitehead WE. Catastrophizing and parental response to child symptom complaints. Children’s Health Care. 2009; 38(3): 169–184.

    Article  Google Scholar 

  33. Walker LS, Williams SE, Smith CA, et al. Parent attention versus distraction: Impact on symptom complaints by children with and without chronic functional abdominal pain. Pain. 2006; 122(1–2): 43–52.

    Article  PubMed  Google Scholar 

  34. Walker LS, Williams SE, Smith CA, et al. Validation of a symptom provocation test for laboratory studies of abdominal pain and discomfort in children and adolescents. J Pediatr Psychol. 2006; 31(7): 703–713.

    Article  PubMed  Google Scholar 

  35. Levy RL, Langer SL, Walker LS, et al. Cognitive-behavioral therapy for children with functional abdominal pain and their parents decreases pain and other symptoms. Am J Gastroenterol. 2010; 105(4): 946–956.

    Article  PubMed  Google Scholar 

  36. van Tilburg MAL, Venepalli N, Ulshen M, et al. Parents’ worries about recurrent abdominal pain in children. Gastroenterol Nurs. 2006; 29(1): 50–55.

    Article  PubMed  Google Scholar 

  37. Hicks CL, von Baeyer CL, Spafford PA, van Korlaar I, Goodenough B. The Faces Pain Scale—Revised: Toward a common metric in pediatric pain measurement. Pain. 2001; 93(2): 173–183.

    Article  PubMed  CAS  Google Scholar 

  38. Walker LS, Beck JE, Garber J, Lambert W. Children’s Somatization Inventory: Psychometric properties of the revised form (CSI-24). J Pediatr Psychol. 2009; 34(4): 430–440.

    Article  PubMed  Google Scholar 

  39. Walker LS, Garber J, Greene JW. Somatization symptoms in pediatric abdominal pain patients: Relation to chronicity of abdominal pain and parent somatization. J Abnorm Child Psychol. 1991; 19(4): 379–394.

    Article  PubMed  CAS  Google Scholar 

  40. Van Slyke DA, Walker LS. Mothers’ responses to children’s pain. Clin J Pain. 2006; 22(4): 387–391.

    Article  PubMed  Google Scholar 

  41. Walker LS, Levy RL, Whitehead WE. Validation of a measure of protective parent responses to children’s pain. Clin J Pain. 2006; 22(8): 712–716.

    Article  PubMed  Google Scholar 

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Conflict of Interest

The author has no conflict of interest to disclose.

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Authors and Affiliations

  1. School of Social Work, University of Washington, Mailstop 354900, Seattle, WA, 98105, USA

    Rona L. Levy M.S.W., Ph.D., M.P.H.

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  1. Rona L. Levy M.S.W., Ph.D., M.P.H.
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Correspondence to Rona L. Levy M.S.W., Ph.D., M.P.H..

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Levy, R.L. Exploring the Intergenerational Transmission of Illness Behavior: From Observations to Experimental Intervention. ann. behav. med. 41, 174–182 (2011). https://doi.org/10.1007/s12160-010-9254-9

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  • DOI: https://doi.org/10.1007/s12160-010-9254-9

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