Brief CBT for Pediatric Abdominal Pain and Anxiety

描述（由申请人提供）：拟议的研究将开发和测试简短的认知行为心理治疗（bbct），用于在传统医疗环境中出现功能性复发性腹痛（RAP）和临床显著焦虑症状的青少年。RAP是一种常见的损伤性疾病，在没有解释性生理疾病的情况下被认为是功能性的。因此，从理论上讲，RAP是由情绪原因引起的。近80%的功能性RAP儿童符合至少一种焦虑症的全部诊断标准，其余患有抑郁症或躯体形式障碍。本研究的重点是最典型的表现- rap与焦虑共病。对RAP的最佳实践干预措施尚无共识。CBT已经显示出与RAP相关的疼痛的希望，并且有证据表明CBT对儿童焦虑有益。拟议的治疗发展研究将通过简洁、相对简单、将身体疾患与行为干预联系起来的基本原理以及对精神疾病合并症的适用性，来测试bbct在医疗环境中是否成功，目的是为未来的有效性和推广试验奠定基础。在3年的时间里，60名患有功能性RAP和焦虑的儿童和青少年，年龄在7岁至16岁之间，包括7岁至16岁，在8周的治疗阶段，由健康教练或转诊者提供2个可选的电话“助推器”，进行6次BCBT治疗

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.