Recurrent Abdominal Pain (RAP), one of the most common complaints of childhood, is associated with many adverse outcomes. However, few treatment studies have been conducted, especially for children with co-morbid RAP and anxiety disorders. The primary aim of the present study was to explore the utility of a cognitive-behavioral treatment (CBT) and a treatment that combined both CBT and family-based approaches in a community sample of children with co-morbid anxiety and RAP. A multiple-baseline across participants design utilizing repeated measures of anxiety and pain was implemented (n = 8 families). An examination of the clinical significance of both treatment approaches is suggestive of their utility in the treatment of anxiety and pain symptoms in children with RAP. More research is warranted in RAP treatment outcome research, particularly with family-based approaches to treatment.
Apley J. and Naish N. ( 1958) Recurrent abdominal pains: a field survey of 1000 schoolchildren . Archives of Disabilities in Children33: 165-170.
2.
Beardslee WR, Gladstone TR, Wright EJ and Cooper AB ( 2003) A family based approach to the prevention of depressive symptoms in children at risk: evidence of parental and child change. Pediatrics112: 199-132.
3.
Beck AT ( 1995) Cognitive therapy: past, present, and future. In: Mahoney J (ed.) Cognitive and Constructive Psychotherapies: Theory, Research, and Practice. New York: Springer Publisher Company, 29-40.
4.
Campo J., Bridge J., Ehmann M., Altman S., Lucas A., Birmaher B., Di Lorenzo C., Iyengar S. and Brent D. ( 2004) Recurrent abdominal pain, anxiety, and depression in primary care. Pediatrics113(4): 817-824.
5.
Colletti RB ( 1998) Recurrent abdominal pain. In: Burg FD, Ingelfinger JR, Wald ER and Polin RA (eds) Current Pediatric Therapy. Philadelphia: WB Saunders.
6.
Di Lorenzo C., Colletti RB, Lehmann HP, Boyle JT, Gerson WT, Hyams JS, Squires RH Jr, Walker LS, Kanda PT, American Academy of Pediatrics Subcommittee on Chronic Abdominal Pain, NASPGHAN Committee on Abdominal Pain (2005) Chronic abdominal pain in children: a clinical report of the American Academy of Pediatrics and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. Journal of Pediatric Gastroenterology Nutrition40: 245-248.
7.
Dufton L., Dunn M and Compas B (2009) Anxiety and somatic complaints in children with recurrent abdominal pain and anxiety disorders. Journal of Pediatric Psychology34(2): 176-186.
8.
Dush D., Hirt M. and Schroder H. ( 1989) Self-statement modification in the treatment of child behavior disorders: A meta-analysis. Psychological Bulletin106: 97-106.
9.
Flannery-Schroeder E. and Kendall P. ( 2000) Group and individual cognitive-behavioral treatments for youth with anxiety disorders: a randomized clinical trial. Cognitive Therapy and Research24(3): 251-278.
10.
Frank L., Kleinman L., Rentz A., Ciesla G., Kim JJ and Zucker C. ( 2002) Health-related quality of life associated with irritable bowel syndrome. Clinical Therapeutics, 24(4): 675-689.
11.
Garber J., van Slyke D. and Walker L. ( 1998) Concordance between mothers’ and children’s reports of somatic and emotional symptoms in patients with recurrent abdominal pain or emotional disorders. Journal of Abnormal Child Psychology26(5): 381-391.
12.
Garber J., Zeman J. and Walker LS ( 1990) Recurrent abdominal pain in children: psychiatric diagnoses and parental psychopathology. Journal of the American Academy of Child and Adolescent Psychiatry29: 648-656.
13.
Gleason T. and Evans M. ( 2004) Perceived vulnerability: a comparison of parents and children . Journal of Child Health Care8(4): 279-287.
14.
Grave J. and Blissett J. ( 2004) Is cognitive behavioral therapy appropriate for young children? A critical review of the evidence. Clinical Psychology Review24(4): 399-420.
15.
Greco L., Freeman K. and Dufton L. ( 2006) Overt and relational victimization among children with frequent abdominal pain: links to social skills, academic functioning, and health service use. Journal of Pediatric Psychology1-11.
16.
Hallberg A., Beckman A and Hakansson A (2010) Many fathers visit the child health care center, but few take part in parent groups. Journal of Child Health Care14(3): 296-303.
17.
Humphreys P. and Gevirtz R. ( 2000) Treatment of recurrent abdominal pain: components Analysis of four treatment protocols. Journal of Pediatric Gastroenterology & Nutrition31(1): 47-51.
18.
Hyams JS, Burke G., Davis PM, Rzepski B. and Andrulonis PA ( 1996) Abdominal pain and irritable bowel syndrome in adolescents: a community-based study. Journal of Pediatrics129: 220-226.
19.
Jacobson N. and Truax P. ( 1991) Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology59: 12-19.
20.
Kazak AE, Simms S., Rourke MT ( 2002) Family systems practice in pediatric psychology. Journal of Pediatric Psychology27: 133-144.
21.
Kendall PC ( 1994) Treating anxiety disorders in children: results of a randomized clinical trial. Journal of Consulting and Clinical Psychology62(1): 100-110.
22.
Kendall PC and Hedtke K. ( 2006) Cognitive-Behavioral Therapy for Anxious Children: Therapist Manual (3rd edn). Ardmore, PA: Workbook Publishing.
23.
Kendall PC, Flannery-Schroeder E., Panichelli-Mindel SM, Southam-Gerow MA, Henin M. and Warman M. ( 1997) Therapy for youths with anxiety disorders: a second randomized clinical trial. Journal of Consulting and Clinical Psychology65: 366-380.
24.
Logan D. and Scharff L. ( 2005) Relationships between family and parent characteristics and functional abilities in children with recurrent pain syndromes: an investigation of moderation effects on the pathway from pain to disability. Journal of Pediatric Psychology30(8): 698-707.
25.
Logan D., Claar R., and Scharff L. ( 2008a) Social desirability response bias and self-report of psychological distress in pediatric chronic pain patients. Pain13(3): 366-372.
26.
Logan DE, Simons LE, Stein MJ and Chastain L. ( 2008b) School impairment in adolescents with chronic pain. Journal of Pain9(5): 407-416.
27.
Maaike N., Scholing A., Emmelkamp P. and Minderaa R. ( 2003) Cognitive-behavioral therapy for children with anxiety disorders in a clinical setting: no additional effect of a cognitive parent training. Journal of the American Academy of Child and Adolescent Psychiatry42(11): 1270--1278.
28.
March JS ( 1997) Multidimensional Anxiety Scale for Children. New York: Multi-Health Systems, Inc.
29.
Newbould J., Smith F. and Francis S. ( 2008) ‘I’m fine doing it on my own’: partnerships between young people and their parents in the management of medication for asthma and diabetes. Journal of Child Health Care12(2): 116-128.
30.
Rapee RM, Barrett PM, Dadds M. and Evans L. ( 1994) Reliability of the DSM-III-R childhood anxiety disorders using structured interview: interrater and parent-child agreement. Journal of the American Academy of Child and Adolescent Psychiatry33: 984-992.
31.
Robins P., Smith S., Gluttin J. and Bishop C. ( 2005) A randomized controlled trial of a cognitive-behavioral family intervention for recurrent abdominal pain. Journal of Pediatric Psychology30(5): 397-408.
32.
Sanders M., Shepherd R., Cleghorn G. and Woolford H. ( 1994) The treatment of recurrent abdominal pain in children: a controlled comparison of cognitive-behavioral family intervention and standard pediatric care. Journal of Consulting and Clinical Psychology62: 306 -314.
33.
Sanders MR, Rebgetz M., Morrison M., Bor W., Gordon A., Dadds M. et al. (1989) Cognitive-behavioral treatments of recurrent non-specific abdominal pain in children: an analysis of generalization, maintenance, and side effects. Journal of Consulting and Clinical Psychology57: 294-300.
34.
Scharff L. ( 1997) Recurrent abdominal pain in children: a review of psychological factors and treatment. Clinical Psychology Review17(2): 145-166.
35.
Silverman WK and Albano A. ( 1996) Anxiety Disorders Interview Schedule for DSM-IV. USAGraywind Publications Incorporated.
36.
Silverman WK and Nelles WB ( 1988) The Anxiety Disorders Interview Schedule for Children . Journal of the American Academy of Child and Adolescent Psychiatry27: 772-778.
37.
Silverman WK and Rabian B. ( 1995) Test-retest reliability of the DSM-III-R childhood anxiety disorder symptoms using the Anxiety Disorders Interview Schedule for Children . Journal of Anxiety Disorders9: 139-150.
38.
Silverman WK, Saavedra LM and Pina AA ( 2001) Test retest reliability of anxiety symptoms and diagnoses with the Anxiety Disorders Interview Schedule for DSM-IV: Child and Parent Versions. Journal of the American Academy of Child and Adolescent Psychiatry40: 937-944.
39.
Spirito A. and Kazak A. ( 2006) Effective and Emerging Treatments in Pediatric Psychology . New York: Oxford University Press .
40.
Walker L. and Greene J. ( 1989) Children with recurrent abdominal pain and their parents: more somatic complaints, anxiety, and depression than other patient families?Journal of Pediatric Psychology14: 231-243.
41.
Walker LS, Smith CA, Garber J. and Van Slyke DA ( 1997) Development and validation of the Pain Response Inventory for children. Psychological Assessment9: 392-405.
42.
Weydert J., Ball T. and Davis M. ( 2003) Systematic review of treatments for recurrent abdominal pain. Pediatrics111(1): 1-11.
43.
Zwaigenbaum L., Szatmari P., Boyle M. and Offord D. ( 1999) Highly somatizing young adolescents and the risk of depression . Pediatrics103(6): 1203-1209.
