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Twelve-month follow-up of cognitive behavioral therapy for children with functional abdominal pain.

OBJECTIVE
To determine whether a brief intervention for children with functional abdominal pain and their parents' responses to their child's pain resulted in improved coping 12 months later.


DESIGN
Prospective, randomized, longitudinal study.


SETTING
Families were recruited during a 4-year period in Seattle, Washington, and Morristown, New Jersey.


PARTICIPANTS
Two hundred children with persistent functional abdominal pain and their parents.


INTERVENTIONS
A 3-session social learning and cognitive behavioral therapy intervention or an education and support intervention.


MAIN OUTCOME MEASURES
Child symptoms and pain-coping responses were monitored using standard instruments, as was parental response to child pain behavior. Data were collected at baseline and after treatment (1 week and 3, 6, and 12 months after treatment). This article reports the 12-month data.


RESULTS
Relative to children in the education and support group, children in the social learning and cognitive behavioral therapy group reported greater baseline to 12-month follow-up decreases in gastrointestinal symptom severity (estimated mean difference, -0.36; 95% CI, -0.63 to -0.01) and greater improvements in pain-coping responses (estimated mean difference, 0.61; 95% CI, 0.26 to 1.02). Relative to parents in the education and support group, parents in the social learning and cognitive behavioral therapy group reported greater baseline to 12-month decreases in solicitous responses to their child's symptoms (estimated mean difference, -0.22; 95% CI, -0.42 to -0.03) and greater decreases in maladaptive beliefs regarding their child's pain (estimated mean difference, -0.36; 95% CI, -0.59 to -0.13).


CONCLUSIONS
Results suggest long-term efficacy of a brief intervention to reduce parental solicitousness and increase coping skills. This strategy may be a viable alternative for children with functional abdominal pain.


TRIAL REGISTRATION
clinicaltrials.gov Identifier: NCT00494260.