1. The Relation of Negative Life Events to Symptoms and Functioning in Adolescents and Young Adults with a Childhood History of Chronic Abdominal Pain Presentation by: Gerianna Kneeland

2. Chronic abdominal pain Defined as intermittent or constant abdominal pain of at least 3 months duration (American Academy of Pediatrics, 2005) Psychosocial factors influence illness in CAP patients Negative life events Competence may serve as moderator Defined as intermittent or constant abdominal pain of at least 3 months duration (American Academy of Pediatrics, 2005) Psychosocial factors influence illness in CAP patients Negative life events Competence may serve as moderator

3. Hypotheses 1) higher levels of personal stress will be associated with poorer patient outcomes at follow-up including more emotional symptoms, somatic symptoms, and disability 2) personal competence will moderate the effect of life stress on patient outcomes, such that life stress will be associated with poorer outcomes in patients with low competence compared to those with high competence 1) higher levels of personal stress will be associated with poorer patient outcomes at follow-up including more emotional symptoms, somatic symptoms, and disability 2) personal competence will moderate the effect of life stress on patient outcomes, such that life stress will be associated with poorer outcomes in patients with low competence compared to those with high competence

4. Method Recruited from research database Telephone Interview Online Surveys Data analysis assessed by health interview and online surveys Recruited from research database Telephone Interview Online Surveys Data analysis assessed by health interview and online surveys

5. Measures SF-36 Health Survey- assesses functioning and emotions of participants Child/adult Somatization Inventory- assesses the severity of nonspecific somatic symptoms most commonly reported by children with chronic abdominal pain Functional Disability Inventory- assesses the extent to which functional disability limits a child in different activities SF-36 Health Survey- assesses functioning and emotions of participants Child/adult Somatization Inventory- assesses the severity of nonspecific somatic symptoms most commonly reported by children with chronic abdominal pain Functional Disability Inventory- assesses the extent to which functional disability limits a child in different activities

6. Measures (cont.) Life Events Questionnaire (LEQ) - assesses negative life events in the past year Self-Perception Profile For Adults/Adolescents- assesses perceived global and domain-specific competence Life Events Questionnaire (LEQ) - assesses negative life events in the past year Self-Perception Profile For Adults/Adolescents- assesses perceived global and domain-specific competence

7. Results 218 CAP patients 12-32 years 57.8% female 40.7% male 90.8% Caucasian 7.8% other 218 CAP patients 12-32 years 57.8% female 40.7% male 90.8% Caucasian 7.8% other

8. Results Hypothesis #1 (Life stress predicts poor outcomes) SF-36 p-value of.001* and ß of -.292 CSI- p-value of.007* and ß of.188 FDI- p-value of.074 Hypothesis #2 (Competence moderates effect of life stress) CSI- p-value of.035* SF-36 p-value of.236 FDI- p-value of.148 *p<.05 Hypothesis #1 (Life stress predicts poor outcomes) SF-36 p-value of.001* and ß of -.292 CSI- p-value of.007* and ß of.188 FDI- p-value of.074 Hypothesis #2 (Competence moderates effect of life stress) CSI- p-value of.035* SF-36 p-value of.236 FDI- p-value of.148 *p<.05

9. Results Figure 1. The two-way interaction effect of stress and competence on CSI scores Low stress high stress High competence Low competence CSISCORESCSISCORES

10. Limitations Competence is a self-report measure Cross-sectional study Life events were assessed for year preceding interview Limited generalizability Competence is a self-report measure Cross-sectional study Life events were assessed for year preceding interview Limited generalizability

11. Future directions Other factors moderating effect of life stress Turn towards a prospective design Other factors moderating effect of life stress Turn towards a prospective design

12. Acknowledgements Dr. Lynn Walker Grace Shelby, doctoral student assistant Dr. Craig Smith Dr. Lynn Walker Grace Shelby, doctoral student assistant Dr. Craig Smith