Behavioural Treatment of Childhood Recurrent Abdominal Pain: Relationships Between Pain, Children's Psychological Characteristics and Family Functioning

Abstract

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.

The treatment of recurrent abdominal pain in children: A controlled comparison of cognitive-behavioral family intervention and standard pediatric care.

“…The data are expressed as a percentage of time intervals of pain behavior per week. This measure has correlated highly with children's pain intensity ratings in prior research (Sanders et al, 1990). Parents monitored the child's pain on the same basis as did children.…”

Cognitive-behavioural treatment of recurrent abdominal pain in children: A primer for paediatricians

“…The most extensively described CBT program for managing RAP is the one developed by Sanders et al (19,23). Several other narrative reviews and descriptions of CBT for recurrent pain are available (17,26).…”

“…The goal is to minimize parental attention given to pain and to support the child in applying coping skills. For example, in the program by Sanders et al (19,23), parents are taught to reinforce (give attention to) well behaviour, respond to complaints of pain by encouraging the child to engage in an alternate activity (distraction), ignore nonverbal pain behaviour, avoid modelling pain behaviour, and learn to distinguish between RAP and other physical complaints that may require medical intervention.…”

“…Results of these trials indicate that eight sessions of CBT is effective in significantly reducing pain and increasing functioning both immediately following treatment and up to a 12-month follow-up period. In addition to these randomized studies, a number of single case designs (21,22) and nonrandomized or noncontrolled group designs (23,24) provide further support for the efficacy of CBT for RAP. Despite these data, many paediatricians are unaware of the value and role of cognitivebehavioural approaches in assisting children with RAP.…”

Restoration of Vagal Tone: A Possible Mechanism for Functional Abdominal Pain

“…The effective combinations include cognitive-behavioral therapy (Huertas-Ceballos et al 2008b;Sanders et al 1989Sanders et al , 1990Sanders et al , 1994, consumption of fiber (Edwards and Bonner 1991;Feldman et al 1985), hypnotherapy (Vlieger et al 2007) and temperature and breathing training biofeedback (Humphreys and Gevirtz 2000;Weydert et al 2003;Bassotti and Whitehead 1994;Gevirtz 2000;Whitehead 1992). Medications have not generally been found to be effective (Huertas-Ceballos et al 2008a;Saps et al 2009).…”