Are child anxiety and somatization associated with pain in pain-related functional gastrointestinal disorders?

Williams, Amy E.; Czyzewski, Danita I.; Self, Mariella M.; Shulman, Robert J.

doi:10.1177/1359105313502564

Cited by 18 publications

(32 citation statements)

References 60 publications

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“…Furthermore, a community‐based study in a nonclinical sample of children and adolescents, found that somatization mediated the relationships of anxiety/depression and abdominal pain . Williams and colleagues also reported that somatization is more strongly associated with pain severity than anxiety, although they did not test for mediation . Other studies suggest that these maladaptive thought processes may also affect other health outcomes in children with abdominal pain.…”

Section: Discussionmentioning

confidence: 99%

“…Evidence exists suggesting this same relation may be true for children. Our research group has shown somatization is associated with abdominal pain symptoms in children with functional abdominal pain . In a sample of healthy children without a functional abdominal pain disorder, Lavigne and colleagues found somatization mediated the relation between anxiety/depression and abdominal pain .…”

Section: Introductionmentioning

confidence: 87%

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Multiple psychological factors predict abdominal pain severity in children with irritable bowel syndrome

Hollier

Tilburg

Liu

et al. 2018

Neurogastroenterology Motil

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Background Anxiety and depression are implicated as contributors to abdominal pain in pediatric irritable bowel syndrome (IBS) but is unclear if this pain is associated with other psychological factors. The study objective was to test if the impact of anxiety or depression on IBS symptom severity is mediated by somatization and/or pain catastrophizing. Methods We utilized baseline data from local pediatric IBS clinical studies. Through mediation analysis, we assessed whether somatization or pain catastrophizing mediated (either independently or combined) the separate relationships of anxiety or depression with IBS abdominal pain severity. Key Results We analyzed 261 participants. All psychological factors were positively correlated with one another and IBS abdominal pain severity. The association of anxiety with IBS abdominal pain was mediated by both somatization and pain catastrophizing in individual analyses (each mediated standardized coefficient [β] 0.11, CI 0.05‐0.18) and in multiple analysis (mediated standardized β 0.18, CI 0.09‐0.27). The association of depression with IBS abdominal pain was also mediated by somatization (mediated standardized β 0.08, CI0.02‐0.14) and pain catastrophizing (mediated standardized β 0.06, CI 0.01‐0.11) in individual analyses and in multiple analysis (mediated standardized β 0.19, CI 0.04‐0.19). Conclusions and Inferences Somatization and pain catastrophizing mediate the relationships between anxiety/depression and IBS abdominal pain severity. These findings suggest that somatization and pain catastrophizing may be better treatment targets than anxiety and depression. Clinicians should assess these psychological factors in pediatric IBS patients and refer for intervention to improve outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 87%

Multiple psychological factors predict abdominal pain severity in children with irritable bowel syndrome

Hollier

Tilburg

Liu

et al. 2018

Neurogastroenterology Motil

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“…18 The CSI has been successfully used and validated in children with functional gastrointestinal disorders such as IBS. 19, 20 Total scores for the CSI range between 0 and 140 with increasing scores indicating greater levels of somatization.…”

Section: Methodsmentioning

confidence: 99%

Self-Perceived Food Intolerances Are Common and Associated with Clinical Severity in Childhood Irritable Bowel Syndrome

Chumpitazi¹,

Weidler²,

Lu³

et al. 2016

Journal of the Academy of Nutrition and Dietetics

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Background Adults with irritable bowel syndrome (IBS) frequently identify foods as exacerbating their gastrointestinal (GI) symptoms. In children with IBS the prevalence of perceived food intolerances and their impact are unknown. Objectives To determine the prevalence of self-perceived food intolerances and the relationship of these intolerances to abdominal pain, psychosocial distress, and quality of life in children with IBS. Design Cross-sectional; questionnaire and prospective diary data were collected from 2008–2014 by trained research coordinators. Participants/Setting Children 7–18 years (pediatric Rome III IBS, n=154; age-sex matched healthy children (HC), n=32) in Houston, Texas. Measures Perceived food intolerances and avoided foods were captured using the Childhood Food and Symptom Association Questionnaire. IBS severity was assessed by a ≥7-day Pain Diary and validated psychosocial questionnaires assessing quality of life, somatization, functional disability, depression, and anxiety. Statistical Analyses Performed Descriptive, Spearman bivariate correlation, chi-square, Poisson log-linear generalized model with Wald chi-square statistics. Results A greater proportion of children with IBS (143/154, 92.9%) vs HC (20/32, 62.5%) identified at least one self-perceived food intolerance (χ2=22.5, P<0.001). Children with IBS identified a greater number (median [25=75%]=4[2–6]) of perceived symptom-inducing foods than HC (median=2[0–4]; χ2=28.6,P<0.001). Children with IBS avoided more foods (median=2[1–4]) than HC (median=0 [0–2.75]; χ2=20.8, P<0.001). The number of self-perceived food intolerances was weakly associated (r-value range of −0.17 to 0.21) with pain frequency, pain severity, somatization, anxiety, functional disability, and decreased quality of life. Conclusions Children with IBS have a high prevalence of self-perceived food intolerances; the number of these intolerances is weakly associated with measures of IBS severity.

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“…Furthermore, somatization is an important predictor of outcomes in children with FAPD. It is associated with pain severity, medical health visits, and pain maintenance into adulthood . Williams et al found somatization to be more strongly associated with pain severity than anxiety.…”

Section: Fapd and Somatizationmentioning

confidence: 99%

“…It is associated with pain severity, medical health visits, and pain maintenance into adulthood . Williams et al found somatization to be more strongly associated with pain severity than anxiety. Studies suggest that anxiety may only indirectly affect symptoms, through its effect on somatization .…”

Section: Fapd and Somatizationmentioning

confidence: 99%

The role of psychological factors in pediatric functional abdominal pain disorders

Newton

Schosheim

Patel

et al. 2019

Neurogastroenterology Motil

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Background Pediatric functional abdominal pain disorders (FAPDs) are disorders of brain‐gut dysregulation. Psychological factors are known to be related to etiology, maintenance, and exacerbation of pediatric FAPDs. With the evolving literature in the past two decades, a better understanding has emerged of precisely which psychological factors are associated with childhood FAPDs. Purpose This narrative literature review summarizes the literature of both child and parent psychological factors in pediatric FAPD. Where anxiety and depression were major targets in the older literature, present‐day focus is increasingly on pain‐specific cognitions and coping strategies including disease threat and catastrophizing. In addition, parental reaction to a child's pain is increasingly recognized as an important moderator of a child's outcomes and has become an area for clinical intervention. Screening for these factors and integrative treatment approaches are recommended in childhood FAPD.

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Are child anxiety and somatization associated with pain in pain-related functional gastrointestinal disorders?

Cited by 18 publications

References 60 publications

Multiple psychological factors predict abdominal pain severity in children with irritable bowel syndrome

Multiple psychological factors predict abdominal pain severity in children with irritable bowel syndrome

Self-Perceived Food Intolerances Are Common and Associated with Clinical Severity in Childhood Irritable Bowel Syndrome

The role of psychological factors in pediatric functional abdominal pain disorders

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