Skip to main content
Top
Published in: International Journal of Behavioral Medicine 3/2013

01-09-2013

Evaluation of a Cognitive–Behavioral Pain Management Program for Children with Chronic Abdominal Pain: A Randomized Controlled Study

Authors: Martina Groß, Petra Warschburger

Published in: International Journal of Behavioral Medicine | Issue 3/2013

Login to get access

Abstract

Background

Chronic abdominal pain (CAP) in childhood is widely prevalent and has adverse effects on mental health and quality of life. Earlier research emphasized the positive effects of psychological intervention on pain symptoms. This study describes the results of a cognitive–behavioral pain management program for children with CAP. The newly developed cognitive–behavioral group program, “Stop the pain with Happy-Pingu,” includes six sessions for the children and one meeting for the parents.

Purpose

We hypothesized that the training would significantly reduce pain symptoms (frequency, duration, intensity, and pain-related impairment) and increase health-related quality of life compared to wait-list controls, with improvement seen both at the end of treatment and at a 3-month follow-up.

Method

In all, 29 children were randomized into two groups: 15 in the intervention group (IG) and 14 as the wait-list controls (WLC). An intent-to-treat analysis was performed using two-factorial multivariate analyses of variance with repeated measures.

Results

Children in the IG experienced both a reduction in pain (primary outcome) and an improvement in health-related quality of life (secondary outcome) as compared to the WLC. The effect sizes ranged from medium to high.

Conclusion

Cognitive–behavioral methods seem to be appropriate for treating children with CAP.
Literature
1.
go back to reference Apley J, Naish N. Recurrent abdominal pain: a field study of 1000 school children. Arch Dis Child. 1958;33:165.PubMedCrossRef Apley J, Naish N. Recurrent abdominal pain: a field study of 1000 school children. Arch Dis Child. 1958;33:165.PubMedCrossRef
2.
go back to reference Berger MY, Gieteling MJ, Benninga MA. Chronic abdominal pain (clinical review). BMJ. 2007;334:997–02. Berger MY, Gieteling MJ, Benninga MA. Chronic abdominal pain (clinical review). BMJ. 2007;334:997–02.
3.
go back to reference Bortz J, Döring N. Forschungsmethoden und Evaluation für Human- und Sozialwissenschaftler. 3. überarb. Auflage. Heidelberg: Springer; 2005. Bortz J, Döring N. Forschungsmethoden und Evaluation für Human- und Sozialwissenschaftler. 3. überarb. Auflage. Heidelberg: Springer; 2005.
4.
go back to reference Campo JV, Di Lorenzo C, Chiappetta L, Bridge J, Colborn DK, Gartner C, et al. Adult outcomes of pediatric recurrent abdominal pain: do they just grow out of it? Pediatrics. 2001;108:e1–7.PubMedCrossRef Campo JV, Di Lorenzo C, Chiappetta L, Bridge J, Colborn DK, Gartner C, et al. Adult outcomes of pediatric recurrent abdominal pain: do they just grow out of it? Pediatrics. 2001;108:e1–7.PubMedCrossRef
5.
go back to reference Chitkara DK, Rawat DJ, Talley NJ. The epidemiology of childhood recurrent abdominal pain in western countries: a systematic review. Am J Gastroenterol. 2005;100:1868–75.PubMedCrossRef Chitkara DK, Rawat DJ, Talley NJ. The epidemiology of childhood recurrent abdominal pain in western countries: a systematic review. Am J Gastroenterol. 2005;100:1868–75.PubMedCrossRef
6.
go back to reference Cohen J. Statistical power analysis for the behavioral science. 2nd ed. Hillsdale: Lawrence Erlbaum Associates; 1988. Cohen J. Statistical power analysis for the behavioral science. 2nd ed. Hillsdale: Lawrence Erlbaum Associates; 1988.
7.
go back to reference Cohen LL, Lemanek K, Blount RL, Dahlquist LM, Lim CS, Palermo TM, et al. Evidence-based assessment of pediatric pain. J Pediatr Psychol. 2008;33:939–55.PubMedCrossRef Cohen LL, Lemanek K, Blount RL, Dahlquist LM, Lim CS, Palermo TM, et al. Evidence-based assessment of pediatric pain. J Pediatr Psychol. 2008;33:939–55.PubMedCrossRef
8.
go back to reference Denecke H, Glier B, Klinger R, Kröner-Herwig B, Nilges P, Redegeld M, et al. Qualitätssicherung in der Schmerztherapie chronischen Schmerzes. X. Instrumente zur Erfassung von Schmerz bei Kindern. Der Schmerz. 1997;11:120–5.PubMedCrossRef Denecke H, Glier B, Klinger R, Kröner-Herwig B, Nilges P, Redegeld M, et al. Qualitätssicherung in der Schmerztherapie chronischen Schmerzes. X. Instrumente zur Erfassung von Schmerz bei Kindern. Der Schmerz. 1997;11:120–5.PubMedCrossRef
9.
go back to reference Denecke H, Kröner-Herwig B. Kopfschmerztherapie mit Kindern und Jugendlichen. Göttingen: Hogrefe; 2000. Denecke H, Kröner-Herwig B. Kopfschmerztherapie mit Kindern und Jugendlichen. Göttingen: Hogrefe; 2000.
10.
go back to reference Duarte MA, Penna FJ, Andrade EMG, Cancela CSP, Neto JCA, Barbosa TF. Treatment of nonorganic recurrent abdominal pain: cognitive–behavioral family intervention. J Pediatr Gastroenterol Nutr. 2006;43:59–64.PubMedCrossRef Duarte MA, Penna FJ, Andrade EMG, Cancela CSP, Neto JCA, Barbosa TF. Treatment of nonorganic recurrent abdominal pain: cognitive–behavioral family intervention. J Pediatr Gastroenterol Nutr. 2006;43:59–64.PubMedCrossRef
11.
go back to reference Eccleston C, Morley S, Williams A, Yorke L, Mastroyannopulou K. Systematic review of randomised controlled trials of psychological therapy for chronic pain in children and adolescents, with a subset meta-analysis of pain relief. Pain. 2002;99:157–65.PubMedCrossRef Eccleston C, Morley S, Williams A, Yorke L, Mastroyannopulou K. Systematic review of randomised controlled trials of psychological therapy for chronic pain in children and adolescents, with a subset meta-analysis of pain relief. Pain. 2002;99:157–65.PubMedCrossRef
12.
go back to reference Ellert U, Neuhauser H, Roth-Isigkeit A. Schmerzen bei Kindern und Jugendlichen in Deutschland: Prävalenz und Inanspruchnahme medizinischer Leistungen. Ergebnisse der Kinder- und Jugendgesundheitssurveys (KIGGS). Bundesgesundheitsbl—Gesunheitsforsch—Gesundheitsschutz. 2007; 50: 711–17. Ellert U, Neuhauser H, Roth-Isigkeit A. Schmerzen bei Kindern und Jugendlichen in Deutschland: Prävalenz und Inanspruchnahme medizinischer Leistungen. Ergebnisse der Kinder- und Jugendgesundheitssurveys (KIGGS). Bundesgesundheitsbl—Gesunheitsforsch—Gesundheitsschutz. 2007; 50: 711–17.
13.
go back to reference Field A. Discovering statistics using SPSS. 3rd ed. London: Sage; 2009. Field A. Discovering statistics using SPSS. 3rd ed. London: Sage; 2009.
14.
go back to reference Greenhouse SW, Geisser S. On methods in the analysis of profile data. Psychometrica. 1959;24:95–112.CrossRef Greenhouse SW, Geisser S. On methods in the analysis of profile data. Psychometrica. 1959;24:95–112.CrossRef
15.
go back to reference Hicks CL, von Baeyer CL, McGarth PJ. Online psychological treatment for pediatric recurrent pain: a randomized evaluation. J Pediatr Psychol. 2006;31:724–36.PubMedCrossRef Hicks CL, von Baeyer CL, McGarth PJ. Online psychological treatment for pediatric recurrent pain: a randomized evaluation. J Pediatr Psychol. 2006;31:724–36.PubMedCrossRef
16.
go back to reference Hotopf M, Carr S, Mayou R, Wadsworth M, Wessely S. Why do children have chronic abdominal pain, and what happens to them when they grow up? Population based cohort study. BMJ. 1998;316:1196–200.PubMedCrossRef Hotopf M, Carr S, Mayou R, Wadsworth M, Wessely S. Why do children have chronic abdominal pain, and what happens to them when they grow up? Population based cohort study. BMJ. 1998;316:1196–200.PubMedCrossRef
17.
go back to reference Humphrey PA, Gevirtz RN. Treatment of recurrent abdominal pain: components analysis of four treatment protocols. Journal of Pediatr Gastroenterol Nutr. 2000;31:47–51.CrossRef Humphrey PA, Gevirtz RN. Treatment of recurrent abdominal pain: components analysis of four treatment protocols. Journal of Pediatr Gastroenterol Nutr. 2000;31:47–51.CrossRef
19.
go back to reference Karlson CW, Rapoff MA. Attrition in randomized controlled trials for pediatric chronic conditions. J Pediatr Psychol. 2009;34:782–93.PubMedCrossRef Karlson CW, Rapoff MA. Attrition in randomized controlled trials for pediatric chronic conditions. J Pediatr Psychol. 2009;34:782–93.PubMedCrossRef
20.
go back to reference Konijnenberg AY, Uiterwaal CS, Kimpen JLL, van der Hoeven J, Buitelaar JK, de Graeff-Meeder ER. Children with unexplained chronic pain: substantial impairment in everyday life. Arch Dis Child. 2005;9:680–6.CrossRef Konijnenberg AY, Uiterwaal CS, Kimpen JLL, van der Hoeven J, Buitelaar JK, de Graeff-Meeder ER. Children with unexplained chronic pain: substantial impairment in everyday life. Arch Dis Child. 2005;9:680–6.CrossRef
21.
go back to reference Levy RL, Langer SL, Walker LS, Romano JM, Christie DL, Youssef N, et al. Cognitive–behavioral therapy for children with functional abdominal pain and their parents decreases pain and other symptoms. Am J Gastroenterol. 2010;105:946–56.PubMedCrossRef Levy RL, Langer SL, Walker LS, Romano JM, Christie DL, Youssef N, et al. Cognitive–behavioral therapy for children with functional abdominal pain and their parents decreases pain and other symptoms. Am J Gastroenterol. 2010;105:946–56.PubMedCrossRef
22.
go back to reference Magista A, De Canio A, Chiarelli T, Leone G, Fico S, Cavallo L, et al. Comparison of Rome II versus Rome III in classifying children with abdominal pain. Dig Liver Dis. 2006;38:A116.CrossRef Magista A, De Canio A, Chiarelli T, Leone G, Fico S, Cavallo L, et al. Comparison of Rome II versus Rome III in classifying children with abdominal pain. Dig Liver Dis. 2006;38:A116.CrossRef
23.
go back to reference Palermo TM, Eccleston C, Lewandowski AS, Williams AC, Morley S. Randomized controlled trials of psychological therapies of chronic pain in children and adolescents: a updated meta-analytic review. Pain. 2010;148:387–97.PubMedCrossRef Palermo TM, Eccleston C, Lewandowski AS, Williams AC, Morley S. Randomized controlled trials of psychological therapies of chronic pain in children and adolescents: a updated meta-analytic review. Pain. 2010;148:387–97.PubMedCrossRef
24.
go back to reference Palermo TM, Wilson AC, Peters M, Lewandowski A, Somhegyi H. Randomized controlled trial of an internet-delivered family cognitive–behavioral therapy intervention for children and adolescents with chronic pain. Pain. 2009;146:205–13.PubMedCrossRef Palermo TM, Wilson AC, Peters M, Lewandowski A, Somhegyi H. Randomized controlled trial of an internet-delivered family cognitive–behavioral therapy intervention for children and adolescents with chronic pain. Pain. 2009;146:205–13.PubMedCrossRef
25.
go back to reference Ravens-Sieberer U, Bullinger M. KINDLR. Manual: Fragebogen zur Erfassung der gesundheitsbezogenen Lebensqualität bei Kindern und Jugendlichen. Revidierte Form; 2000. Ravens-Sieberer U, Bullinger M. KINDLR. Manual: Fragebogen zur Erfassung der gesundheitsbezogenen Lebensqualität bei Kindern und Jugendlichen. Revidierte Form; 2000.
26.
go back to reference Robins PM, Smith SM, Glutting JJ, Bishop CT. A randomized controlled trial of a cognitive–behavioral family intervention for pediatric recurrent abdominal pain. J Pediatr Psychol. 2005;30:397–408.PubMedCrossRef Robins PM, Smith SM, Glutting JJ, Bishop CT. A randomized controlled trial of a cognitive–behavioral family intervention for pediatric recurrent abdominal pain. J Pediatr Psychol. 2005;30:397–408.PubMedCrossRef
27.
go back to reference Sanders MR, Shepherd RW, Cleghorn G, Woolford H. The treatment of abdominal pain in children: a controlled comparison of cognitive behavioral family intervention and standard pediatric care. J Consult Clin Psychol. 1994;62:306–14.PubMedCrossRef Sanders MR, Shepherd RW, Cleghorn G, Woolford H. The treatment of abdominal pain in children: a controlled comparison of cognitive behavioral family intervention and standard pediatric care. J Consult Clin Psychol. 1994;62:306–14.PubMedCrossRef
28.
go back to reference Subcommittee on chronic abdominal pain. Clinical report: chronic abdominal pain in children. Pediatrics. 2005;115:812–5.CrossRef Subcommittee on chronic abdominal pain. Clinical report: chronic abdominal pain in children. Pediatrics. 2005;115:812–5.CrossRef
29.
go back to reference Schlarb A, Gulewitsch MD, Bock I, Enck P, Hautzinger M. Recurrent abdominal pain in children and adolescents—a survey among paediatricians. GMS Psycho-Social-Medicine. 2011;8:1–7. Schlarb A, Gulewitsch MD, Bock I, Enck P, Hautzinger M. Recurrent abdominal pain in children and adolescents—a survey among paediatricians. GMS Psycho-Social-Medicine. 2011;8:1–7.
30.
go back to reference Unnewehr S, Schneider S, Margraf J. Diagnostisches Interview bei psychischen Störungen im Kindes- und Jugendalter (Kinder-DIPS). Heidelberg: Springer; 1998. Unnewehr S, Schneider S, Margraf J. Diagnostisches Interview bei psychischen Störungen im Kindes- und Jugendalter (Kinder-DIPS). Heidelberg: Springer; 1998.
31.
go back to reference van Gessel H, Gaßmann J, Kröner-Herwig B. Children in pain: recurrent back pain, abdominal pain, and headache in children and adolescents in a four-year-period. J Pediatr. 2011;158:977–83.PubMedCrossRef van Gessel H, Gaßmann J, Kröner-Herwig B. Children in pain: recurrent back pain, abdominal pain, and headache in children and adolescents in a four-year-period. J Pediatr. 2011;158:977–83.PubMedCrossRef
32.
go back to reference Varni JW, Lane MM, Burwinkle TM, Fontaine EN, Youseff NN, Schwimmer JB, et al. Health-related quality of life in pediatric patients with irritable bowel syndrome: a comparative analysis. J Dev Behav Pediatr. 2006;27:451–8.PubMedCrossRef Varni JW, Lane MM, Burwinkle TM, Fontaine EN, Youseff NN, Schwimmer JB, et al. Health-related quality of life in pediatric patients with irritable bowel syndrome: a comparative analysis. J Dev Behav Pediatr. 2006;27:451–8.PubMedCrossRef
33.
go back to reference Varni JW, Limbers CA, Burwinkle TM. Impaired health-related quality of life in children and adolescents wih chronic conditions: a comparative analysis of 10 disease clusters and 33 disease categories/severeties utilizing the PedsQL™ Version 4.0 generic core scales. Health Qual Life Outcomes. 2007;5:43–58.PubMedCrossRef Varni JW, Limbers CA, Burwinkle TM. Impaired health-related quality of life in children and adolescents wih chronic conditions: a comparative analysis of 10 disease clusters and 33 disease categories/severeties utilizing the PedsQL™ Version 4.0 generic core scales. Health Qual Life Outcomes. 2007;5:43–58.PubMedCrossRef
34.
go back to reference Varni JW, Seid M, Kurtin PS. PedsQL™ version 4.0: reliability and validity of the pediatric quality of life inventory™ version 4.0 generic core scales in healthy and patient populations. Med Care. 2001;39:800–12.PubMedCrossRef Varni JW, Seid M, Kurtin PS. PedsQL™ version 4.0: reliability and validity of the pediatric quality of life inventory™ version 4.0 generic core scales in healthy and patient populations. Med Care. 2001;39:800–12.PubMedCrossRef
35.
go back to reference Walker LS, Garber J, van Slyke DA, Greene JW. Long-term health outcomes in patients with recurrent abdominal pain. J Pediatr Psychol. 1995;20:233–45.PubMedCrossRef Walker LS, Garber J, van Slyke DA, Greene JW. Long-term health outcomes in patients with recurrent abdominal pain. J Pediatr Psychol. 1995;20:233–45.PubMedCrossRef
36.
go back to reference Warschburger P. Psychologie der atopischen Dermatitis im Kindes-und Jungendalter. München: Quintessenz; 1996. Warschburger P. Psychologie der atopischen Dermatitis im Kindes-und Jungendalter. München: Quintessenz; 1996.
37.
go back to reference Warschburger P, Groß M. “Stopp den Schmerz”—Ein kognitiv-behaviorales Behandlungsprogramm für Kinder mit Bauchschmerzen—Erste Ergebnisse einer Pilotstudie. Verhaltenstherapie. 2008;18:162–7.CrossRef Warschburger P, Groß M. “Stopp den Schmerz”—Ein kognitiv-behaviorales Behandlungsprogramm für Kinder mit Bauchschmerzen—Erste Ergebnisse einer Pilotstudie. Verhaltenstherapie. 2008;18:162–7.CrossRef
38.
go back to reference Wittchen HU, Perkonigg A, Lachner G, Nelson B. Early development stages of psychopathology study (EDSP): objectives and design. Eur Addict Res. 1998;4:18–27.PubMedCrossRef Wittchen HU, Perkonigg A, Lachner G, Nelson B. Early development stages of psychopathology study (EDSP): objectives and design. Eur Addict Res. 1998;4:18–27.PubMedCrossRef
Metadata
Title
Evaluation of a Cognitive–Behavioral Pain Management Program for Children with Chronic Abdominal Pain: A Randomized Controlled Study
Authors
Martina Groß
Petra Warschburger
Publication date
01-09-2013
Publisher
Springer US
Published in
International Journal of Behavioral Medicine / Issue 3/2013
Print ISSN: 1070-5503
Electronic ISSN: 1532-7558
DOI
https://doi.org/10.1007/s12529-012-9228-3

Other articles of this Issue 3/2013

International Journal of Behavioral Medicine 3/2013 Go to the issue