From 10% to 15% of school-aged children experience recurring abdominal pain. This study evaluated the efficacy of a cognitive-behavioral program for the treatment of nonspecific recurrent abdominal pain (RAP) using a controlled group design. The multicomponent treatment program consisted of differential reinforcement of well behavior, cognitive coping skills training, and various generalization enhancement procedures. Multiple measures of pain intensity and pain behavior were conducted, including children's self-monitoring, parent observation, teacher observation, and observation by independent observers. Results showed that both the experimental and the control groups reduced their levels of pain. However, the treated group improved more quickly, the effects generalized to the school setting, and a larger proportion of subjects were completely pain-free by 3-months follow-up (87.5% vs. 37.5%). There was no evidence for any negative side effects of treatment.
Few researchers have assessed family interaction patterns associated with childhood depression, especially using observations in natural settings. We directly sampled the interaction patterns of families with depressed, conduct-disordered, mixed depressed-conduct-disordered, and comparison children ages 7-14 years in their homes during the evening meal. Observational measures were taken of positive and aversive behaviors and affect expression for both parents, the referred children, and their siblings. Results replicated previous research showing that conduct-disordered children express high levels of aversive behavior and anger and are part of a family system marked by conflict and aggression. The depressed children were exposed to maternal aversiveness but did not show any evidence of elevated levels of anger or aversiveness in their own behavior. Surprisingly, this was also true for the mixed-disorder children. High levels of depression in both groups of depressed children were associated with low levels of conflict and anger in family members. Overall, siblings showed very similar patterns of behavior, and were exposed to similar patterns of parental behavior, as the referred children. Results are discussed in terms of family models that emphasize the function of aggression and depression in the maintenance of child psychopathology. child category. All kappas were higher than 75% (M= 86.3, SD = 6.5). Observers were unaware of the family's group status and the specific hypotheses under investigation. depression in 7-to 14-year-olds or the rate at which such depression is detected and referred in this group is considerably lower in our community than elsewhere (Kazdin, 1990). Further research into ethnocultural variations in the occurrence and referral of childhood depression might reveal valuable epidemiological data.
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This study examined the impact and side effects of a cognitive behavioural program for the treatment of recurrent abdominal pain (R.A.P.) on children's behavioural adjustment and family functioning. It assessed the extent to which changes in children's pain symptoms covaried with family processes thought to be etiologically significant in cases of R.A.P. Results showed that pain symptoms of both experimental and control children improved significantly six months after initial assessment. Treatment achieved its objectives more quickly with a higher proportion of completely pain-free children. None of the measures of child adjustment or family conflict, expressiveness, independence or achievement orientation were associated with changes in pain intensity ratings or parent observational measures of pain behaviour. There was no evidence that treatment was associated with any negative side effects.
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