Managing Recurrent Abdominal Pain
Condition: Abdominal Pain
MeSH terms: Abdominal Pain; Illness Behavior
Study type: Interventional
Phase: Phase 2

Summary: 
      The purpose of this study is to evaluate the efficacy of a social learning and cognitive
      behavior therapy approach for treating children with Recurrent Abdominal Pain (RAP).
    

Detailed description: 
      Recurrent Abdominal Pain (RAP) is one of many disorders in adults and children for which
      there is no identifiable organic or physiological cause, yet which is associated with illness
      behavior that has significant societal and personal costs. Although 10-15% of children have
      RAP, there is at present no accepted medical or behavioral treatment for it. We have
      conducted a series of studies that suggests that illness behavior is, at least in part,
      learned during childhood when parents model sick role behavior or respond to their children's
      somatic complaints in a way that encourages or reinforces sick role behavior. The goal of
      this project is to evaluate the efficacy of a social learning and cognitive behavior therapy
      approach for treating children with RAP.

      The study is a randomized clinical trial. Children with RAP are assigned to one of two
      treatment conditions: 1) a social learning and cognitive behavior therapy condition (SLCBT)
      or 2) an education and support condition (ES). The SLCBT protocol teaches parents and
      children cognitive-behavioral methods such as relaxation and coping for managing RAP pain and
      stress. Patients and parents in the ES condition receive educational information regarding
      nutrition and the gastrointestinal system. Both treatment arms consist of three sessions with
      a mental health professional, each one week apart.

      Study families are recruited from physicians in the community and through community flyers
      and newsletters. Outcome measures are collected at baseline, end of treatment, and at
      follow-up evaluations conducted three, six and 12 months later. Measures are designed to
      assess: RAP symptoms, health care utilization, psychological symptoms, school absences,
      functional disabilities, and family stress).

      Primary Hypothesis: Children in the SLCBT condition will exhibit a greater decrease in
      symptoms of RAP and related maladaptive behaviors and cognitions than children in a
      comparison condition.
    

Intervention name(s): Social Learning and Cognitive Behavioral Therapy (SLCBT); Education Support (ES)
Intervention type(s): Behavioral; Behavioral
Intervention description(s): The SLCBT condition consists of 3 main components: 1.) relaxation training, 2.) working with parent and child to modify family responses to illness and wellness behaviors, and 3.) cognitive restructuring to address and alter dysfunctional cognitions regarding symptoms and their implications for functioning through cognitive therapy techniques; The ES condition focuses on education about GI system anatomy and function, information about the United States Department of Agriculture nutrition guidelines, and additional food-related information such as how to read food product labels. The ES condition was developed to provide a credible alternative condition that would control for therapist and patient time and attention.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: recurrent abdominal pain; illness behavior; social learning; cognitive behavioral therapy