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Behav Res Ther. 2017 Oct;97:200-212. doi: 10.1016/j.brat.2017.07.009. Epub 2017 Jul 29.

Acceptance-based interoceptive exposure for young children with functional abdominal pain.

Author information

1
Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, United States; Department of Psychology and Neuroscience, Duke University United States. Electronic address: zucke001@mc.duke.edu.
2
Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, United States.
3
Department of Psychology, University of California Los Angeles, United States; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, United States.
4
Department of Psychology and Neuroscience, Duke University United States.
5
Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, United States; Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, United States.

Abstract

Functional abdominal pain (FAP) is a common childhood somatic complaint that contributes to impairment in daily functioning (e.g., school absences) and increases risk for chronic pain and psychiatric illness. Cognitive behavioral treatments for FAP target primarily older children (9 + years) and employ strategies to reduce a focus on pain. The experience of pain may be an opportunity to teach viscerally hypersensitive children to interpret the function of a variety of bodily signals (including those of hunger, emotions) thereby reducing fear of bodily sensations and facilitating emotion awareness and self-regulation. We designed and tested an interoceptive exposure treatment for younger children (5-9 years) with FAP. Assessments included diagnostic interviews, 14 days of daily pain monitoring, and questionnaires. Treatment involved 10 weekly appointments. Using cartoon characters to represent bodily sensations (e.g., Gassy Gus), children were trained to be "FBI agents" - Feeling and Body Investigators - who investigated sensations through exercises that provoked somatic experience. 24 parent-child dyads are reported. Pain (experience, distress, and interference) and negative affect demonstrated clinically meaningful and statistically significant change with effect sizes ranging from 0.48 to 71 for pain and from 0.38 to 0.61 for pain distress, total pain: X2 (1, n = 24) = 13.14, p < 0.0003. An intervention that helps children adopt a curious stance and focus on somatic symptoms reduces pain and may help lessen somatic fear generally.

CLINICAL TRIAL REGISTRATION:

NCT02075437.

KEYWORDS:

Functional abdominal pain; Interoceptive awareness; Interoceptive exposure; Somatic fear; Visceral hypersensitivity

PMID:
28826066
PMCID:
PMC5786377
DOI:
10.1016/j.brat.2017.07.009
[Indexed for MEDLINE]
Free PMC Article

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