ICBT for Children With FAPDs - the Child's Pain Regulation
Study Details
Study Description
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?
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| FAPDs Children 8-17 years with FAPDs |
Other: Internet-delivered cognitive behavioral therapy
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.
|
| Controls Children 8-17 years without FAPDs |
Outcome Measures
Primary Outcome Measures
- 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 Outcome Measures
- 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
Eligibility Criteria
Criteria
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)
Contacts and Locations
Locations
No locations specified.Sponsors and Collaborators
- Karolinska Institutet
- Child and Adolescent Psychiatry, Stockholm
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 20223238