%0 Journal Article %J JAMA Pediatr %D 2013 %T Twelve-month follow-up of cognitive behavioral therapy for children with functional abdominal pain. %A Levy, Rona L %A Langer, Shelby L %A Walker, Lynn S %A Romano, Joan M %A Christie, Dennis L %A Youssef, Nader %A DuPen, Melissa M %A Ballard, Sheri A %A Labus, Jennifer %A Welsh, Ericka %A Feld, Lauren D %A Whitehead, William E %K Abdominal Pain %K Adaptation, Psychological %K Adolescent %K Adult %K Child %K Cognitive Therapy %K Female %K Follow-Up Studies %K Gastrointestinal Diseases %K Humans %K Illness Behavior %K Linear Models %K Male %K Middle Aged %K Pain Measurement %K Parent-Child Relations %K Prospective Studies %K Treatment Outcome %X

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.

%B JAMA Pediatr %V 167 %P 178-84 %8 2013 Feb %G eng %N 2 %R 10.1001/2013.jamapediatrics.282 %0 Journal Article %J Am J Gastroenterol %D 2010 %T Cognitive-behavioral therapy for children with functional abdominal pain and their parents decreases pain and other symptoms. %A Levy, Rona L %A Langer, Shelby L %A Walker, Lynn S %A Romano, Joan M %A Christie, Dennis L %A Youssef, Nader %A DuPen, Melissa M %A Feld, Andrew D %A Ballard, Sheri A %A Welsh, Ericka M %A Jeffery, Robert W %A Young, Melissa %A Coffey, Melissa J %A Whitehead, William E %K Abdominal Pain %K Adaptation, Psychological %K Adolescent %K Child %K Cognitive Therapy %K Disability Evaluation %K Female %K Humans %K Linear Models %K Male %K Pain Measurement %K Parent-Child Relations %K Parents %K Prospective Studies %K Treatment Outcome %X

OBJECTIVES: Unexplained abdominal pain in children has been shown to be related to parental responses to symptoms. This randomized controlled trial tested the efficacy of an intervention designed to improve outcomes in idiopathic childhood abdominal pain by altering parental responses to pain and children's ways of coping and thinking about their symptoms.

METHODS: Two hundred children with persistent functional abdominal pain and their parents were randomly assigned to one of two conditions-a three-session intervention of cognitive-behavioral treatment targeting parents' responses to their children's pain complaints and children's coping responses, or a three-session educational intervention that controlled for time and attention. Parents and children were assessed at pretreatment, and 1 week, 3 months, and 6 months post-treatment. Outcome measures were child and parent reports of child pain levels, function, and adjustment. Process measures included parental protective responses to children's symptom reports and child coping methods.

RESULTS: Children in the cognitive-behavioral condition showed greater baseline to follow-up decreases in pain and gastrointestinal symptom severity (as reported by parents) than children in the comparison condition (time x treatment interaction, P<0.01). Also, parents in the cognitive-behavioral condition reported greater decreases in solicitous responses to their child's symptoms compared with parents in the comparison condition (time x treatment interaction, P<0.0001).

CONCLUSIONS: An intervention aimed at reducing protective parental responses and increasing child coping skills is effective in reducing children's pain and symptom levels compared with an educational control condition.

%B Am J Gastroenterol %V 105 %P 946-56 %8 2010 Apr %G eng %N 4 %R 10.1038/ajg.2010.106