(301) Youth with Functional Abdominal Pain Disorders Experience a Reduction in Anxiety after CBT Despite the Presence of Maternal Anxiety

Abstract

Pediatric functional abdominal pain disorders (FAPD) are associated with increased rates of anxiety in affected youth and in their parents and child anxiety has been shown to adversely impact response to cognitive behavioral therapy (CBT) for pain. Novel CBT approaches targeting both pain and anxiety have demonstrated effectiveness in reducing symptoms in youth with FAPD (i.e., Aim to Decrease Anxiety in Pain Treatment [ADAPT]), though it is unknown how parental anxiety may impact treatment response. Parental anxiety may warrant further study given that anxiety often aggregates in families. The current study explored how maternal anxiety impacted changes in child anxiety following ADAPT versus treatment as usual. A total of 74 mother-child dyads participated in the 6-session randomized trial, with 51% (n=38) completing ADAPT. Maternal report of anxiety symptoms at baseline (Differential Abilities Scale, Anxiety Subscale) and child report of anxiety symptoms at baseline and following the trial were collected (Screen for Child Anxiety and Related Emotional Disorders, Generalized Anxiety Subscale). The ADAPT intervention moderated the relation between maternal anxiety and change in the child's anxiety symptoms (b=4.34, SE=1.56, t=2.79, p=.007). Probing this interaction revealed that maternal anxiety tended to relate to greater decreases in child anxiety only for those families in the ADAPT condition. Children assigned to the control group with more anxious mothers actually demonstrated increases in their anxiety symptoms over the course of the trial. Results reveal the effectiveness of ADAPT for potentially disrupting the intergenerational transmission of anxiety, which in turn may improve pain-related outcomes for youth with chronic pain conditions. Funded by American Pain Society Sharon S Keller Chronic Pain Research Grant (2015-2017) and Cincinnati Children's Hospital Place Outcomes Research Award. (Campo, Arch Pediatr Adolesc Med, 2007; Cunningham, J Pediatr, 2016; Cunningham, J Pediatr Gastroenterol Nutr, 2018; Eley, Am J Psychiatry, 2015)