3 research outputs found
Evaluation of guided imagery as treatment for recurrent abdominal pain in children: a randomized controlled trial
BACKGROUND: Because of the paucity of effective evidence-based therapies for children with recurrent abdominal pain, we evaluated the therapeutic effect of guided imagery, a well-studied self-regulation technique. METHODS: 22 children, aged 5 – 18 years, were randomized to learn either breathing exercises alone or guided imagery with progressive muscle relaxation. Both groups had 4-weekly sessions with a therapist. Children reported the numbers of days with pain, the pain intensity, and missed activities due to abdominal pain using a daily pain diary collected at baseline and during the intervention. Monthly phone calls to the children reported the number of days with pain and the number of days of missed activities experienced during the month of and month following the intervention. Children with ≤ 4 days of pain/month and no missed activities due to pain were defined as being healed. Depression, anxiety, and somatization were measured in both children and parents at baseline. RESULTS: At baseline the children who received guided imagery had more days of pain during the preceding month (23 vs. 14 days, P = 0.04). There were no differences in the intensity of painful episodes or any baseline psychological factors between the two groups. Children who learned guided imagery with progressive muscle relaxation had significantly greater decrease in the number of days with pain than those learning breathing exercises alone after one (67% vs. 21%, P = 0.05), and two (82% vs. 45%, P < 0.01) months and significantly greater decrease in days with missed activities at one (85% vs. 15%, P = 0.02) and two (95% vs. 77%. P = 0.05) months. During the two months of follow-up, more children who had learned guided imagery met the threshold of ≤ 4 day of pain each month and no missed activities (RR = 7.3, 95%CI [1.1,48.6]) than children who learned only the breathing exercises. CONCLUSION: The therapeutic efficacy of guided imagery with progressive muscle relaxation found in this study is consistent with our present understanding of the pathophysiology of recurrent abdominal pain in children. Although unfamiliar to many pediatricians, guided imagery is a simple, noninvasive therapy with potential benefit for treating children with RAP
Recommended from our members
Childhood maltreatment: Associated psychopathology and attentional functioning in a healthy college sample
The relationship between childhood maltreatment, depression, anxiety, and neuropsychological performance was assessed in a two-part study of healthy college students. The primary hypotheses predicted that more severe self-reported histories of childhood maltreatment in this population would be correlated with: (a) increased current symptoms of anxiety and depression; (b) poorer attentional performance; and (c) that anxiety and depression would moderate the relationship between maltreatment and attentional performance. Phase 1: In the first college student study (n = 202), moderate associations were found between self-reported childhood maltreatment and current depression symptoms (r = .348, p < .001), as well as current anxiety symptoms (r = .286, p < .001). Performance on the Digit Symbol test, used here as a measure of sustained attention, was significantly correlated with sexual abuse (r = -.157, p = .013), but was not correlated with total maltreatment, punishment, or neglect scores. Depression and anxiety symptoms neither moderated nor mediated the relationship between sexual maltreatment and Digit Symbol test performance. Phase II: In the second college student study (n = 71), multiple measures of attention and other domains of neuropsychological function were added to better understand the potential relationship between maltreatment, attention, and depression and anxiety symptoms. Total self-reported childhood maltreatment was found to significantly correlate with depression (r = .315, p = .004), and anxiety (r = .271, p = .011) symptoms. Scores on neglect/negative home environment and punishment subscales also significantly correlated with depression and anxiety symptoms. Surprisingly, sexual abuse did not. No maltreatment scores significantly correlated with performance on neuropsychological measures in this sample. However, the multiplicative interaction of anxiety and sexual abuse significantly correlated with a factor-determined index of verbal fluency. No other of the multiplicative interactions of abuse scales and depression or anxiety symptoms were correlated with any other factor-derived indices of attention or cognitive functioning (total of 40 correlations examined). These findings highlight the relationship between childhood maltreatment and anxiety and depression in an otherwise healthy, high-functioning sample. Within such a sample, however, there is little evidence for significant effects of maltreatment on attentional or other aspects of cognitive executive functioning. These results are discussed in relationship to previously reported research and the methodological limitations of the present study