COGNITIVE MEDIATORS OF TREATMENT OUTCOMES IN PEDIATRIC FUNCTIONAL ABDOMINAL PAIN

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 COGNITIVE MEDIATORS OF TREATMENT OUTCOMES IN PEDIATRIC FUNCTIONAL ABDOMINAL PAIN

`   TABLE OF CONTENTS

Cover page

Title page

Certification        –       –       –       –       –       –       –       –       i

Dedication –       –       –       –       –       –       –       –       –       ii

Acknowledgement      –       –       –       –       –       –       –       iii

Abstract     –       –       –       –       –       –       –       –       –       v

Table of contents        –       –       –       –       –       –       –       –       vi

CHAPTER ONE: INTRODUCTION

1.1    Background of the Study     –       –       –       –       –       1

1.2    Statement of Problem  –       –       –       –       –       –       7

1.3    Purpose of the study           –       –       –       –       –       8

1.4    Objective of the Study –       –       –       –       –       –       9

1.4    Research Questions    –       –       –       –       –       –       10

1.5    Research Hypothesis   –       –       –       –       –       –       10

1.6    Significance of the Study     –       –       –       –       –       11

1.7    Scope of the study      –       –       –       –       –       –       11

1.8    Limitation of the study         –       –       –       –       –

1.9    Definition of Terms             –       –       –       –       –       12

CHAPTER TWO: REVIEW OF RELATED LITERATURE

2.1    Introduction       –       –       –       –       –       –       –       14

2.2 The Theoretical frame Work –       –       –       –       –       21

2.3 conceptual frame work

2.4 empirical review

CHAPTER THREE: RESEARCH METHODOLOGY

3.1    Introduction       –       –       –       –       –       –       –       82

3.2    Area of the study                –       –       –       –       –       –       82

3.3    Research Design        –       –       –       –       –       –       82

3.4    Sample and sampling techniques –       –       –       –       83

3.5    Population of the study               –       –       –       –       –       84

3.6    Procedure for Data Collection      –       –       –       –       85

3.7    Method of Data Analysis      –       –       –       –       –       85

CHAPTER FOUR: PRESENTATION, ANALYSIS AND INTERPRETATION OF DATA

4.1    Introduction       –       –       –       –       –       –       –       87

4.2    Presentation of Data           –       –       –       –       –       87

4.3    Data Analysis     –       –       –       –       –       –       –       88

4.4    Testing of Hypothesis          –       –       –       –       –       91

4.5    Discussion and summary of findings             –       –       94

CHAPTER FIVE:

INTRODUCTION, SUMMARY, RECOMMENDATIONS AND CONCLUSION

5.0    Introduction       –       –       –       –       –       –       –       98

5.1    Summary           –       –       –       –       –       –       –       99

5.2    Conclusion –       –       –       –       –       –       –       –       100

5.3    Recommendations      –       –       –       –       –       –       101

REFERENCES

Appendix

Questionnaire

Abstract

Objectives

Cognitive-behavioral interventions improve outcomes for many pediatric health conditions, but little is known about which mechanisms mediate these outcomes. The goal of this study was to identify whether changes in targeted process variables from baseline to one week post-treatment mediate improvement in outcomes in a randomized controlled trial of a brief cognitive-behavioral intervention for idiopathic childhood abdominal pain.

Methods

Two-hundred children with persistent functional abdominal pain and their parents were randomly assigned to one of two conditions: a 3-session social learning and cognitive-behavioral treatment (SLCBT) (N=100), or a 3-session educational intervention controlling for time and attention (N=100). Outcomes were assessed at 3, 6 and 12 month follow-ups. The intervention focused on altering parental responses to pain and on increasing adaptive cognitions and coping strategies related to pain in both parents and children.

Results

Multiple mediation analyses were applied to examine the extent to which the effects of the SLCBT condition on child GI symptom severity and pain as reported by children and their parents were mediated by changes in targeted cognitive process variables and parents’ solicitous responses to their child’s pain symptoms. Reductions in parents’ perceived threat regarding their child’s pain mediated reductions in both parent- and child-reported GI symptom severity and pain. Reductions in children’s catastrophic cognitions mediated reductions in child-reported GI symptom severity but no other outcomes. Reductions in parental solicitousness did not mediate outcomes.

Discussion

Results suggest that reductions in reports of children’s pain and GI symptoms following a social learning and cognitive-behavioral intervention were mediated at least in part by decreasing maladaptive parent and child cognitions.

 COGNITIVE MEDIATORS OF TREATMENT OUTCOMES IN PEDIATRIC FUNCTIONAL ABDOMINAL PAIN

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