Journal of the American Academy of Child & Adolescent Psychiatry
ARTICLESTrajectories of Symptoms and Impairment for Pediatric Patients With Functional Abdominal Pain: A 5-Year Longitudinal Study
Section snippets
Sample
The sample was consecutive new pediatric patients evaluated at a tertiary care center for abdominal pain and followed for 5 years. Patients between the ages of 6 and 18 years were eligible if, by parental report, they had no other chronic illness or handicapping condition. Of 302 subjects initially contacted, 16 declined, 50 did not meet eligibility, and 31 had incomplete medical examinations, resulting in a sample of 205. Only patients without evidence of organic disease (132/205; 66%) were
Descriptive Statistics
Table 1 reports the characteristics of all of the study variables for the entire sample at baseline. Sample sizes for dependent variables varied by measure and time point. For the CSI, the baseline sample was 132. Subsequent time points each had smaller sample sizes because of an inability to locate families. At time 2, the CSI sample was 124; at time 3, it was 131; and at time 4, it was 112. For the FDI, the sample size at each time point was 118, 123, 128, and 111, respectively.
Reliability of Measures
Baseline
DISCUSSION
This study identified relatively long-term trajectories of symptoms and impairment in pediatric patients with abdominal pain without identifiable organic disease. Three distinct trajectories of change described the course of symptoms and functional impairment. The majority of patients fell into a group labeled low risk. Children and adolescents in this group initially showed relatively low levels of symptoms and impairment, improved within 2 months, and maintained those gains 1 and 5 years
REFERENCES (49)
Do pain problems in young school children persist into early adulthood? A 13-year follow-up
Eur J Pain
(2004)- et al.
Somatization in pediatric primary care: association with psychopathology, functional impairment, and use of services
J Am Acad Child Adolesc Psychiatry
(1999) - et al.
Psychological comorbidity and stress reactivity in children and adolescents with recurrent abdominal pain anxiety disorders
J Am Acad Child Adolesc Psychiatry
(2003) - et al.
Somatic complaints and psychopathology in children and adolescents: stomach aches, musculoskeletal pains, and headaches
J Am Acad Child Adolesc Psychiatry
(1999) - et al.
Recurrent abdominal pain in children: psychiatric diagnoses and maternal psychopathology
J Am Acad Child Psychiatry
(1990) - et al.
Abdominal pain and irritable bowel syndrome in adolescents: a community-based study
J Pediatr
(1996) - et al.
Recurrent abdominal pain: a potential precursor of irritable bowel syndrome in adolescents and young adults
J Pediatr
(1998) Integrative Guide for the 1991 CBCL/4-18, YSR, and TRF Profiles
(1991)Practical Statistics for Medical Research
(1991)- et al.
Children with recurrent abdominal pain: how do they grow up?
BMJ
(1973)
Recurrent abdominal pain in children and associated DSM-III diagnosis
Am J Psychiatry
Recurrent abdominal pain: an update
Pediatr Rev
Recurrent abdominal pain, anxiety, and depression in primary care
Pediatrics
Long-term prognosis in children with recurrent abdominal pain
Arch Dis Child
Functional disability in adolescents and young adults with symptoms of irritable bowel syndrome: the role of academic, social, and athletic competence
J Pediatr Psychol
Tripartite model of anxiety and depression: psychometric evidence and taxonomic implications
J Abnorm Psychol
The development of impulsivity, fearfulness, and helpfulness during childhood: patterns of consistency and change in the trajectories of boys and girls
J Child Psychol Psychiatry
Psychological therapies for the management of chronic and recurrent pain in children and adolescents
Cochrane Database Syst Rev
Abdominal pain in children and symptoms of somatization disorder
J Pediatr Psychol
Personality and Individual Differences: A Natural Science Approach
Somatization symptoms in a community sample of children and adolescents: further validation of the Children's Somatization Inventory
Psychol Assess
The perceived competence scale for children
Child Dev
Manual for the Self-Perception Profile for Children
A SAS procedure based on mixture models for estimating developmental trajectories
Sociol Method Res
Cited by (134)
Pediatric and adolescent GI motility disorders and management
2023, Handbook of Gastrointestinal Motility and Disorders of Gut-Brain Interactions, Second EditionChild-Focused Cognitive Behavioral Therapy for Pediatric Abdominal Pain Disorders Reduces Caregiver Anxiety in Randomized Clinical Trial
2022, Journal of PainCitation Excerpt :Anxiety disorders co-occur in up to two-thirds of youth with chronic pain,36 with high rates of clinical anxiety evidenced in youth with FAPD.10,20,21,23 Further, anxiety disorders predict the maintenance of somatic symptoms over time,49,65 heightened pain sensitivity,67 increased functional impairment,73 and limited response to cognitive-behavioral treatment (CBT) in youth with FAPD.16 Although co-occurring anxiety in FAPD can affect child functioning and treatment response, the literature has recently focused on examining the dynamic association between child pain, psychological function, and the broader family environment and dynamics.4,43,50,54
Mediation of outcomes for cognitive behavioral therapy targeted to parents of children with Functional Abdominal Pain Disorders
2021, Journal of Psychosomatic ResearchPrevalence and Progression of Recurrent Abdominal Pain, From Early Childhood to Adolescence
2021, Clinical Gastroenterology and HepatologyCognitive Behavior Therapy Tailored to Anxiety Symptoms Improves Pediatric Functional Abdominal Pain Outcomes: A Randomized Clinical Trial
2021, Journal of PediatricsCitation Excerpt :This is important because the presence of anxiety in conjunction with FAPD is quite common.8-12,16 Further, anxiety is associated with increased pain and disability,10,12-14 and adverse outcomes in youth with FAPD in cross-sectional10,13 and longitudinal studies.14,49 Left untreated, youth with FAPD are prone to long-term mental health issues.49
Research was supported by the National Institute of Child Health and Human Development to Lynn S. Walker (R01 HD23264) and by the Vanderbilt Kennedy Center (P30 HD15052).
Disclosure: The authors have no financial relationships to disclose.