Research code: 162384511
Ethics code: IR.IAU.NAJAFABAD.REC.1401.1
Clinical trials code: مستخرج از رساله دکتری
Assistant Professor, Department of Health Psychology, Faculty of Medicine, Najafabad Branch, Islamic Azad University, Najafabad, Iran. , Dransarishahidi@gmail.com
Abstract: (615 Views)
Background & Aims: Children are the most vulnerable human population and are highly vulnerable to life-threatening conditions including diseases (1). The majority of abdominal chronic pain (FAP) is functional in children and adolescents and has no objective evidence for organic pathology. Meanwhile, psychological pain in children is a common disease that affects both psychological and physiological aspects. This disease is characterized by frequent symptoms such as abdominal pain, headache, chest pain, and musculoskeletal pain (3). Functional abdominal pain syndrome is characterized by frequent or continuous abdominal pain along with the degree of loss of daily activity in the absence of a change in bowel habits (5).
These pains create various physical and psychological stresses such as lack of health, continuous pain, sensory deprivation, and a different degree of psychological reactions such as despair, fatigue, and fear, leading to feelings of worthlessness and loss of confidence in the patient and consequently, inability to perform everyday tasks (6). Therefore, psychological distress appearing through physical symptoms is common among children and treatment can be challenging (7).
Children are facing significant changes in understanding other people's minds. The study of how and when children grow up to be aware of beliefs, their mental states, and that of others, leads to better understanding and better predictions of their behaviors, which have been discussed as theories of children's minds (13). The theory of mind or mind-building in terms of phonetics and Batman in terms of the ability to think and understand other people's state of mind to understand what they feel and why those feelings are caused (14). Foonagy and Concrete proposed that the children's experiences are perceived by caregivers and given feedback to them about the experience, which makes them a useful model for children. also mental ability is a key determinant in self-organization and the growth of emotion regulation ability (16).
Early childhood environments can significantly affect the physical and psychological problems of children (8). The interaction between parent-child relationships is how the child-parent relationship affects the emotional and psychological relationships. The quality of this relationship affects behavior, emotional growth, educational performance, and social growth (10). Inappropriate interactions can cause emotional and behavioral disturbances and eliminate many children's intellectual and emotional talents.
Emotion regulation is significantly associated with mental pain in children. Children with more emotional, positive, and negative instabilities experience higher pain intensity. Pain intensity also changes when positive and negative emotions are higher or lower than the normal level of the child (17). Furthermore, pain intensity is less when negative and positive emotions are successfully adjusted or recovered to adaptive levels (18).
Chronic abdominal pain can negatively affect the quality of life of a child and lead to a decrease in educational and social performance in children. The lack of research background and research gap in the literature and presenting the abdominal pain model, led to this study to attempt to provide the structure model of abdominal PSD based on the relationship between parent-child and mind-making with emotion regulation in children aged 10-12 years.
Methods: The present research method was descriptive and correlation and structural equations type.
The statistical population of the study included all children aged 10 to 12 years with functional abdominal paine disorders in Isfahan city in 1402. 179 children were selected by available sampling method from specialized gastrointestinal disorders clinics of Isfahan city based on inclusion criteria. Data collection tools included Parent-Child Relationship Questionnaires (Pianta, 2011), Ziegelman Theory of Mind (1999), Gulen and Toff Emotion Regulation Questionnaire (2012), and Walker&al (2012) Revised Index of Abdominal Pain (2012). To test the hypotheses, the structural equation statistical method was used in SMART PLS-4 software.
Result: To present the structural model of functional abdominal pain based on the relationship between the child's parent and the child's emotional regulation for 10-12 years, the research data are analyzed both descriptive and inferential. In the descriptive statistics section, the average indicators and standard deviation were used to describe the research data. In terms of the demographic variable of children's age; The mean and standard deviation of the age of participation in this study were 11.45 and 13.1, respectively and the mean and standard deviation of the age of parents were 42.00 and 50.7, respectively.the results of the research revealed that, the direct regression paths of the parent-child relationship to abdominal pain are -0.25 and the parent-child relation to suppression is -0.28, which is significant at 0.01 levels. Also, there are paths direct of mentalization to re-evaluate 0.21, mentalization to abdominal pain -0.24, and mentalization to suppression strategies -0.17. These coefficients are significant (p<0.05). The results showed that of four indirect paths with mediating the role of emotional regulation strategy, only two indirect paths are the parent-child relation-> suppression-> abdominal pain with the amount of modified relationship equal to -0.042 and t=2/8-0.042 and mentalization -> stomach aches are significantly related to the level of 05/0p<0.040 and t=1/99 -0.040, which is statistically significant. That is, the repression strategy has indirectly and significantly affected the child's parent's relationship with the children's abdominal paine and reevaluation strategy (p<0.05).
Conclusion: study called Psychological Factors in Children's Abdominal Pain Disorder, states that attachment is an emotional bond between parent and child and that it creates normal behaviors in children, especially when they feel uncomfortable or threatened. Pain is a threatening experience that drives attachment behaviors in children. In pain, children look to their parents for comfort and help. However, if children cannot trust their parents to provide comfort (insecure attachment), they may not benefit from learning opportunities that parents can provide about the best way to cope with pain. Mark 2012 and Robert 2013 have stated in their research that emotion regulation has been significantly associated with psychological pain in children. Children with more emotional, positive, and negative instabilities experience higher pain intensity. Pain intensity also changes when positive and negative emotions are higher or lower than the normal level of the child (17).
A review of articles from 2013 to 2023 shows mental pain and emotion regulation can play a role in predicting abdominal pain in children aged 10 to 12 years. During their research over the years, the authors have found out that children with chronic abdominal pain are mentally sensitive to pain and can perform more negative motor therapy than healthy children. They also had more difficulty adjusting their emotions (38-40).
Therefore, it is recommended to perform more research in other geographical regions to increase the generalization of the findings. The study population is limited to the patients referring to the specialized children's digestive clinic. Meanwhile, a sample of this study is available and generalization of results to all children with functional abdominal pain disorder in Isfahan city and other areas of the country should be collected with caution. It is necessary that in future studies, a larger sample size is investigated. On the other hand, considering the special conditions of social quarantine, it is not possible to hold a follow-up period. It is recommended that others should consider the tracking stage to evaluate the persistence of medical results and of course the research limitations in this area.
These pains create various physical and psychological stresses such as lack of health, continuous pain, sensory deprivation, and a different degree of psychological reactions such as despair, fatigue, and fear, leading to feelings of worthlessness and loss of confidence in the patient and consequently, inability to perform everyday tasks (6). Therefore, psychological distress appearing through physical symptoms is common among children and treatment can be challenging (7).
Children are facing significant changes in understanding other people's minds. The study of how and when children grow up to be aware of beliefs, their mental states, and that of others, leads to better understanding and better predictions of their behaviors, which have been discussed as theories of children's minds (13). The theory of mind or mind-building in terms of phonetics and Batman in terms of the ability to think and understand other people's state of mind to understand what they feel and why those feelings are caused (14). Foonagy and Concrete proposed that the children's experiences are perceived by caregivers and given feedback to them about the experience, which makes them a useful model for children. also mental ability is a key determinant in self-organization and the growth of emotion regulation ability (16).
Early childhood environments can significantly affect the physical and psychological problems of children (8). The interaction between parent-child relationships is how the child-parent relationship affects the emotional and psychological relationships. The quality of this relationship affects behavior, emotional growth, educational performance, and social growth (10). Inappropriate interactions can cause emotional and behavioral disturbances and eliminate many children's intellectual and emotional talents.
Emotion regulation is significantly associated with mental pain in children. Children with more emotional, positive, and negative instabilities experience higher pain intensity. Pain intensity also changes when positive and negative emotions are higher or lower than the normal level of the child (17). Furthermore, pain intensity is less when negative and positive emotions are successfully adjusted or recovered to adaptive levels (18).
Chronic abdominal pain can negatively affect the quality of life of a child and lead to a decrease in educational and social performance in children. The lack of research background and research gap in the literature and presenting the abdominal pain model, led to this study to attempt to provide the structure model of abdominal PSD based on the relationship between parent-child and mind-making with emotion regulation in children aged 10-12 years.
Methods: The present research method was descriptive and correlation and structural equations type.
The statistical population of the study included all children aged 10 to 12 years with functional abdominal paine disorders in Isfahan city in 1402. 179 children were selected by available sampling method from specialized gastrointestinal disorders clinics of Isfahan city based on inclusion criteria. Data collection tools included Parent-Child Relationship Questionnaires (Pianta, 2011), Ziegelman Theory of Mind (1999), Gulen and Toff Emotion Regulation Questionnaire (2012), and Walker&al (2012) Revised Index of Abdominal Pain (2012). To test the hypotheses, the structural equation statistical method was used in SMART PLS-4 software.
Result: To present the structural model of functional abdominal pain based on the relationship between the child's parent and the child's emotional regulation for 10-12 years, the research data are analyzed both descriptive and inferential. In the descriptive statistics section, the average indicators and standard deviation were used to describe the research data. In terms of the demographic variable of children's age; The mean and standard deviation of the age of participation in this study were 11.45 and 13.1, respectively and the mean and standard deviation of the age of parents were 42.00 and 50.7, respectively.the results of the research revealed that, the direct regression paths of the parent-child relationship to abdominal pain are -0.25 and the parent-child relation to suppression is -0.28, which is significant at 0.01 levels. Also, there are paths direct of mentalization to re-evaluate 0.21, mentalization to abdominal pain -0.24, and mentalization to suppression strategies -0.17. These coefficients are significant (p<0.05). The results showed that of four indirect paths with mediating the role of emotional regulation strategy, only two indirect paths are the parent-child relation-> suppression-> abdominal pain with the amount of modified relationship equal to -0.042 and t=2/8-0.042 and mentalization -> stomach aches are significantly related to the level of 05/0p<0.040 and t=1/99 -0.040, which is statistically significant. That is, the repression strategy has indirectly and significantly affected the child's parent's relationship with the children's abdominal paine and reevaluation strategy (p<0.05).
Conclusion: study called Psychological Factors in Children's Abdominal Pain Disorder, states that attachment is an emotional bond between parent and child and that it creates normal behaviors in children, especially when they feel uncomfortable or threatened. Pain is a threatening experience that drives attachment behaviors in children. In pain, children look to their parents for comfort and help. However, if children cannot trust their parents to provide comfort (insecure attachment), they may not benefit from learning opportunities that parents can provide about the best way to cope with pain. Mark 2012 and Robert 2013 have stated in their research that emotion regulation has been significantly associated with psychological pain in children. Children with more emotional, positive, and negative instabilities experience higher pain intensity. Pain intensity also changes when positive and negative emotions are higher or lower than the normal level of the child (17).
A review of articles from 2013 to 2023 shows mental pain and emotion regulation can play a role in predicting abdominal pain in children aged 10 to 12 years. During their research over the years, the authors have found out that children with chronic abdominal pain are mentally sensitive to pain and can perform more negative motor therapy than healthy children. They also had more difficulty adjusting their emotions (38-40).
Therefore, it is recommended to perform more research in other geographical regions to increase the generalization of the findings. The study population is limited to the patients referring to the specialized children's digestive clinic. Meanwhile, a sample of this study is available and generalization of results to all children with functional abdominal pain disorder in Isfahan city and other areas of the country should be collected with caution. It is necessary that in future studies, a larger sample size is investigated. On the other hand, considering the special conditions of social quarantine, it is not possible to hold a follow-up period. It is recommended that others should consider the tracking stage to evaluate the persistence of medical results and of course the research limitations in this area.
Keywords: abdominal pain, child-parent relationship, mentalization, emotional regulation, children, psychosomatic
Type of Study: Research |
Subject:
Clinical Psychiatry
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