Brief CBT for Pediatric Abdominal Pain and Anxiety

针对小儿腹痛和焦虑的简短 CBT

• 批准号: 7037714
• 负责人: John Vincent Campo
• 金额: $ 20.09万
• 依托单位: RESEARCH INST NATIONWIDE CHILDREN'S HOSP
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-21 至 2009-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7037714
• 关键词: abdomen; adolescence (12-20); anxiety disorders; behavioral /social science research tag; chronic pain; clinical research; clinical trials; cognitive behavior therapy; comorbidity; coping; depression; early /brief intervention /therapy; human subject; human therapy evaluation; interview; middle childhood (6-11); psychological stressor; psychosomatic disorders; telemedicine

DESCRIPTION (provided by applicant): The proposed study will develop and test brief cognitive behavioral psychotherapy (BCBT) for youth presenting with functional recurrent abdominal pain (RAP) and clinically significant anxiety symptoms in traditional medical settings. RAP is common and impairing, and is considered functional in the absence of explanatory physical disease. As such, RAP has been theorized to be due to emotional causes. Nearly 80% of children with functional RAP meet full diagnostic criteria for at least 1 anxiety disorder, with the remainder suffering depression or somatoform disorder. The proposed study focuses on the most prototypic presentation-RAP comorbid with anxiety. There is no consensus on best-practice interventions for RAP. CBT has shown promise for the pain associated with RAP, and there is evidence that CBT benefits pediatric anxiety. The proposed treatment development study will test BCBT adapted for success in medical settings by virtue of brevity, relative simplicity, a rationale linking physical complaints to behavioral interventions, and applicability to psychiatric comorbidity, with the goal of setting the stage for future effectiveness and dissemination trials. Over a 3 year period, 60 children and adolescents with functional RAP and anxiety between the ages of 7 and 16 years, inclusive, to 6 sessions of BCBT with 2 optional telephone "boosters" delivered over the 8 week treatment phase by a health coach or to usual care (UC) by the referring physician consisting of diagnostic explanation, reassurance and encouragement to return to usual activities. Outcomes will be assessed by an independent evaluator blind to participant status at 8 and 20 weeks following initial assessment. Primary outcomes will be global clinical improvement, abdominal pain, and anxiety. Depression, other somatic symptoms, and functional impairment will be assessed, and potential mediators and moderators of global treatment response will be secondarily examined, along with the acceptability and durability of BCBT.

描述（由申请人提供）：拟议的研究将为在传统医疗环境中出现功能性复发性腹痛（RAP）和临床显着焦虑症状的青少年开发和测试简短的认知行为心理治疗（BCBT）。 RAP 很常见且具有损害性，在没有可解释的身体疾病的情况下被认为是功能性的。因此，RAP 被认为是由情绪原因引起的。近 80% 患有功能性 RAP 的儿童符合至少一种焦虑症的完整诊断标准，其余患者患有抑郁症或躯体形式障碍。拟议的研究重点关注最典型的表现——伴有焦虑的 RAP。对于 RAP 的最佳实践干预措施尚未达成共识。 CBT 已显示出治疗 RAP 相关疼痛的希望，并且有证据表明 CBT 有益于儿童焦虑症。拟议的治疗开发研究将测试 BCBT 是否在医疗环境中取得成功，其优点是简洁、相对简单、将身体不适与行为干预联系起来的基本原理以及对精神共病的适用性，目的是为未来的有效性和传播试验奠定基础。在 3 年的时间里，60 名患有功能性 RAP 和焦虑（7 岁至 16 岁）的儿童和青少年接受 6 次 BCBT 治疗，并在 8 周的治疗阶段由健康教练或医生提供 2 次可选的电话“助推器”通过转介到常规护理 (UC) 医生的诊断解释、保证和鼓励恢复正常活动。结果将由独立评估员在初次评估后 8 周和 20 周对参与者状态进行评估。主要结果是整体临床改善、腹痛和焦虑。将评估抑郁症、其他躯体症状和功能障碍，并对整体治疗反应的潜在调节因素和调节因素以及 BCBT 的可接受性和持久性进行二次检查。