Brief CBT for Pediatric Abdominal Pain and Anxiety

针对小儿腹痛和焦虑的简短 CBT

• 批准号: 7289267
• 负责人: John Vincent Campo
• 金额: $ 19.44万
• 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/7289267
• 关键词: Abdominal Pain; Adherence; Adolescent; Affect; Age; Anxiety; Anxiety Disorders; Arts; Behavior Therapy; Behavioral; Caring; Child; Childhood; Clinical; Clinical Trials; Cognitive; Comorbidity; Condition; Consensus; Consumer Satisfaction; Coping Behavior; Diagnostic; Disease; Effectiveness; Emotional; Frequencies; Future; Gender; Goals; Health; High Prevalence; Impairment; Intervention; Investigation; Link; Manuals; Measures; Mediator of activation protein; Medical; Mental Depression; Mental Health; Mental disorders; Nurses; Outcome; Pain; Pain management; Participant; Phase; Physicians; Practice based research; Primary Care Physician; Primary Health Care; Protocols documentation; Psychotherapy; Randomized; Range; Rate; Recruitment Activity; Recurrence; Relative (related person); Research; Research Support; Score; Site; Somatoform Disorders; Staging; Symptoms; Syndrome; Telephone; Testing; Week; Youth; base; biopsychosocial; blind; clinically significant; coping; depressive symptoms; design; dissemination trial; follow-up; functional disability; impression; indexing; psychologic; psychosocial; response; size; success; therapy development

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）：拟议的研究将开发和测试简短的认知行为心理疗法（BCBT），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年。RAP是常见的和损害性的，并被认为是功能性的，在没有解释性的身体疾病。因此，RAP理论上被认为是由于情绪原因。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，其余患有抑郁症或躯体形式障碍。建议的研究重点是最典型的演示RAP共病焦虑。对于区域行动方案的最佳做法干预措施没有达成共识。CBT已经显示出与RAP相关的疼痛的希望，并且有证据表明CBT有益于儿科焦虑。拟议的治疗开发研究将测试BCBT适用于医疗环境中的成功，凭借简洁，相对简单，将身体投诉与行为干预联系起来的理由，以及对精神病合并症的适用性，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7至16岁（含）的患有功能性RAP和焦虑症的儿童和青少年接受了6次BCBT治疗，其中2次可选的电话“助推器”由健康教练在8周的治疗阶段提供，或由转诊医生进行常规护理（UC）。 医生包括诊断解释，安慰和鼓励恢复日常活动。在初始评估后第8周和第20周，将由一名独立评估员（对受试者状态不知情）评估结局。主要结局为总体临床改善、腹痛和焦虑。将评估抑郁、其他躯体症状和功能障碍，并将对整体治疗反应的潜在介导剂和调节剂沿着BCBT的可接受性和持久性进行二次检查。