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Predictors of Clinical Improvement in Children with Recurrent Abdominal Pain

Published online by Cambridge University Press:  16 June 2009

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

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
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 1996

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