Exposure-Based Cognitive Behavior Therapy for Children with Abdominal Pain: A Pilot Trial

PLoS One. 2016 Oct 13;11(10):e0164647. doi: 10.1371/journal.pone.0164647. eCollection 2016.

Abstract

Background: Children with pain-related functional gastrointestinal disorders (P-FGIDs) have an increased risk for school absenteeism, depression, anxiety and low quality of life. Exposure-based cognitive behavior therapy (CBT) has shown large treatment effects in adults with irritable bowel syndrome, but has not been tested for children 8-12 years with P-FGIDs.

Aim: The aim of this trial was to test the feasibility, acceptability and potential efficacy of a newly developed exposure-based CBT for children with P-FGIDs.

Method: The children (n = 20) with a P-FGID, were referred by their treating physicians. The participants received 10 weekly sessions of exposure-based CBT and were assessed at pre-treatment, post-treatment and 6-month follow-up.

Results: Children improved significantly on the primary outcome measure pain intensity at post (Cohen's d = 0.40, p = 0.049) and at 6-month follow-up (Cohen's d = 0.85, p = 0.004). Improvements were also seen in pain frequency, gastrointestinal symptoms, quality of life, depression, anxiety, school absenteeism and somatic symptoms. Improvements were maintained or further increased at 6-month follow-up. The children engaged in the exposures and were satisfied with the treatment.

Conclusions: Exposure-based CBT for children with P-FGIDs is feasible, acceptable and potentially efficacious.

MeSH terms

  • Abdominal Pain / psychology
  • Abdominal Pain / therapy*
  • Absenteeism
  • Anxiety
  • Child
  • Cognitive Behavioral Therapy*
  • Depression
  • Female
  • Follow-Up Studies
  • Humans
  • Interviews as Topic
  • Male
  • Medically Unexplained Symptoms
  • Pilot Projects
  • Quality of Life
  • Telephone
  • Treatment Outcome

Grants and funding

This research was supported by grants from: Jane and Dan Olsson foundation, 4-1559/2013 [http://www.jodfoundations.com] (to OO); Kempe-Carlgrenska foundation, [http://www.kc-fonden.se] (to OO); Ruth and Richard Julin foundation, 2012Juli0048, [https://fonder.ki.se] (to OO); Ishizu Matsumurais Donation, [https://fonder.ki.se] (to OO); Majblomman foundation, [http://www.majblomman.se] (to OO); Bengt Ihre research fellowship, [http://ihrefellowship.se] (to OO); Bengt Ihre foundation, SLS-331861, [http://www.sls.se] (to OO); The Samariten foundation, [http://www.stiftelsensamariten.se] (to OO); The Swedish society of medicine, SLS-331681, SLS-410501, [http://www.sls.se] (to OO); Värkstadststiftelsen, [http://www.varkstaden.se] (to OO); Gadelius foundation, [http://stiftelsemedel.se/stiftelsen-professor-bror-gadelius-minnesfond/] (to MB); Swedish Research Council, 521-2013-2846, [www.vr.se] (to BL); Regional agreement on medical training and clinical research between Stockholm County Council and Karolinska Institutet, 20130129, [https://forskningsstod.sll.se] (to BL). The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.