Trajectories of symptoms and impairment for pediatric patients with functional abdominal pain: a 5-year longitudinal study.
OBJECTIVE
This prospective study characterizes trajectories of symptoms and impairment in pediatric patients with abdominal pain not associated with identifiable organic disease.


METHODS
The Children's Somatization Inventory and the Functional Disability Inventory were administered four times over 5 years to 132 patients (6-18 years old) seen in a pediatric gastroenterology clinic. Individual trajectories were empirically grouped and correlates of trajectory group membership at baseline were evaluated.


RESULTS
A model with three unique trajectories was found to adequately fit both symptom and impairment data. Two trajectories indicated relatively long-term improvement and one indicated continued high levels of symptoms and impairment. At baseline, the long-term risk group did not have the most severe pain but had significantly more anxiety, depression, lower perceived self-worth, and more negative life events.


CONCLUSIONS
These results indicate that several distinct trajectories of relatively long-term outcomes may exist in children with functional abdominal pain. One trajectory indicated long-term risk for a high level of symptoms and impairment. Psychosocial correlates of long-term risk for physical symptoms and impairment, such as child-reported stress and internalizing symptoms, may be useful for treatment planning.
Mulvaney
Shelagh
S
Dr. Mulvaney is with the Department of Pediatrics and Center for Evaluation and Program Improvement, Vanderbilt University; Dr. Lambert is with the Center for Evaluation and Program Improvement, Vanderbilt University; Dr. Garber is with the Department of Psychology, Vanderbilt University; and Dr. Walker is with the Department of Pediatrics, Vanderbilt University Medical Center. Electronic address: shelagh.mulvaney@vanderbilt.edu.
Lambert
E Warren
EW
Dr. Mulvaney is with the Department of Pediatrics and Center for Evaluation and Program Improvement, Vanderbilt University; Dr. Lambert is with the Center for Evaluation and Program Improvement, Vanderbilt University; Dr. Garber is with the Department of Psychology, Vanderbilt University; and Dr. Walker is with the Department of Pediatrics, Vanderbilt University Medical Center.
Garber
Judy
J
Dr. Mulvaney is with the Department of Pediatrics and Center for Evaluation and Program Improvement, Vanderbilt University; Dr. Lambert is with the Center for Evaluation and Program Improvement, Vanderbilt University; Dr. Garber is with the Department of Psychology, Vanderbilt University; and Dr. Walker is with the Department of Pediatrics, Vanderbilt University Medical Center.
Walker
Lynn S
LS
Dr. Mulvaney is with the Department of Pediatrics and Center for Evaluation and Program Improvement, Vanderbilt University; Dr. Lambert is with the Center for Evaluation and Program Improvement, Vanderbilt University; Dr. Garber is with the Department of Psychology, Vanderbilt University; and Dr. Walker is with the Department of Pediatrics, Vanderbilt University Medical Center.
D015746:Abdominal Pain / Q000175:diagnosis* / Q000503:physiopathology*; D000293:Adolescent; D002648:Child; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D013001:Somatoform Disorders / Q000175:diagnosis / Q000503:physiopathology*