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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
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden, (SWE), Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden, (SWE), Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden, (SWE).
Swedish Defence University, Institutionen för ledarskap och ledning, Leadership and Command & Control Division Stockholm. Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden, (SWE), Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet / Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden, (SWE).
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden, (SWE).
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2022 (English)In: Frontiers in Pain Research, E-ISSN 2673-561X, Vol. 3Article in journal (Refereed) Published
Abstract [en]

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), Protectand 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 withthe Pediatric Quality of Life Gastrointestinal Symptoms Scale (PedsQL).

Results: A total of 90 dyads of children with FAPDs and their parents were includedin 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% CI0.020–2.331), 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.

Place, publisher, year, edition, pages
2022. Vol. 3
Keywords [en]
functional abdominal pain, parents, children, irritable bowel syndrome, mediation analysis
National Category
Pediatrics
Research subject
Leadership and Command & Control
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URN: urn:nbn:se:fhs:diva-12105DOI: 10.3389/fpain.2022.962037OAI: oai:DiVA.org:fhs-12105DiVA, id: diva2:1825081
Available from: 2024-01-08 Created: 2024-01-08 Last updated: 2024-01-08Bibliographically approved

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