Cognitive Behavior Therapy Tailored to Anxiety Symptoms Improves Pediatric Functional Abdominal Pain Outcomes: A Randomized Clinical Trial.
Cognitive Behavior Therapy Tailored to Anxiety Symptoms Improves Pediatric Functional Abdominal Pain Outcomes: A Randomized Clinical Trial.
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针对焦虑症状的认知行为疗法可改善儿童功能性腹痛的预后：一项随机临床试验。
DOI：
10.1016/j.jpeds.2020.10.060
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Kashikar-Zuck S
中科院分区：
文献类型：
--
作者：
Cunningham NR;Kalomiris A;Peugh J;Farrell M;Pentiuk S;Mallon D;Le C;Moorman E;Fussner L;Dutta RA;Kashikar-Zuck S
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To evaluate the feasibility of a stepped care model, and establish the effect of a tailored cognitive behavioral therapy (CBT), the Aim to Decrease Anxiety and Pain Treatment (ADAPT), compared with standard medical treatment as usual on pain-related outcomes and anxiety. Eligible patients between the ages of 9 and 14 years with FAPD (n = 139) received enhanced usual care (EUC) during their medical visit to a gastroenterologist. Those that failed to respond to EUC were randomized to receive either a tailored CBT (ADAPT) plus TAU, or TAU only. ADAPT dose (4 sessions of pain management or 6 sessions of pain and anxiety management) was based on presence of clinically significant anxiety. Outcomes included feasibility, based on recruitment and retention rates. Response to ADAPT+TAU versus TAU on pain-related outcomes and anxiety measures was also investigated using a structural equation modeling (SEM) equivalent of a MANCOVA. Anxiety levels and ADAPT dose as moderators of treatment effects were also explored. Based on recruitment and retention rates, stepped care was feasible. EUC was effective for only 8% of youth. Participants randomized to ADAPT+TAU showed significantly greater improvements in pain-related disability, but not pain levels, and greater improvements in anxiety symptoms compared with those randomized to TAU only. Anxiety and ADAPT treatment dose did not moderate the effect of treatment on disability nor pain. Tailoring care based on patient need may be optimal for maximizing the use of limited psychotherapeutic resources while enhancing care. ClinicalTrials.gov: NCT03134950
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影响因子：
3.6
作者：
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