The Influence of Caregiver Distress and Child Anxiety in Predicting Child Somatization in Youth with Functional Abdominal Pain Disorders

Pediatric functional abdominal pain disorders (FAPD) are associated with adverse outcomes including increased somatization (e.g., heightened physiological sensations that include gastroenterological and non-gastroenterological symptoms) and increased functional disability. Caregiver distress and child anxiety are separately associated with the adverse outcomes of pediatric FAPD. However, the cumulative role of caregiver (i.e., stress, anxiety, and depression) and child psychological functioning (anxiety) in relation to adverse outcomes associated with FAPD, and particularly somatization, is unclear. Thus, the present investigation sought to examine the role of caregiver distress and child anxiety in relation to pain-related functioning (i.e., somatization, pain intensity, functional disability) in youth with FAPD. Data were gathered as part of a larger study examining a psychological treatment for youth with FAPD. Participants (ages 9–14) with FAPD completed measures of child anxiety, pain, and pain-related functioning. Caregivers completed a measure of caregiver distress (e.g., stress, anxiety, depressive symptoms). Pearson correlations revealed significant positive associations between child anxiety and child functional disability. Additionally, caregiver anxiety, child anxiety, and child somatization were all significantly and positively correlated with one another. Therefore, we assessed whether child anxiety may potentially mediate the relationship between caregiver anxiety and child somatization in this cross-sectional study. The indirect association between caregiver anxiety and child somatization via child anxiety was not significant. Future research including longitudinal designs to further understand the relationship between caregiver anxiety, child anxiety, and child pain-related functioning, would enhance understanding of how these potentially modifiable psychological factors may impact adverse outcomes of FAPD.

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(102) Child Anxiety Mediates the Relationship between Parent Anxiety and Child Somatization in Youth with Functional Abdominal Pain

Journal of Pain ◽

10.1016/j.jpain.2019.01.021 ◽

2019 ◽

Vol 20 (4) ◽

pp. S2

Author(s):

S. Love ◽

A. Kalomiris ◽

C. Le ◽

N. Cunningham

Keyword(s):

Abdominal Pain ◽

Child Anxiety ◽

Functional Abdominal Pain ◽

The Relationship

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Elevated fecal calprotectin is linked to psychosocial complexity in pediatric functional abdominal pain disorders

BMC Research Notes ◽

10.1186/s13104-021-05776-5 ◽

2021 ◽

Vol 14 (1) ◽

Author(s):

Erin L. Moorman ◽

Michael Farrell ◽

Neha Santucci ◽

Lee Denson ◽

Christine Le ◽

...

Keyword(s):

Risk Factors ◽

Abdominal Pain ◽

Functional Disability ◽

Rating Scale ◽

Child Anxiety ◽

Risk Groups ◽

Fecal Calprotectin ◽

Numeric Rating Scale ◽

Functional Abdominal Pain ◽

Increased Risk

Abstract Objective Children with functional abdominal pain disorders (FAPD) and clinical elevations in three risk areas (anxiety, functional disability, and pain) have been found to be at increased risk for persistent disability. We evaluated if the presence of these three risk factors corresponded with greater gastrointestinal inflammation (measured via fecal calprotectin; FC) compared to those with no risk factors. FC concentration differences between children with three risk factors and those with one and two risk factors were explored. Results Fifty-six children with FAPD (Mage = 12.23) completed measures of anxiety (Screen for Child Anxiety Related Disorders), disability (Functional Disability Inventory), and pain intensity (Numeric Rating Scale). Participants were stratified into risk groups (range: 0–3). Fisher’s exact tests were conducted to determine if children with three versus fewer risk factors were more likely to have elevated FC (≥ 50 µg/g) versus normal levels. Children with three risk factors (MFC = 86.04) were more likely to have elevated FC compared to children with zero (MFC = 25.78), one (MFC = 38.59), and two risk factors (MFC = 45.06; p’s < 0.05). Those with three risk factors had borderline elevated FC concentrations whereas those with fewer had normal FC concentrations. Findings suggest the importance of a biopsychosocial approach to help elucidate a FAPD phenotype.

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The role of selected dietary and lifestyle factors in the occurrence of symptoms in children with functional abdominal pain – a pilot study

Acta Scientiarum Polonorum Technologia Alimentaria ◽

10.17306/j.afs.0833 ◽

2020 ◽

Vol 19 (3) ◽

pp. 291-300

Author(s):

Katarzyna M. Boradyn ◽

◽

Katarzyna E. Przybyłowicz ◽

Elżbieta Jarocka-Cyrta ◽

Keyword(s):

Abdominal Pain ◽

Pilot Study ◽

Lifestyle Factors ◽

Functional Abdominal Pain

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Role of Gas in Functional Abdominal Pain

Southern Medical Journal ◽

10.1097/00007611-198408000-00005 ◽

1984 ◽

Vol 77 (8) ◽

pp. 962-964

Author(s):

MICHAEL D. LEVITT

Keyword(s):

Abdominal Pain ◽

Functional Abdominal Pain

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Associations of caregiver-oncologist discordance in prognostic understanding with caregiver-reported therapeutic alliance and anxiety.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.31_suppl.15 ◽

2019 ◽

Vol 37 (31_suppl) ◽

pp. 15-15

Author(s):

Kah Poh Loh ◽

Huiwen Xu ◽

Ronald M. Epstein ◽

Supriya Gupta Mohile ◽

Holly Gwen Prigerson ◽

...

Keyword(s):

Life Expectancy ◽

Therapeutic Alliance ◽

Secondary Analysis ◽

Linear Regression Models ◽

Patient Death ◽

System A ◽

Caregiver Anxiety ◽

The Relationship ◽

Clinical Trial Information

15 Background: Discordance in prognostic understanding between caregivers of adults with cancer and the patient’s oncologist is common. However, the relationship between caregiver-oncologist discordance and caregiver bereavement outcomes is unknown. We evaluated the associations of caregiver-oncologist discordance in beliefs about the patient’s curability and life expectancy with caregiver-reported therapeutic alliance and anxiety. Methods: This is a secondary analysis of a multicenter study that assessed the effect of a communication intervention among patients with advanced cancer and their caregivers. Prior to intervention exposure, caregivers and oncologists were asked about their belief in the patient’s chances for cure and living ≥2 years: 100%, about 90%, about 75%, about 50/50, about 25%, about 10%, and 0%. Discordance was defined as a difference by 2 response levels on each prognostic understanding item. Outcomes at 7 months after patient death included caregiver-reported therapeutic alliance [modified 5-item Human Connection (THC) scale] and anxiety (Generalized Anxiety Disorder-7). We used multivariable linear regression models to assess the independent associations of discordance with therapeutic alliance and anxiety. Results: We included 97 caregivers (mean age 63, range 22-83). Approximately 40% of caregiver-oncologist dyads had discordant beliefs about curability (caregivers were more optimistic in 100% of dyads) and 63% had discordant beliefs about life expectancy (caregivers were more optimistic in 94% of dyads). On multivariate analysis, discordance in beliefs about prognostic estimates was associated with lower THC score (b = -6.94, SE 3.17, p = 0.03). Discordance in beliefs about curability was associated with lower anxiety levels (b = -1.79, SE 0.90, p = 0.05). Conclusions: Caregiver-oncologist discordance may decrease caregiver-reported therapeutic alliance and anxiety, both of which may shape how caregivers interact with the healthcare system. A better understanding the role of caregivers’ prognostic understanding will guide interventions to improve caregiver-oncologist therapeutic alliance and caregiver anxiety. Clinical trial information: NCT01485627.

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The role of psychological factors in pediatric functional abdominal pain disorders

Neurogastroenterology & Motility ◽

10.1111/nmo.13538 ◽

2019 ◽

Vol 31 (6) ◽

pp. e13538 ◽

Cited By ~ 5

Author(s):

Emily Newton ◽

Alex Schosheim ◽

Samit Patel ◽

Denesh K. Chitkara ◽

Miranda A. L. Tilburg

Keyword(s):

Abdominal Pain ◽

Psychological Factors ◽

Functional Abdominal Pain

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Pain Neuroscience Education for Children with Functional Abdominal Pain Disorders: A Randomized Comparative Pilot Study

Journal of Clinical Medicine ◽

10.3390/jcm9061797 ◽

2020 ◽

Vol 9 (6) ◽

pp. 1797 ◽

Cited By ~ 2

Author(s):

Roselien Pas ◽

Emma Rheel ◽

Sophie Van Oosterwijck ◽

Anthe Foubert ◽

Robby De Pauw ◽

...

Keyword(s):

Abdominal Pain ◽

Functional Disability ◽

Pain Catastrophizing ◽

Pain Modulation ◽

Therapy Session ◽

Control Group ◽

Functional Abdominal Pain ◽

Local Pressure ◽

Neuroscience Education

This article explores the effectiveness of a newly developed Pain Neuroscience Education program for children (PNE4Kids) with functional abdominal pain disorder (FAPD). Children (6–12 years) with FAPD were randomly assigned to 1) the experimental group (n = 14), participating in one hypnotherapy session (i.e., usual care) and one additional PNE4Kids session, or 2) the control group (n = 14), participating in two hypnotherapy sessions. Parental pain catastrophizing, the child’s functional disability (parental-proxy), pain-related fear (parent-proxy) and pain intensity, were assessed at baseline and one and three weeks after each therapy session. Pressure algometry and a conditioned pain modulation paradigm were performed at baseline and three weeks after completion of the last therapy session. Parents from both the experimental as well as the control group showed significantly less parental pain catastrophizing (p < 0.01). Children showed significantly less functional disability (p < 0.05), pain-related fear (p < 0.01) and local pressure pain sensitivity (p < 0.05) at short-term follow-up (three weeks after last intervention) in both groups. No significant (p > 0.05) between-group differences were found. Hypnotherapy combined with PNE4Kids did not result in better clinical outcomes compared to hypnotherapy alone. Study limitations include the application of one single PNE4Kids session and the short follow-up time.

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Phosphate, Microbiota and CKD

Nutrients ◽

10.3390/nu13041273 ◽

2021 ◽

Vol 13 (4) ◽

pp. 1273

Author(s):

Chiara Favero ◽

Sol Carriazo ◽

Leticia Cuarental ◽

Raul Fernandez-Prado ◽

Elena Gomá-Garcés ◽

...

Keyword(s):

Gut Microbiota ◽

Current Knowledge ◽

Adverse Outcomes ◽

Phosphate Binders ◽

Uremic Toxin ◽

Mineral And Bone Disorder ◽

Dietary Phosphate ◽

The Impact ◽

The Relationship

Phosphate is a key uremic toxin associated with adverse outcomes. As chronic kidney disease (CKD) progresses, the kidney capacity to excrete excess dietary phosphate decreases, triggering compensatory endocrine responses that drive CKD-mineral and bone disorder (CKD-MBD). Eventually, hyperphosphatemia develops, and low phosphate diet and phosphate binders are prescribed. Recent data have identified a potential role of the gut microbiota in mineral bone disorders. Thus, parathyroid hormone (PTH) only caused bone loss in mice whose microbiota was enriched in the Th17 cell-inducing taxa segmented filamentous bacteria. Furthermore, the microbiota was required for PTH to stimulate bone formation and increase bone mass, and this was dependent on bacterial production of the short-chain fatty acid butyrate. We review current knowledge on the relationship between phosphate, microbiota and CKD-MBD. Topics include microbial bioactive compounds of special interest in CKD, the impact of dietary phosphate and phosphate binders on the gut microbiota, the modulation of CKD-MBD by the microbiota and the potential therapeutic use of microbiota to treat CKD-MBD through the clinical translation of concepts from other fields of science such as the optimization of phosphorus utilization and the use of phosphate-accumulating organisms.

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