Physical and Emotional Health of Mothers of Youth With Functional Abdominal Pain

Campo, John V.; Bridge, Jeff; Lucas, Amanda; Savorelli, Steven; Walker, Lynn S.; Lorenzo, Carlo Di; Iyengar, Satish; Brent, David A.

doi:10.1001/archpedi.161.2.131

Cited by 179 publications

(163 citation statements)

References 56 publications

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“…Parental anxiety levels and somatic symptom reporting has been examined in other pediatric conditions; mothers of children who suffer recurrent abdominal pain have significantly higher anxiety levels than comparison groups of mothers of healthy controls. [27][28][29] Additionally, parental depression and stress has been associated with reporting of pediatric neurologic symptoms, including headaches, vertigo, and syncope. 30 The objective of this study was to determine whether elevated parental anxiety at time of injury is a risk factor for PCS in children following acute concussion.…”

Section: Discussionmentioning

confidence: 99%

Parental Anxiety at Initial Acute Presentation Is Not Associated With Prolonged Symptoms Following Pediatric Concussion

Zemek

Clarkin

Farion

et al. 2013

Academic Emergency Medicine

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Objectives: Anxiety modulates symptom perception in adults following concussion, prolonging the time to full recovery. The authors sought to determine whether parental anxiety was associated with persistent postconcussive symptoms (PCS) in their children following concussion.Methods: A prospective observational cohort with 98 children aged 5 to 17 years following concussion participated from a tertiary pediatric emergency department (ED). The main exposure was parental anxiety at the time of acute presentation following pediatric concussion, measured using the selfadministered, validated Spielberger State-Trait Anxiety Inventory-State Anxiety Scale (STAI-S). The primary outcome measured was presence of PCS in the child at 1 month, per the validated PostConcussive Symptom Inventory (PCSI). Secondary outcome measures included parental anxiety score over time, school absenteeism, and return to sports. Data were collected during the initial ED visit and at 3-day, 7-day, 2-week, 1-month, and 3-month follow-ups.Results: Of 98 children enrolled, 27% (95% confidence interval [CI] = 19% to 36%) developed PCS at 1 month. No significant associations were detected between parental anxiety at the index visits and the number of previous pediatric concussions (p = 0.73), sex (p = 0.61), loss of consciousness (p = 0.43), history of migraines (p = 0.31), or history of anxiety diagnosed in the patients (p = 0.09). A significant association was noted between patient diagnosis of attention deficit hyperactivity disorder (ADHD) and parental anxiety at the index visits (p = 0.001). Parental anxiety at acute presentation was not associated with children's prolonged symptoms at 1 month (p = 0.63). Parental anxiety remained elevated in parents whose children had prolonged symptoms compared to those parents whose children's symptoms resolved (median = 30, interquartile range [IQR] = 22 to 44; and median = 21, IQR = 20 to 25, respectively; p < 0.001). Initial parental anxiety presentation was not associated with school absenteeism (p = 0.23) or not returning to sport or gym class (p = 0.89). There were no significant effects involving ADHD alone (p = 0.44) or together with baseline parental anxiety (p = 0.36 for ADHD and p = 0.55 for anxiety) using logistic regression analysis to examine potential predictive effects of child's ADHD combined with parental anxiety at the index visit on persistent symptoms at 1 month.Conclusions: Parental anxiety at time of acute presentation does not appear to be associated with prolongation of postconcussive symptoms in their children. However, parents of persistently symptomatic children remain significantly more anxious than those whose children's symptoms have resolved. Future research should attempt to reduce the familial burden of concussion through expectation management strategies.

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Section: Discussionmentioning

confidence: 99%

Parental Anxiety at Initial Acute Presentation Is Not Associated With Prolonged Symptoms Following Pediatric Concussion

Zemek

Clarkin

Farion

et al. 2013

Academic Emergency Medicine

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“…proposed that various mechanisms such as genetics, early life events, environmental, gastrointestinal and psychosocial factors act together in a complex interplay ultimately resulting in an alteration to the gut-brain axis 10,11,12,13,14,15,16 . Afferent signals from the gastrointestinal tract transmitted via the pain pathways are subsequently amplified and the patient's perception of painful stimuli is in turn enhanced 17 .…”

Section: Pathophysiologymentioning

confidence: 99%

Gastrointestinal and nutritional problems in neurologically impaired children

Quitadamo

Thapar

Staiano

et al. 2016

European Journal of Paediatric Neurology

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Fax: + 44 20 7813 8382Gut Motility disorders comprise a heterogeneous group of disorders that result from disruption of the functional integrity of the intrinsic neuromusculature of the gastrointestinal (GI) tract. This intrinsic neuromusculature includes the smooth muscle layers, the intrinsic nervous system of the GI tract (enteric nervous system or ENS) and the interstitial cells of Cajal. The contribution of each of these components to function can be compromised by alterations in structure (ranging from absence to derangement in numbers and/or anatomy) or of function (complete or partial failure in physiological function). This pathology can be primary or secondary to a number of insults e.g. infections, inflammation, toxins etc. In children disorders may be congenital being present from birth or acquired later in life. Finally involvement of the enteric neuromusculature can be patchy/segmental or affect the gastrointestinal tract diffusely.Neuro-gastroenterology is the study of the interface of all aspects of the gastrointestinal tract or digestive system with the different branches of the body's nervous system including the enteric, central and autonomic nervous systems. The combined terms 'Neurogastroenterology and motility' are designed to encompass the study of all the components of the enteric neuromuscualture and their modulating influences and represents one of the fastest growing areas in gastroenterology clinical practice and research. This chapter aims to address some of the most common neurogastroenterology and motility conditions seen in clinical practice ranging from those with defined pathology to those which fall under the umbrella of functional gastrointestinal disorders. The latter comprise some of the commonest but challenging disorders and the term 'functional' reflects the fact that in the majority of such conditions no organic cause can be found. It should also be noted that at the present time many functional disorders e.g. abdominal pain-related functional GI disorders, represent symptom complexes that can further be subdivided into more discrete entities e.g. irritable bowel syndrome, functional abdominal pain etc depending on the nature, location and associations of the symptoms. Clinicians will often rely on the presence or absence of 'red flags' e.g. associated weight loss, severe or significant symptoms etc to decide whether patients are likely to have organic or functional disorders. Exhaustive investigations in the latter are likely to prove fruitless, expensive and perpetuate 'illness behaviours' in the patients. Abdominal pain-related functional gastrointestinal disorders IntroductionAbdominal pain-related functional gastrointestinal disorders (FGID) constitute a spectrum of conditions characterised by the presence of recurrent abdominal pain in the absence of any defined pathology 1 . In the past these disorders fell under the single term 'Recurrent abdominal pain' (RAP) but have since been recategorised under an international initiative (Rome Foundation) to improve the dia...

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“…Families of patients with FAP showed poorer communication among family members, higher role expectation, less affective responsiveness and involvement, a maladaptive problem-solving style and performed less well than families of control children. In two studies, Campo et al [35,38] found that mothers of children with FAP were less likely to be living with the child’s biological father, less likely to be married [38] and more likely to live alone with their child/children [35]. Logan and Scharff [39] explored whether parental and family characteristics are associated with children’s pain-related disability after accounting for the effects of pain intensity in families with children suffering from recurrent pain (headache, FAP).…”

Section: Two-stage Pathway Modelmentioning

confidence: 99%

Functional Abdominal Pain in Childhood: From Etiology to Maladaptation

Schulte

Petermann

Noeker

2009

Psychother Psychosom

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Objective: To review the extant literature on functional abdominal pain in childhood through the lens of the developmental psychopathology perspective and to systematize research results by means of a two-stage pathway model in which the emergence of functional abdominal pain and its potential transition into a somatoform adjustment disorder is outlined. Methods: Using electronic searches for published studies and previous reviews about functional abdominal pain. Results: An association of functional abdominal pain with internalizing symptoms, poor well-being of family members, major life events and daily stressors is found. The impact of stress on pain seems to be moderated by the children’s coping style and their perceived competence and self-efficacy to manage the pain experience. There is evidence for the influence of modeling and operant mechanisms on pain experiences. A new term, ‘somatoform adjustment disorder’, and its relation to functional abdominal pain is discussed. Conclusions: It seems that those children with functional abdominal pain who cannot adapt to the pain indeed run the risk of developing a somatoform adjustment disorder.

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Physical and Emotional Health of Mothers of Youth With Functional Abdominal Pain

Abstract: Functional abdominal pain may be better conceptualized as a disorder of emotion than a narrowly defined disorder of gastrointestinal function. Low rates of mental health service use by mothers of youth with FAP suggest that family health and illness attitudes deserve study.

Cited by 179 publications

References 56 publications

Parental Anxiety at Initial Acute Presentation Is Not Associated With Prolonged Symptoms Following Pediatric Concussion

Parental Anxiety at Initial Acute Presentation Is Not Associated With Prolonged Symptoms Following Pediatric Concussion

Gastrointestinal and nutritional problems in neurologically impaired children

Functional Abdominal Pain in Childhood: From Etiology to Maladaptation

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