Managing Recurrent Abdominal Pain
Managing Recurrent Abdominal Pain
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).
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.
Inclusion Criteria:

 -  child experienced at least 3 episodes of abdominal pain over a 3-month period which
 affected his/her activities

 -  primary caregiver willing and able to complete questionnaires

 -  child aged 7-17

 -  child has lived with the primary caregiver full-time for at least the past 5 years and
 for at least half of his/her lifetime

 Exclusion Criteria:

 -  positive physical or laboratory findings which would explain the child's abdominal
 pain

 -  chronic disease

 -  major surgery in past year

 -  developmental disabilities that require full-time special education or impair ability
 to respond

 -  inability to comprehend English