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<p>It is unknown whether youth with abdominal pain-related disorders of gut–brain interaction (AP-DGBI) and clinically elevated pain intensity, functional disability, and anxiety (“high-risk”) respond differentially to the Aim to Decrease Anxiety and Pain Treatment (ADAPT), an evidence-based cognitive behavioral therapy program, compared to youth with fewer risk factors (“low-risk”). This secondary analysis included youth aged 9–14 with AP-DGBI recruited from outpatient gastroenterology clinics and randomized to receive ADAPT plus treatment as usual (TAU) or TAU-alone. Baseline risk status was determined using an established grading system derived from validated measures. Differences in post-treatment (~ 8&#xa0;weeks) pain intensity, functional disability, and anxiety were examined using a multivariate analysis of covariance model with an interaction of risk-status-by-treatment-allocation. Data from 79 youth were analyzed; 29 (36.7%) were high-risk. Risk status (F(3, 72) = 3.30, Wilks’ Λ = 0.879, <i>p</i> = 0.025) predicted higher post-treatment pain intensity (estimated marginal mean difference high versus low risk 1.47 [95% Confidence Interval (CI) 0.44, 2.50]) and functional disability (5.71 [95% CI 1.38, 10.05]), but not anxiety. Accounting for risk status, ADAPT did not affect post-treatment outcomes and no risk-by-treatment-interaction emerged. Risk status predicted post-treatment outcomes for youth with AP-DGBI. Clinical implications&#xa0;include screening of psychosocial risk factors.</p>

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The Role of Psychosocial Risk Status in Relation to Outcomes Following Cognitive Behavioral Therapy for Youth with Abdominal Pain-Related Disorders of Gut–Brain Interaction

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月20日

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  • Thea Senger-Carpenter,
  • Steven Pierce,
  • Jocelyn Zuckerman,
  • Elise Cheney-Makens,
  • Michelle Adler,
  • Natoshia Cunningham

摘要

It is unknown whether youth with abdominal pain-related disorders of gut–brain interaction (AP-DGBI) and clinically elevated pain intensity, functional disability, and anxiety (“high-risk”) respond differentially to the Aim to Decrease Anxiety and Pain Treatment (ADAPT), an evidence-based cognitive behavioral therapy program, compared to youth with fewer risk factors (“low-risk”). This secondary analysis included youth aged 9–14 with AP-DGBI recruited from outpatient gastroenterology clinics and randomized to receive ADAPT plus treatment as usual (TAU) or TAU-alone. Baseline risk status was determined using an established grading system derived from validated measures. Differences in post-treatment (~ 8 weeks) pain intensity, functional disability, and anxiety were examined using a multivariate analysis of covariance model with an interaction of risk-status-by-treatment-allocation. Data from 79 youth were analyzed; 29 (36.7%) were high-risk. Risk status (F(3, 72) = 3.30, Wilks’ Λ = 0.879, p = 0.025) predicted higher post-treatment pain intensity (estimated marginal mean difference high versus low risk 1.47 [95% Confidence Interval (CI) 0.44, 2.50]) and functional disability (5.71 [95% CI 1.38, 10.05]), but not anxiety. Accounting for risk status, ADAPT did not affect post-treatment outcomes and no risk-by-treatment-interaction emerged. Risk status predicted post-treatment outcomes for youth with AP-DGBI. Clinical implications include screening of psychosocial risk factors.