Hostname: page-component-cc8bf7c57-xrnlw Total loading time: 0 Render date: 2024-12-09T22:21:00.187Z Has data issue: false hasContentIssue false
  • English
  • Français

Predictors of Clinical Improvement in Children with Recurrent Abdominal Pain

Published online by Cambridge University Press:  16 June 2009

Matthew R. Sanders ,
Geoffrey Cleghorn ,
Ross W. Shepherd  and
Mark Patrick
Matthew R. Sanders
Affiliation:
Departments of Psychology and Child Health, The University of Queensland and Department of Gastroenterology, Royal Children's Hospital, Brisbane, Queensland, Australia
Geoffrey Cleghorn
Affiliation:
Departments of Psychology and Child Health, The University of Queensland and Department of Gastroenterology, Royal Children's Hospital, Brisbane, Queensland, Australia
Ross W. Shepherd
Affiliation:
Departments of Psychology and Child Health, The University of Queensland and Department of Gastroenterology, Royal Children's Hospital, Brisbane, Queensland, Australia
Mark Patrick
Affiliation:
Departments of Psychology and Child Health, The University of Queensland and Department of Gastroenterology, Royal Children's Hospital, Brisbane, Queensland, Australia
Get access Rights & Permissions [Opens in a new window]

Abstract

Forty-three children with recurrent abdominal pain who had received treatment from a paediatric gastroenterology clinic were reassessed 6 and 12 months after initial presentation. Measures of children's pain included a pain diary (PD) which measured pain intensity, a parent observation record (POR) which assessed pain behaviour and a structured interview to assess the degree to which pain interferes with the child's activities. Pretreatment measures of the child's history of pain, coping strategies in dealing with pain, and their mother's caregiving strategies were examined as predictors of two indices of clinical improvement: the extent of change in pain on the child's pain diary from pre-test to 6 months follow-up, and the degree of interference to the child's activities. All children had shown significant improvement in the level of pain at follow up, with 74.4% being pain free at 12 month follow-up on the PD and 83.7% being pain free on the POR. The amount of change they showed varied, with some showing residual impairment even though they were significantly improved. Regression analyses showed that children with greatest reductions on the child's pain diary at the 6 month follow-up were those with a stress-related mode of onset, whose mothers used more adaptive caregiving strategies, and who received cognitive behavioural family intervention. There was also a non significant trend for younger children to fare better. These data suggest the importance of early diagnosis and routinely assessing parental caregiving behaviour and beliefs about the origins of pain in planning treatment for children with RAP.

Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 24 , Issue 1 , January 1996 , pp. 27 - 38
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Apley, J. (1975). The child with abdominal pains. London: Blackwell Scientific Publications.Google Scholar
Apley, J. and Naish, N. (1958). Recurrent abdominal pains: a field survey of 1000 school children. Archives of Diseases of Childhood 33, 165–170.CrossRefGoogle Scholar
Branson, S.M. and Craig, K.D. (1988). Children's spontaneous strategies for coping with pain: a review of the literature. Canadian Journal of Behavioral Science 20, 402–412.CrossRefGoogle Scholar
Farrell, M.K. (1993). Dr Apley meets Helicobacter pylor. Journal of Pediatric Gastroenterology and Nutrition 16, 118–119.Google Scholar
Fordyce, W.E. (1976). Behavioral methods for chronic pain and illness. St. Louis: Mosby.Google Scholar
McGrath, P.A. (1990). Pain in children: nature, assessment and treatment. New York, Guilford.Google Scholar
Sanders, M.R., Rebgetz, M., Morrison, M.M., Bor, W., Gordon, A., Dadds, M.R. and Shepherd, R. (1989). Cognitive behavioural treatment of recurrent nonspecific abdominal pain in children: an analysis of generalization, maintenance and side effects. Journal of Consulting and Clinical Psychology 57, 294–200.CrossRefGoogle ScholarPubMed
Sanders, M.R., Morrison, M., Rebgetz, M., Bor, W., Dadds, M. and Shepherd, R. (1990). Behavioural treatment of childhood recurrent abdominal pain: relationships between pain, children's psychological characteristics and family functioning. Behaviour Change 7, 16–24.CrossRefGoogle Scholar
Sanders, M.R., Woolford, H., Shepherd, R.W. and Cleghorn, G. (1992). Children's coping with pain and maternal caregiving: the family interactions of children with recurrent abdominal pain, organic pain and pain free controls.Paper presented at the World Congress of Behavior Therapy, Surfers Paradise,Australia,July.Google Scholar
Sanders, M.R., Shepherd, R.W., Cleghorn, G. and Woolford, H. (1994). Recurrent abdominal pain in children: a comparison of cognitive behavioral family intervention and standard pediatric care. Journal of Consulting and Clinical Psychology 62, 306–314.CrossRefGoogle ScholarPubMed
Siegel, L.J. and Smith, K.E. (1989). Children's strategies for coping with pain. Pediatrician 16, 110–118.Google ScholarPubMed
Sobell, L.C., Toneatto, T., Sobell, M.B., Schuller, R. and Maxwell, M. (1990). A procedure for reducing errors in reports of life events. Journal of Psychosomatic Research 34, 163–170.CrossRefGoogle ScholarPubMed
Stichler, G.B. and Murphy, D.B. (1979). Recurrent abdominal pain. American Journal of the Diseases of Childhood 133, 486–489.Google Scholar
Turk, D.C., Flor, H. and Rudy, T.E. (1987). Pain and families. I. Etiology, maintenance, and psychosocial impact. Pain 30, 3–27.CrossRefGoogle ScholarPubMed
Varnie, J.W., Thompson, K.L. and Hanson, V. (1987). The Varnie/Thompson pediatric pain questionnaire: I. Chronic musculoskeletal pain in juvenile rheumatoid arthritis. Pain 26, 27–38.CrossRefGoogle Scholar
Varnie, J.W., Walco, G.A. and Katz, E.R. (1989). Assessment and management of chronic and recurrent pain in children with chronic disease. Pediatrician 16, 56–63.Google Scholar
Walker, , and Greene, , (1990). Negative life events and symptom resolution in pediatric abdominal pain patients. Journal of Pediatric Psychology 16, 341–360.CrossRefGoogle Scholar
Submit a response

Comments

No Comments have been published for this article.