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

Abstract

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.

Effect of percutaneous electrical nerve field stimulation on mechanosensitivity, sleep, and psychological comorbidities in adolescents with functional abdominal pain disorders

“…15,16 They also affect disability and other outcomes in children with functional abdominal pain. 17,18 Patients in our cohort exhibited somatization and catastrophizing consistent with previously described literature. We noted marked improvements in these variables with PENFS that were sustained at long-term follow-up.…”

“…1 Pain-associated impairment is prevalent in approximately one third of those affected, [2][3][4] and poor treatment outcomes are associated with significant psychosocial dysfunction. 5,6 The manifestations of chronic abdominal pain are associated with underlying visceral hyperalgesia, 7,8 disturbances in sleep, [9][10][11][12] and/or psychological comorbidities, [13][14][15][16][17][18] but the causeand-effect relationship is unknown. Visceral hyperalgesia is an altered sensation in response to non-noxious, physiological stimuli in the gastrointestinal (GI) tract and is often impacted by psychosocial factors.…”

“…2,14 Catastrophizing and somatization have shown to result in worse psychosocial and functional outcomes. [15][16][17][18] Sleep disturbances may be a result of pain, but have also been suggested to worsen pain in children with chronic pain conditions. [19][20][21][22][23][24] Preclinical and clinical data have shown increased pain sensitivity with sleep deprivation, and there is some suggestion that interventions directed toward sleep improve pain.…”

Anxiety Levels of the Mothers with Children Aged Under Four with Functional Constipation

“…In a meta-analysis including maternal mental disorders such as major depressive disorder and anxiety disorder; It has been determined that children have more physical health problems (5). Again, studies have shown that high stress level of caregivers predicts somatization symptoms in children (6). But in the majority of the studies investigating the psychological aspect in the etiology of functional constipation, children have been the main subject, and remarkably, there are very limited studies scrutinizing the mental state of parents, specifically in the age group where communication is expressed through body language (7).…”

The Impact of Posttraumatic Stress Disorder on Clinical Presentation and Psychosocial Treatment Response in Youth with Functional Abdominal Pain Disorders: An Exploratory Study

“…In fact, a history of traumatic events and/or life stressors may lead to the development of persistent abdominal pain in a subset of youth [ 3 , 4 ]. A significant subset of youth with FAPDs also report a high rate of functional disability (e.g., minimizing physical activity) [ 5 , 6 ] and psychological impairment (e.g., anxiety, depression [ 5 , 7 , 8 ], somatic symptoms [ 9 , 10 ], and distress [ 11 ]) that may be related to the high rates of trauma experiences in this group [ 2 ]. Despite this, the link between pediatric FAPDs, trauma, and other clinical indicators, such as functional impairment and treatment response, have not yet been investigated.…”