title: Exposure-Based Cognitive Behavior Therapy for Children with Abdominal Pain: A Pilot Trial.
abstract: BACKGROUND
  Children with pain-related functional gastrointestinal disorders (P-FGIDs) have an increased risk for school absenteeism, depression, anxiety and low quality of life. Exposure-based cognitive behavior therapy (CBT) has shown large treatment effects in adults with irritable bowel syndrome, but has not been tested for children 8-12 years with P-FGIDs.
  
  
  OBJECTIVE
  The aim of this trial was to test the feasibility, acceptability and potential efficacy of a newly developed exposure-based CBT for children with P-FGIDs.
  
  
  METHODS
  The children (n = 20) with a P-FGID, were referred by their treating physicians. The participants received 10 weekly sessions of exposure-based CBT and were assessed at pre-treatment, post-treatment and 6-month follow-up.
  
  
  RESULTS
  Children improved significantly on the primary outcome measure pain intensity at post (Cohen's d = 0.40, p = 0.049) and at 6-month follow-up (Cohen's d = 0.85, p = 0.004). Improvements were also seen in pain frequency, gastrointestinal symptoms, quality of life, depression, anxiety, school absenteeism and somatic symptoms. Improvements were maintained or further increased at 6-month follow-up. The children engaged in the exposures and were satisfied with the treatment.
  
  
  CONCLUSIONS
  Exposure-based CBT for children with P-FGIDs is feasible, acceptable and potentially efficacious.
authors.affiliation: Department of Medicine Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden.|Stockholm Health Care Services, Stockholm County Council, Sweden.
authors.forename: Maria
authors.identifier: http://orcid.org/0000-0002-6818-8156
authors.initials: M
authors.lastname: Lalouni
authors.affiliation: Department of Medicine Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden.|Department of pediatric gastroenterology and nutrition, Sachs' Children's hospital, Stockholm, Sweden.
authors.forename: Ola
authors.initials: O
authors.lastname: Olén
authors.affiliation: Stockholm Health Care Services, Stockholm County Council, Sweden.|Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Marianne
authors.initials: M
authors.lastname: Bonnert
authors.affiliation: Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Erik
authors.initials: E
authors.lastname: Hedman
authors.affiliation: Stockholm Health Care Services, Stockholm County Council, Sweden.|Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Serlachius
authors.affiliation: Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden.|Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Brjánn
authors.initials: B
authors.lastname: Ljótsson
mesh_terms: D015746:Abdominal Pain / Q000523:psychology / Q000628:therapy*; D000041:Absenteeism; D001007:Anxiety; D002648:Child; D015928:Cognitive Behavioral Therapy; D003863:Depression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D000071896:Medically Unexplained Symptoms; D010865:Pilot Projects; D011788:Quality of Life; D013689:Telephone; D016896:Treatment Outcome