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Article
February 2013

Twelve-Month Follow-up of Cognitive Behavioral Therapy for Children With Functional Abdominal Pain

Author Affiliations

Author Affiliations: School of Social Work (Drs Levy and Langer and Mss DuPen and Ballard), and Department of Psychiatry and Behavioral Sciences (Dr Romano), University of Washington, Seattle; Department of Pediatrics, Vanderbilt University, Nashville, Tennessee (Dr Walker); Department of Gastroenterology, Seattle Children's Hospital, Seattle, Washington (Dr Christie); Digestive Healthcare Center, Hillsborough, and NPS Pharmaceuticals, Bedminster (Dr Youssef), New Jersey; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (Dr Labus); Division of Epidemiology, University of Minnesota, Minneapolis (Dr Welsh); Mount Sinai School of Medicine, New York, New York (Ms Feld); and Department of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill (Dr Whitehead).

JAMA Pediatr. 2013;167(2):178-184. doi:10.1001/2013.jamapediatrics.282
Abstract

Objective To determine whether a brief intervention for children with functional abdominal pain and their parents' responses to their child's pain resulted in improved coping 12 months later.

Design Prospective, randomized, longitudinal study.

Setting Families were recruited during a 4-year period in Seattle, Washington, and Morristown, New Jersey.

Participants Two hundred children with persistent functional abdominal pain and their parents.

Interventions A 3-session social learning and cognitive behavioral therapy intervention or an education and support intervention.

Main Outcome Measures Child symptoms and pain-coping responses were monitored using standard instruments, as was parental response to child pain behavior. Data were collected at baseline and after treatment (1 week and 3, 6, and 12 months after treatment). This article reports the 12-month data.

Results Relative to children in the education and support group, children in the social learning and cognitive behavioral therapy group reported greater baseline to 12-month follow-up decreases in gastrointestinal symptom severity (estimated mean difference, −0.36; 95% CI, −0.63 to −0.01) and greater improvements in pain-coping responses (estimated mean difference, 0.61; 95% CI, 0.26 to 1.02). Relative to parents in the education and support group, parents in the social learning and cognitive behavioral therapy group reported greater baseline to 12-month decreases in solicitous responses to their child's symptoms (estimated mean difference, −0.22; 95% CI, −0.42 to −0.03) and greater decreases in maladaptive beliefs regarding their child's pain (estimated mean difference, −0.36; 95% CI, −0.59 to −0.13).

Conclusions Results suggest long-term efficacy of a brief intervention to reduce parental solicitousness and increase coping skills. This strategy may be a viable alternative for children with functional abdominal pain.

Trial Registration clinicaltrials.gov Identifier:NCT00494260

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