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Parental responses and catastrophizing in online cognitive behavioral therapy for pediatric functional abdominal pain : A mediation analysis of a randomized controlled trial

Lalouni, Maria ; Bujacz, Aleksandra ; Bonnert, Marianne ; Jensen, Karin B. ; Rosengren, Anna ; Hedman-Lagerlöf, Erik ; Serlachius, Eva LU ; Olén, Ola and Ljótsson, Brjánn (2022) In Frontiers in Pain Research 3.
Abstract

Objective: To test if decreased parental protective behaviors, monitoring behaviors, and parental catastrophizing mediate relief of gastrointestinal symptoms in children 8–12 years with functional abdominal pain disorders (FAPDs). The study uses secondary data analyses of a randomized controlled trial in which exposure-based online cognitive behavioral therapy (ICBT) was found superior to treatment as usual in decreasing gastrointestinal symptoms. Methods: The ICBT included 10 weekly modules for children and 10 weekly modules for parents. Treatment as usual consisted of any medication, dietary adjustments, and healthcare visits that the participants engaged in during 10 weeks. All measures were self-assessed online by parents. Biweekly... (More)

Objective: To test if decreased parental protective behaviors, monitoring behaviors, and parental catastrophizing mediate relief of gastrointestinal symptoms in children 8–12 years with functional abdominal pain disorders (FAPDs). The study uses secondary data analyses of a randomized controlled trial in which exposure-based online cognitive behavioral therapy (ICBT) was found superior to treatment as usual in decreasing gastrointestinal symptoms. Methods: The ICBT included 10 weekly modules for children and 10 weekly modules for parents. Treatment as usual consisted of any medication, dietary adjustments, and healthcare visits that the participants engaged in during 10 weeks. All measures were self-assessed online by parents. Biweekly assessments of the Adult Responses to Children's Symptoms (ARCS), Protect and Monitor subscales, and the Pain Catastrophizing Scale, parental version (PCS-P) were included in univariate and multivariate growth models to test their mediating effect on the child's gastrointestinal symptoms assessed with the Pediatric Quality of Life Gastrointestinal Symptoms Scale (PedsQL). Results: A total of 90 dyads of children with FAPDs and their parents were included in the study, of which 46 were randomized to ICBT and 44 to treatment as usual. The PCS-P was found to mediate change in the PedsQL ab = 0.639 (95% CI 0.020–2.331), while the ARCS Monitor ab = 0.472 (95% CI −1.002 to 2.547), and Protect ab = −0.151 (95% CI −1.455 to 0.674) were not mediators of change. Conclusions: To target parental catastrophizing in ICBT for pediatric FAPDs is potentially important to reduce abdominal symptoms in children.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
children, functional abdominal pain, irritable bowel syndrome, mediation analysis, parents
in
Frontiers in Pain Research
volume
3
article number
962037
publisher
Frontiers Media S. A.
external identifiers
  • pmid:36262179
  • scopus:85163695342
ISSN
2673-561X
DOI
10.3389/fpain.2022.962037
language
English
LU publication?
yes
id
92b46c90-c56d-4827-bdc4-d0b7621390f3
date added to LUP
2023-10-20 14:17:24
date last changed
2024-04-19 02:40:05
@article{92b46c90-c56d-4827-bdc4-d0b7621390f3,
  abstract     = {{<p>Objective: To test if decreased parental protective behaviors, monitoring behaviors, and parental catastrophizing mediate relief of gastrointestinal symptoms in children 8–12 years with functional abdominal pain disorders (FAPDs). The study uses secondary data analyses of a randomized controlled trial in which exposure-based online cognitive behavioral therapy (ICBT) was found superior to treatment as usual in decreasing gastrointestinal symptoms. Methods: The ICBT included 10 weekly modules for children and 10 weekly modules for parents. Treatment as usual consisted of any medication, dietary adjustments, and healthcare visits that the participants engaged in during 10 weeks. All measures were self-assessed online by parents. Biweekly assessments of the Adult Responses to Children's Symptoms (ARCS), Protect and Monitor subscales, and the Pain Catastrophizing Scale, parental version (PCS-P) were included in univariate and multivariate growth models to test their mediating effect on the child's gastrointestinal symptoms assessed with the Pediatric Quality of Life Gastrointestinal Symptoms Scale (PedsQL). Results: A total of 90 dyads of children with FAPDs and their parents were included in the study, of which 46 were randomized to ICBT and 44 to treatment as usual. The PCS-P was found to mediate change in the PedsQL ab = 0.639 (95% CI 0.020–2.331), while the ARCS Monitor ab = 0.472 (95% CI −1.002 to 2.547), and Protect ab = −0.151 (95% CI −1.455 to 0.674) were not mediators of change. Conclusions: To target parental catastrophizing in ICBT for pediatric FAPDs is potentially important to reduce abdominal symptoms in children.</p>}},
  author       = {{Lalouni, Maria and Bujacz, Aleksandra and Bonnert, Marianne and Jensen, Karin B. and Rosengren, Anna and Hedman-Lagerlöf, Erik and Serlachius, Eva and Olén, Ola and Ljótsson, Brjánn}},
  issn         = {{2673-561X}},
  keywords     = {{children; functional abdominal pain; irritable bowel syndrome; mediation analysis; parents}},
  language     = {{eng}},
  publisher    = {{Frontiers Media S. A.}},
  series       = {{Frontiers in Pain Research}},
  title        = {{Parental responses and catastrophizing in online cognitive behavioral therapy for pediatric functional abdominal pain : A mediation analysis of a randomized controlled trial}},
  url          = {{http://dx.doi.org/10.3389/fpain.2022.962037}},
  doi          = {{10.3389/fpain.2022.962037}},
  volume       = {{3}},
  year         = {{2022}},
}