Functional Abdominal Pain Syndrome
Conditions
Brief summary
Functional abdominal pain disorders (FAPDs) in children are common (14%) and abdominal pain has increased rapidly in children during the last ten years in Sweden. Many children with FAPDs have low quality of life, missed school days, and about 30-40% suffer from psychiatric comorbidity. FAPDs are often sustained into adulthood and a large Swedish cohort study showed that abdominal pain during childhood is an independent strong predictor anxiety and depression later in life. Internet-cognitive behavioral therapy (Internet-CBT) can improve FAPD symptoms, but a significant number of children does not respond to the treatment. We will here determine the pain regulation in children with FAPDs, compared with healthy controls, and assess: What aspects of the child's pain regulation is related to improvement for children with FAPDs engaging in Internet-CBT? Does some aspects of the child's pain regulation change during treatment?
Interventions
Ten weekly modules for children and ten weekly modules for parents. Exposure-based cognitive behavioral therapy delivered online with asynchronous support via text messages from psychologists.
Sponsors
Karolinska Institutet
Child and Adolescent Psychiatry, Stockholm
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
8 Years to 17 Years
Healthy volunteers
Yes
Inclusion criteria
Children 8-17 years with FAPDs: Have been offered treatment at BUP Internetbehandling for FAPDs. Children 8-17 years without FAPDs: Not affected by recurrent (every week) or persistant pain during the last year.
Exclusion criteria
Contraindication for MR (metal implant or metal object in body, claustrophobia, pregnancy)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pressure pain threshold on navel | Baseline differences and baseline to follow-up after 10 week's treatment (or 10 week's wait for healthy children) | Algometer pressure (in kPa) for the pain threshold |
| Unpleasantness of pressure pain threshold on navel | Baseline differences and baseline to follow-up after 10 week's treatment (or 10 week's wait for healthy children) | Children rate their unpleasantness on a scale 0-10 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pressure pain threshold on thigh | Baseline differences and baseline to follow-up after 10 week's treatment (or 10 week's wait for healthy children) | Algometer pressure (in kPa) for the pain threshold |
| Unpleasantness of pressure pain threshold on thigh | Baseline differences and baseline to follow-up after 10 week's treatment (or 10 week's wait for healthy children) | Children rate their unpleasantness on a scale 0-10 |
| Conditioned pain modulation | Baseline differences and baseline to follow-up after 10 week's treatment (or 10 week's wait for healthy children) | Conditioned pain: hand in 10°C cold water, test pain: presseure pain thresholds by algometer on the participant's thigh. Difference in pressure pain thresholds with and without the simultaneous conditioned stimuli |
| Temporal summation | Baseline differences and baseline to follow-up after 10 week's treatment (or 10 week's wait for healthy children) | Pinprick stimuli of low pain, one time, then repeated 10 times. Pain after repeated stimulus minus pain for the single stimulus. |
| Sensory attenuation of pain | Baseline differences and baseline to follow-up after 10 week's treatment (or 10 week's wait for healthy children) | Pressure pain thresholds (kPa) applied by the child or the experimenter. Sensory attenuation = difference in pain threshold between self-induced and experimenter induced |
| Resting state fMRI | Baseline differences and baseline to follow-up after 10 week's treatment (or 10 week's wait for healthy children) | Differences in network connectivity (Yeo networks + subcortical areas) and between seed (trunk in the somatosensory cortex) to Yeo brain networks + subcortical areas). |
| fMRI during low pain compared with non-painful tactile stimulus | Baseline differences and baseline to follow-up after 10 week's treatment (or 10 week's wait for healthy children) | Differences in network connectivity (Yeo networks + subcortical areas) and between seed (trunk in the somatosensory cortex) to Yeo brain networks + subcortical areas). |
| Pediatric Quality of Life Inventory Gastrointestinal Symptom Scale (PedsQL Gastro) | Baseline differences and baseline to follow-up after 10 week's treatment (or 10 week's wait for healthy children) | Self-assessed questionnaire of abdominal symptoms |
| Faces Pain Rating Scale (FACES) | Baseline differences and baseline to follow-up after 10 week's treatment (or 10 week's wait for healthy children) | Self-assessed questionnaire of pain intensity |
| Visceral sensitivity Index, child-adapted short version (VSI-C) | Baseline differences and baseline to follow-up after 10 week's treatment (or 10 week's wait for healthy children) | Self-assessed questionnaire of gastrointestinal-specific anxiety |
| Irritable bowel syndrome-behavioral responses questionnaire, child-adapted short version (BRQ-C) | Baseline differences and baseline to follow-up after 10 week's treatment (or 10 week's wait for healthy children) | Self-assessed questionnaire of gastrointestinal-specific avoidance and controlling behaviors |
Countries
Sweden
Contacts
PRINCIPAL_INVESTIGATORMaria Lalouni, PhD
Karolinska Institutet
Outcome results
None listed