Abstract
Pediatric functional abdominal pain disorders (FAPD) are associated with adverse outcomes including increased somatization (e.g., heightened physiological sensations that include gastroenterological and non-gastroenterological symptoms) and increased functional disability. Caregiver distress and child anxiety are separately associated with the adverse outcomes of pediatric FAPD. However, the cumulative role of caregiver (i.e., stress, anxiety, and depression) and child psychological functioning (anxiety) in relation to adverse outcomes associated with FAPD, and particularly somatization, is unclear. Thus, the present investigation sought to examine the role of caregiver distress and child anxiety in relation to pain-related functioning (i.e., somatization, pain intensity, functional disability) in youth with FAPD. Data were gathered as part of a larger study examining a psychological treatment for youth with FAPD. Participants (ages 9–14) with FAPD completed measures of child anxiety, pain, and pain-related functioning. Caregivers completed a measure of caregiver distress (e.g., stress, anxiety, depressive symptoms). Pearson correlations revealed significant positive associations between child anxiety and child functional disability. Additionally, caregiver anxiety, child anxiety, and child somatization were all significantly and positively correlated with one another. Therefore, we assessed whether child anxiety may potentially mediate the relationship between caregiver anxiety and child somatization in this cross-sectional study. The indirect association between caregiver anxiety and child somatization via child anxiety was not significant. Future research including longitudinal designs to further understand the relationship between caregiver anxiety, child anxiety, and child pain-related functioning, would enhance understanding of how these potentially modifiable psychological factors may impact adverse outcomes of FAPD.
Highlights
Functional abdominal pain disorders (FAPD) are among the most common pain conditions in children and adolescents, with a median prevalence rate of 12% [1]
* beta significant at the 0.05 level (2-tailed); ** beta is significant at the 0.01 level (2-tailed); The indirect effect was not significant (p = 0.082). This is the first study to our knowledge that examined the relationships between caregiver distress, child anxiety, and pain-related outcomes such as somatization, pain, and functional disability amongst youth with FAPD
Aside from examining relationships between caregiver distress, child anxiety, and child pain-related outcomes, the present study examined the potential role of child anxiety as a mediator of the relationship between caregiver distress and child FAPD outcomes
Summary
Functional abdominal pain disorders (FAPD) are among the most common pain conditions in children and adolescents, with a median prevalence rate of 12% [1]. In terms of the relationships between child mental health functioning and adverse outcomes in youth with FAPD, the presence of anxiety symptoms in pediatric FAPD is associated with greater impairment and higher rates of adverse outcomes, including the maintenance of abdominal pain symptoms and increased functional disability that persists over time [18]. There is a critical need for research to examine how caregiver distress and child anxiety simultaneously impact child outcomes related to FAPD including somatization, functional disability, and pain intensity. The present investigation sought to examine the role of caregiver distress (e.g., stress, anxiety, depression) and child anxiety in relation to FAPD-related outcomes (e.g., somatization, pain levels, functional disability) in youth with FAPD.
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