Sample Of Healthy Children Research Articles

The relationship between children’s rumination and parental rumination, worry and depressive symptoms

IntroductionRumination is a transdiagnostic phenomenon that is linked to psychological and physical symptoms not only in adulthood but also in childhood. Several distal and proximal factors are believed to underlie the development of ruminative tendencies, with parental characteristics and modelling being among those with a potential association with the increased levels of children’s rumination.ObjectivesThe primary aim of the study was to investigate the link between rumination in children and parental functioning, including rumination, worry and depressive symptoms. Additionally, we aimed to test the association between rumination and psychological and somatic health in a sample of healthy children and early adolescents.Methods153 children (87 girls, mean age = 10.74; SD = 0.91 years) and their parents (130 females, mean age = 42.65; SD = 4.08 years) participated in the study. For children, Kid Rumination Interview (KRI; Baiocco et al., 2017) was used, alongside the assessment of nine subjective health complaints. KRI employes 4 images to measure the frequency of rumination. Self-reported questionnaires were also completed by parents to report on worry, rumination, and depressive symptoms.ResultsContrary to our expectations, there was no significant association between children’s rumination and parental rumination (r = .06, p = .506), worry (r = -.02, p = .850) and depressive symptoms (r = -.01, p = .979). Psychosomatic complaints in children exhibited a positive albeit weak association with parental depressive symptoms (r = .17, p = .046). Regression analysis revealed that the frequency of rumination occurring in the four situations associated significantly with psychosomatic symptoms (β = .266; t = 3.321; p = .001) after controlling for sex and age.Conclusions Our findings are in line with previous studies demonstrating the relationship between rumination and psychosomatic symptoms in older adolescent samples. However, parental perseverative cognitions and depression were unrelated to ruminative tendencies in children. Nevertheless, the modest sample size and the employment of a different assessment approach compared to self-report questionnaires may have influenced our findings.Disclosure of InterestNone Declared

Associations of Hyperactivity and Inattention Scores with Theta and Beta Oscillatory Dynamics of EEG in Stop-Signal Task in Healthy Children 7-10 Years Old.

Simple SummaryMost studies on ADHD have been focused on the comparisons between healthy subjects and clinical patients. The dimensional approaches propose that the main pathological behavioral domains are distributed in the normal population and not only in individual categories of people (as assumed in traditional schemes of comparisons between patients and controls). In the current study, we used a similar approach to identify potential markers of ADHD by studying the EEG dynamics of healthy children with a natural variability in hyperactivity and inattention scores during performance of the Stop-Signal task. We found that hyperactivity/inattention scores were positively associated with RT variability. Hyperactivity/inattention scores were negatively associated with an increase in beta spectral power in the first 200 ms and positively associated with an increase in theta rhythm at about 300 ms after presentation of the Go stimulus. It has been hypothesized that such results imply insufficient vigilance in the early stages of perception and subsequent compensatory enhancing of attention to the stimulus in children with higher hyperactivity and inattention scores.In the current study, we aimed to investigate the associations between the natural variability in hyperactivity and inattention scores, as well as their combination with EEG oscillatory responses in the Stop-Signal task in a sample of healthy children. During performance, the Stop-Signal task EEGs were recorded in 94 Caucasian children (40 girls) from 7 to 10 years. Hyperactivity/inattention and inattention scores positively correlated with RT variability. Hyperactivity/inattention and inattention scores negatively correlated with an increase in beta spectral power in the first 200 ms after presentation of the Go stimulus. Such results are in line with the lack of arousal model in ADHD children and can be associated with less sensory arousal in the early stages of perception in children with symptoms of inattention. The subsequent greater increase in theta rhythm at about 300 ms after presentation of the Go stimulus in children with higher inattention scores may be associated with increased attention processes and compensation for insufficient vigilance in the early stages of perception.

The longitudinal relationship between BOLD signal variability changes and white matter maturation during early childhood

Intra-individual transient temporal fluctuations in brain signal, as measured by fMRI blood oxygenation level dependent (BOLD) variability, is increasingly considered an important signal rather than measurement noise. Evidence from computational and cognitive neuroscience suggests that signal variability is a good proxy-measure of brain functional integrity and information processing capacity. Here, we sought to explore across-participant and longitudinal relationships between BOLD variability, age, and white matter structure in early childhood. We measured standard deviation of BOLD signal, total white matter volume, global fractional anisotropy (FA) and mean diffusivity (MD) during passive movie viewing in a sample of healthy children (aged 2–8 years; N = 83). We investigated how age and white matter development related to changes in BOLD variability both across- and within-participants. Our across-participant analyses using behavioural partial least squares (bPLS) revealed that the influence of age and white matter maturation on BOLD variability was highly interrelated. BOLD variability increased in widespread frontal, temporal and parietal regions, and decreased in the hippocampus and parahippocampal gyrus with age and white matter development. Our longitudinal analyses using linear mixed effects modelling revealed significant associations between BOLD variability, age and white matter microstructure. Analyses using artificial neural networks demonstrated that BOLD variability and white matter micro and macro-structure at earlier ages were strong predictors of BOLD variability at later ages. By characterizing the across-participant and longitudinal features of the association between BOLD variability and white matter micro- and macrostructure in early childhood, our results provide a novel perspective to understand structure-function relationships in the developing brain.

Looking for a cutoff value for the decongestant test in children suffering with turbinate hypertrophy.

The main causes for objectively confirmed chronic impaired nasal breathing in children are adenoid and turbinate hypertrophy. Turbinate hypertrophy may be addressed by turbinate surgery. However, specialized guidelines include no specific indications for pediatric patients. The decongestant test consists of simulating the effect of turbinate surgery by means of a nasal decongestant. This project, developed by the YO-IFOS rhinology group, aims to establish a cutoff value for the nasal decongestant test with rhinomanometry to select children for turbinate surgery. Children between 4 and 15years of age were included. Cases were consecutively selected from children affected by turbinate hypertrophy undergoing turbinate radiofrequency ablation with or without adenoidectomy. Controls were consecutively selected from a sample of healthy children. All the subjects were examined with anterior active rhinomanometry with and without nasal decongestant. Sample included 72 cases and 24 healthy controls. There was a statistically significant difference in the improvement with the decongestant between cases (57.91%) and controls (15.67%). The ROC curve revealed an area under the curve of 0.97. The highest amount of correctly classified individuals (93.44%) corresponded to the cutoff value of 31.66%. However, the value with the highest specificity and highest Youden's index was the 38.88% improvement in nasal resistance with nasal decongestant. In conclusion, a preliminary cutoff value for the decongestant test used with rhinomanometry in children has been established. This test could help identify children for turbinate surgery.

Normal values and ranges of the lateral capitello-humeral angle in healthy children.

The lateral capitello-humeral angle (LCHA), which is an index of sagittal alignment of the elbow, has gradually been adopted for the postoperative assessment of radiographic results. However, the normal values and ranges of the LCHA remain unclear. A retrospective cohort study was performed to evaluate the normal values and ranges of the LCHA in a sample of healthy children with even distributions of age, sex and laterality. A total of 168 radiographs of the elbows of healthy children (age range, 0-11 years) with even distributions of age, sex and laterality were reviewed. The primary aim was to analyze the normal values and ranges of the LCHA categorized by age, sex and laterality. The secondary aim was to assess the association of the LCHA with increasing age. The LCHA between sex or laterality in each age category was also compared. The mean LCHA of the 168 patients was 47.1° (range, 27°-63°). There was a weak association between the LCHA and increasing age (r = 0.41). The mean LCHA in females (49.1°) was significantly larger than that in males (45.1°). Significant sex-related differences were observed in age categories between 2 and 7 years. Results of this study will be useful in the postoperative radiographic assessment of sagittal alignment of the elbow in children.

Swedish translation and validation of the Pediatric Insomnia Severity Index

BackgroundTo increase health and well-being in young children, it is important to acknowledge and promote the child’s sleep behaviour. However, there is a lack of brief, validated sleep screening instruments for children. The aims of the study were to (1) present a Swedish translation of the PISI, (2) examine the factor structure of the Swedish version of PISI, and test the reliability and validity of the PISI factor structure in a sample of healthy children in Sweden.MethodsThe English version of the PISI was translated into Swedish, translated back into English, and agreed upon before use. Parents of healthy 3- to 10-year-old children filled out the Swedish version of the PISI and the generic health-related quality of life instrument KIDSCREEN-27 two times. Exploratory and confirmatory factor analyses for baseline and test-retest, structural equation modelling, and correlations between the PISI and KIDSCREEN-27 were performed.ResultsIn total, 160 parents filled out baseline questionnaires (test), whereof 100 parents (63%) filled out the follow-up questionnaires (retest). Confirmative factor analysis of the PISI found two correlated factors: sleep onset problems (SOP) and sleep maintenance problems (SMP). The PISI had substantial construct and test-retest reliability. The PISI factors were related to all KIDSCREEN-27 dimensions.ConclusionsThe Swedish version of the PISI is applicable for screening sleep problems and is a useful aid in dialogues with families about sleep.

Health-related Quality of Life in Newly Diagnosed Pediatric Patients With Celiac Disease.

Celiac disease (CD) is a common chronic condition with potential adverse physical and psychosocial implications for affected children. The study purpose was to characterize health-related quality of life (HRQOL) in a large sample of pediatric patients with newly diagnosed CD using the PedsQL 4.0 Generic Core Scales, and compare it to that of healthy children and children with nonceliac gastrointestinal (GI) conditions using historic data. The PedsQL was administered to 159 children with newly diagnosed CD and their parents at either the time of diagnostic esophagogastroduodenoscopy or before their initial dietitian appointment for gluten-free diet teaching. Mean parent-report and self-report PedsQL summary and subscale scores were calculated, then compared to published means from a sample of healthy children and a sample of children with nonceliac GI symptoms using 1-sample t tests. Compared to the healthy children, those with newly diagnosed CD had lower Total Scores, Physical Health, Psychosocial Health, Emotional Functioning, and School Functioning on parent report (P < 0.008) with similar findings on self-report. Within the CD sample, clinically significant scores were found in 55.9% for School Functioning, 62.7% for Physical Health, 54.4% for Emotional Functioning, 43.7% for Social Functioning, and 49% for Total Score. Children and adolescents with newly diagnosed CD had lower HRQOL than healthy children and similar HRQOL to that of patients with nonceliac GI conditions. Patients with deficits in domains such as school or emotional functioning may benefit from early interventions including a Section 504 plan or meeting with a psychologist or social worker.

P22 What impact does juvenile idiopathic arthritis (JIA) have on quality of life over time?

Poster presentation Tuesday 8 October Background Juvenile idiopathic arthritis (JIA) is a heterogeneous group of arthritic conditions presenting in children and young people, in which physical limitations and associated complications can have detrimental effects on physical and psychosocial wellbeing. This study aims to investigate the impact of living with JIA on different aspects of health-related quality of life (HRQoL) and to explore how this changes over time, using data from the Childhood Arthritis Prospective Study (CAPS). Methods Longitudinal data collected as part of CAPS were analysed. HRQoL was assessed at baseline, 1 year and 3 years post-diagnosis using the Child Health Questionnaire (CHQ), a parent-completed form for children from 5 years of age. The CHQ measures physical, emotional and social components of child health status. Raw domain scores were transformed via algorithm into values ranging from 0-100, with higher scores indicating better health status. Mean (standard deviation) and median (interquartile range) for each domain were determined. Differences between median scores at baseline and 3 years were assessed using the Wilcoxon signed-rank test. Mean scores of each domain were visually compared with a reference population sample of healthy children from the United States. Results 184 participants completed the questionnaire at all 3 time points. At baseline, compared to the reference population, children with JIA scored lower in every domain although scores were closer between the 2 groups at 3 years. Median scores improved over time, the exception being the “general health perceptions” domain which decreased after baseline. Domains with the greatest improvement were “physical functioning”, “bodily pain” and “social-physical”. The largest changes occurred from baseline to 1 year. Statistically significant differences between baseline and 3 year scores were found for all domains. Conclusion JIA has significant impact on HRQoL, which improves within 3 years of diagnosis. Physical health domains show greater improvement over time than psychosocial domains, although psychosocial scores were generally higher throughout the study. Further research should explore measurable patient or disease-related drivers of HRQoL. Conflicts of Interest The authors declare no conflicts of interest.

Assessment of EPInfant scale for exercise intensity perceptual self-regulation in healthy children.

The EPInfant scale has been validated for the perceptual estimation of physical exer tion in Chilean children, but its usefulness for self-regulation of exercise intensity is unknown. The objective of the study was to evaluate the criterion validity of the EPInfant scale to regulate and re produce exercise intensity in a sample of healthy children. 15 children between the ages of eight and 12 were selected for an incremental exercise test (IET) and three perceptually regulated exercise tests (PRET) on a treadmill. The tests were performed with a 48-hour interval between them. In the PRET, the exercise load was adjusted perceptually for five minutes, randomly considering levels 3, 6, and 9 of the EPInfant scale. The average heart rate (HR) during PRET was considered as the perceptually reproduced intensity. Variance analysis, simple linear regression, and reliability analysis were used to determine the reproducibility of HR during PRET. There was a significant difference in HR between perceptual levels during PRET (p < 0.001). Additionally, a correlation was observed between HR during the IET and the PRET (r = 0.83, r2 = 0.69). The intra class correlation coefficient was 0.76, 0.83. and 0.93 at perceptual levels 3, 6, and 9; and the mean dis cordance between HR during the IET and the PRET was -2.4 beats/min. In the studied sample, the EPInfant scale was valid to allow the perceptual regulation and reproduction of exercise intensity in a treadmill.

Bullying the Brain? Longitudinal Links Between Childhood Peer Victimization, Cortisol, and Adolescent Brain Structure.

Background: Childhood peer victimization is a stressful life experience associated with long-lasting adverse psychological consequences. While there is some evidence that victimization is associated with alterations in brain function, little is known about effects on brain structure. This study explored the relationships between childhood peer victimization, cortisol, and adolescent ventrolateral prefrontal cortex (vlPFC) structure in a sample of healthy children.Methods: A total of 50 (Mage = 9.29 years at baseline) children participated in this longitudinal study. We examined whether diurnal cortisol levels (assessed at baseline) moderated the link between children’s self-reported peer victimization (assessed at baseline) and vlPFC surface area, gray matter volume, and thickness 5 years later.Results: For boys, cortisol levels moderated the association between victimization and brain structure. For boys with a low daily cortisol output (assessed as area under the curve; AUC), high victimization was associated with a smaller right vlPFC surface area, and for boys with a high AUC, high victimization was associated with a larger right vlPFC surface area. In addition, for boys with a steeper diurnal slope, high victimization was associated with a smaller right vlPFC surface area, and for boys with a low flatter diurnal slope, high victimization was associated with a larger right vlPFC surface area.Conclusion: These results indicate the differential influence of cortisol on the relationship between victimization and brain structure. Findings suggest that victimization may have differential effects on brain development in boys who are more versus less biologically sensitive to stress.

The Influence of Age, Sex, Visual Feedback, Bulb Position, and the Order of Testing on Maximum Anterior and Posterior Tongue Strength in Healthy Belgian Children.

Tongue strength and its role in the pathophysiology of dysphagia in adults are well accepted and studied. An objective and reliable measurement of tongue strength in children necessitates equally good methodology, knowledge of influencing factors, and normative data. Only limited data on testing tongue strength in children are available thereby limiting its potential use. The present study examined tongue strength and several parameters known to be important in adults in the largest sample of healthy children from 3 to 11years old to date using the Iowa Oral Performance Instrument with standard bulbs. Tongue strength increases markedly for children between 6 and 7years, with slower increases before and after this age. Unlike adults, no influence of sex or location was found on the maximum tongue strength in children, and visual feedback was found to be counterproductive in obtaining the highest tongue pressures. The normative data obtained can be used for objective assessment of tongue weakness and subsequent therapy planning in dysphagic children.

Normal value and range of the humerus-elbow-wrist angle in a sample of healthy children with even distributions of age, sex, and laterality.

This study was performed to evaluate the normal value of the humerus-elbow-wrist angle (HEWA) in a sample of healthy children with even distributions of age, sex, and laterality. A total of 168 radiographs of the elbows of healthy children with even distributions of age, sex, and laterality were reviewed. The mean HEWA was 12.1° (range: 5°-20°). The value of HEWA was significantly associated with increasing age. Neither sex nor side showed significant differences for the HEWA. The data should be useful for postoperative radiographic assessment of cubitus varus or valgus deformities.

An exploratory factor analysis of the procedural coping questionnaire

ABSTRACTThe current study seeks to examine the factor structure of the Procedural Coping Questionnaire (PCQ) in a sample of healthy children. In addition, the relation between the PCQ, a measure of medical procedure-specific coping strategies, was examined in relation to the Children’s Behavioral Styles Scale (CBSS), a measure of dispositional coping style. A sample of 192 healthy children completed an 18-item version of the PCQ and the CBSS. Exploratory factor analyses were conducted to examine factor structure of the PCQ. Correlations between each factor of the PCQ and subscales of the CBSS were examined. The EFA yielded a two-factor solution for the final 15 items of the PCQ retained, fitting theoretical conceptualizations of engagement/approach and disengagement/avoidant coping styles. Moderate to strong correlations were found between the Approach/Avoidant factors of the PCQ and the Monitoring/Blunting subscales of the CBSS. The results support the PCQ as a measure of situation-specific (i.e., medical procedure) approach-avoidant coping styles in healthy children.

Determination of peak cardiorespiratory fitness parameters in children: which averaging method should we use?

ABSTRACTThe purpose of this study was to identify which averaging methods most accurately measures peak cardiorespiratory fitness (CRF) parameters [peak O2 uptake (VO2), peak O2pulse and peak respiratory exchange ratio (RER)] in a sample of healthy children and adolescents. In this cross-sectional multicenter study, we recruited 278 healthy children aged 12–17 years. We compared the mean peak value of three CRF parameters using the recommended averaging methods (30-second block average) with alternative averaging methods such as moving averages or shorter smoothing periods. We also assessed averaging methods for accuracy by individually reviewing breath-by-breath scatter plots. The 30-second block average method resulted in a lower mean peak VO2 and in an increased proportion of underestimated peak values. Using a 30-second moving average significantly increased mean peak values which increased accuracy. Similar results were found for peak RER and peak O2pulse. In conclusion, the currently recommended averaging method (30-second block average) increased the risk of misinterpretation of peak CRF values in children. Using a moving average approach decreased misinterpretation and increased accuracy.

Cortical Structures Associated With Sports Participation in Children: A Population-Based Study

ABSTRACTWe studied cortical morphology in relation to sports participation and type of sport using a large sample of healthy children (n = 911). Sports participation data was collected through a parent-reported questionnaire. Magnetic resonance scans were acquired, and different morphological brain features were quantified. Global volumetric measures were not associated with sports participation. We observed thicker cortex in motor and premotor areas associated with sports participation. In boys, team sports participation, relative to individual sports, was related to thinner cortex in prefrontal brain areas involved in the regulation of behaviors. This study showed a relationship between sports participation and brain maturation.

The relationship between foot arch measurements and walking parameters in children.

BackgroundWalking mechanics are influenced by body morphology. Foot arch height is one aspect of body morphology central to walking. However, generalizations about the relationship between arch height and walking are limited due to previous methodologies used for measuring the arch and the populations that have been studied. To gain the knowledge needed to support healthy gait in children and adults, we need to understand this relationship in unimpaired, typically developing children and adults using dynamic measures. The purpose of the current study was to examine the relationship between arch height and gait in a sample of healthy children and adults using dynamic measures.MethodsData were collected from 638 participants (n = 254 children and n = 384 adults) at the Museum of Science, Boston (MOS) and from 18 4- to 8-year-olds at the Motor Development and Motor Control Laboratories. Digital footprints were used to calculate two arch indices: the Chippaux-Smirak (CSI) and the Keimig Indices (KI). The height of the navicular bone was measured. Gait parameters were captured with a mechanized gait carpet at the MOS and three-dimensional motion analyses and in-ground force plates in the Motor Development and Motor Control Laboratories.ResultsLinear regression analyses on data from the MOS confirmed that as age increases, step length increases. With a linear mixed effect regression model, we found that individuals who took longer steps had higher arches as measured by the KI. However, this relationship was no longer significant when only adults were included in the model. A model restricted to children found that amongst this sample, those with higher CSI and higher KI values take longer relative step lengths. Data from the Motor Development and Motor Control Laboratories showed that both CSI and KI added to the prediction; children with lower anterior ground reaction forces had higher CSI and higher KI values. Arch height indices were correlated with navicular height.ConclusionsThese results suggest that more than one measure of the arch may be needed elucidate the relationship between arch height and gait.Electronic supplementary materialThe online version of this article (doi:10.1186/s12887-016-0554-5) contains supplementary material, which is available to authorized users.

Acute Effects of Whole Body Vibration on Inhibition in Healthy Children.

ObjectivesWhole Body Vibration (WBV) is a passive exercise method known to have beneficial effects on various physical measures. Studies on adults furthermore demonstrated beneficial effects of WBV treatment on cognition (e.g. inhibition). The present study replicated these findings in healthy children and examined acute effects of WBV treatment on inhibition.MethodsFifty-five healthy children (aged 8–13) participated in this within-subject design study. WBV treatment was applied by having the children sit on a chair mounted to a vibrating platform. After each condition (vibration vs. non-vibration), inhibition was measured by using the Stroop Color-Word Interference Test. Repeated measures analyses were applied in order to explore the effects of WBV treatment on inhibition, and correlations were computed between the treatment effect and participant characteristics in order to explore individual differences in treatment sensitivity.ResultsThree-minute WBV treatments had significant beneficial effects on inhibition in this sample of healthy children. Especially the repeated application (three times) of WBV treatment appeared beneficial for cognition. Stronger WBV treatment effects were correlated with higher intelligence and younger age, but not with symptoms of Attention Deficit Hyperactivity Disorder (ADHD).ConclusionsThis study demonstrates that especially repeated WBV treatment improves inhibition in healthy children. As this cognitive function is often impaired in children with developmental disorders (e.g. ADHD), future studies should further explore the effects, working mechanism and potential applicability of WBV treatment for this target group.

Serum Polybrominated Diphenyl Ether Concentrations And Thyroid Function In Young Children

Introduction: Thyroid hormones are essential for neurodevelopment in early childhood. There is evidence that exposure to polybrominated diphenyl ethers (PBDEs) affects thyroid function, but previous studies have been inconsistent, and no studies in children have been conducted in the United States where PBDE levels are particularly high. Methods: Serum levels of six low-brominated PBDE congeners and thyroid hormones were measured in a sample of healthy children (N=81) aged 1-5 years who were under anesthesia for ear tube surgery. Parents of the children completed a questionnaire with details on demographics, behaviors such as smoking and breastfeeding, and family history of thyroid disorders. In multivariate linear regression models, we assessed quartiles and continuous log-transformed PBDE concentrations in relation to markers of thyroid function. PBDEs were expressed on a volume basis, and serum lipids were included as a covariate. Results: Detection frequencies varied by congener. PBDE-47, 99 and 100 were detected in =80% of samples, and were summed (∑PBDE). The median ∑PBDE was 54.04 ng/g lipid or 0.19 ng/mL. PBDEs were positively associated with thyroid-stimulating hormone (TSH) and inversely associated with total thyroxine (T4). Compared with children in the lowest quartile of ∑PBDE exposure, children in higher quartiles had significantly increased TSH (β=0.45, 95% confidence interval (CI): 0.04, 0.85, β=0.46, 95% CI: 0.07, 0.86, and β=0.48, 95% CI: 0.06, 0.90 for the second, third and fourth quartiles, respectively). For an interquartile range increase in ∑PBDE we estimated a 20.9% increase in TSH (95% CI: 3.4, 41.2), and a 0.28 ug/dl decrease in total T4 (95% CI: -0.76, 0.20). Conclusion: Results suggest that exposure to PBDEs during childhood disrupts thyroid hormone function, with a tendency toward hypothyroidism. These results highlight the importance of considering early life exposures in the context of critical windows of development.

Factor structure of the Inventory of Parent Accommodations of Children’s Symptoms (IPACS) in a community sample

ABSTRACTObjective: To examine the factor structure of the Inventory of Parent Accommodations of Children’s Symptoms (IPACS) among a community sample of healthy children. Method: An online survey was completed by 220 parents ages 18-65 (M = 34.49; 96% female) for a study examining the effects of parent behaviors on frequency of general sickness and pain complaints (e.g., headaches and stomachaches) in otherwise healthy children. The survey included the IPACS, a measure of parent behaviors and responses to sickness or pain complaints, as well as items that assessed sociodemographics and frequency of sickness and pain complaints in children. Results: Exploratory factors analysis of the IPACS revealed a 12-item measure yielding three discrete, yet related subscales. Additionally, parent accommodations were slightly associated with an increase in sickness and pain complaints in children (r (220) = .153, p<.05). Conclusions: These findings suggest that parent behaviors during general sickness and pain complaints may serve as clinically relevant information that can be used to inform interventions that target specific parent behaviors that might exacerbate symptoms. Future research should examine the convergent validity of this measure with other measures of parenting behavior, as well as the specific utility of the IPACS in chronic illness and pain populations.

Relationship of Salivary Alpha Amylase and Cortisol to Social Anxiety in Healthy Children Undergoing Laboratory Pain Tasks

Objective: Salivary alpha amylase (sAA) has been shown to be a sensitive and reliable marker of the autonomic nervous system (ANS) response to stress. A link between sAA, cortisol, and social/evaluative stress has been established in youth, but little is known about these relationships in response to other stressors in children, and how social anxiety might moderate these relationships. The current study explored the associations among sAA and salivary cortisol responses to laboratory pain tasks and self-reported social anxiety symptoms in a sample of healthy children. Method: Two hundred thirty-one children (114 girls; 49.4%) with a mean age 12.68 years (SD=3.0; range 7-18) participated in the study. Participants completed self-report questionnaires prior to undergoing a series of laboratory pain tasks involving cold, pressure, and heat pain. Saliva samples were collected upon arrival to the laboratory (pretask), following the completion of the pain tasks (post-task1), and 20 minutes after the completion of the pain tasks (post-task2). Results: Demographic factors (age, sex, pubertal stage) did not predict either sAA or cortisol levels. However, children reporting higher levels of social anxiety demonstrated significantly higher sAA but not cortisol levels across three salivary collection times, compared to children reporting lower levels of social anxiety. Further, it does not appear that reduced state levels of anxiety before or during the tasks buffer this relationship. Conclusion: These data highlight the possibility of identifying biomarkers of stress that are consistent across time and developmental stage. sAA appears to be a marker of stress response in children with self-reported social anxiety. There may also be a potentially unique relationship of sAA to stress in this population. In addition, sAA may reflect stable individual differences in levels of ANS arousal and may be a useful biomarker for identifying children at risk for stress.