Miranda A L van Tilburg1, Robyn L Claar, Joan M Romano, Shelby L Langer, Lynn S Walker, William E Whitehead, Bisher Abdullah, Dennis L Christie, Rona L Levy. 1. *Center for Functional Gastrointestinal and Motility Disorders, University of North Carolina, Chapel Hill, NC †School of Social Work ‡Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA §Department of Pediatrics, Vanderbilt University, Nashville, TN ||Prime Health Clinic, Puyallup ¶Division of Pediatric Gastroenterology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle WA.
Abstract
BACKGROUND: Inflammatory bowel disease (IBD) and abdominal pain of functional origin (AP) are common gastrointestinal disorders in children, which are associated with increased risk for depression and disability. Both symptom severity and coping with symptoms may contribute to these outcomes. We hypothesized that children with AP use different coping strategies compared with those with IBD for a number of reasons, including the fact that fewer treatment options are available to them. We also examined whether coping was related to depression and functional disability beyond the contributions of symptom severity. METHODS: The study method included secondary data analysis of 2 existing data sets including 200 children with AP (73% girls, mean age 11.2 years) and 189 children with IBD (49% girls, mean age 13.8 years). RESULTS: Compared with patients with IBD, patients with AP reported more use of coping strategies of self-isolation, behavioral disengagement, and catastrophizing, as well as problem solving and seeking social support. Multivariate analyses revealed that, in both samples, ≥1 coping strategies were associated with depression and functional disability, independent of symptom severity, and controlling for age and sex. In IBD, symptoms were not a significant predictor of depression but coping was. Catastrophizing predicted depression and disability in both samples. CONCLUSIONS: Patients with AP report more frequent use of several of the coping strategies we measured compared with patients with IBD. Certain types of coping, particularly catastrophizing, were associated with greater depression and functional disability in both groups. Clinicians should be aware of maladaptive coping, which may be a risk factor for poor psychosocial and functional outcomes in both patient groups.
BACKGROUND:Inflammatory bowel disease (IBD) and abdominal pain of functional origin (AP) are common gastrointestinal disorders in children, which are associated with increased risk for depression and disability. Both symptom severity and coping with symptoms may contribute to these outcomes. We hypothesized that children with AP use different coping strategies compared with those with IBD for a number of reasons, including the fact that fewer treatment options are available to them. We also examined whether coping was related to depression and functional disability beyond the contributions of symptom severity. METHODS: The study method included secondary data analysis of 2 existing data sets including 200 children with AP (73% girls, mean age 11.2 years) and 189 children with IBD (49% girls, mean age 13.8 years). RESULTS: Compared with patients with IBD, patients with AP reported more use of coping strategies of self-isolation, behavioral disengagement, and catastrophizing, as well as problem solving and seeking social support. Multivariate analyses revealed that, in both samples, ≥1 coping strategies were associated with depression and functional disability, independent of symptom severity, and controlling for age and sex. In IBD, symptoms were not a significant predictor of depression but coping was. Catastrophizing predicted depression and disability in both samples. CONCLUSIONS:Patients with AP report more frequent use of several of the coping strategies we measured compared with patients with IBD. Certain types of coping, particularly catastrophizing, were associated with greater depression and functional disability in both groups. Clinicians should be aware of maladaptive coping, which may be a risk factor for poor psychosocial and functional outcomes in both patient groups.
Authors: Andrea A Wojtowicz; Rachel Neff Greenley; Amitha Prasad Gumidyala; Andrew Rosen; Sara E Williams Journal: J Crohns Colitis Date: 2014-03-12 Impact factor: 9.071
Authors: Laura M Mackner; Rachel Neff Greenley; Eva Szigethy; Michele Herzer; Kate Deer; Kevin A Hommel Journal: J Pediatr Gastroenterol Nutr Date: 2013-04 Impact factor: 2.839
Authors: Bonney Reed-Knight; Miranda A L van Tilburg; Rona L Levy; Shelby L Langer; Joan M Romano; Tasha B Murphy; Melissa M DuPen; Andrew D Feld Journal: J Pediatr Psychol Date: 2018-01-01
Authors: Miranda A L van Tilburg; Robyn Lewis Claar; Joan M Romano; Shelby L Langer; Douglas A Drossman; William E Whitehead; Bisher Abdullah; Rona L Levy Journal: J Pediatr Date: 2017-02-24 Impact factor: 4.406
Authors: Rona L Levy; Miranda A L van Tilburg; Shelby L Langer; Joan M Romano; Lynn S Walker; Lloyd A Mancl; Tasha B Murphy; Robyn L Claar; Shara I Feld; Dennis L Christie; Bisher Abdullah; Melissa M DuPen; Kimberly S Swanson; Melissa D Baker; Susan A Stoner; William E Whitehead Journal: Inflamm Bowel Dis Date: 2016-09 Impact factor: 5.325
Authors: Inmaculada Riquelme; Isabel Escobio-Prieto; Ángel Oliva-Pascual-Vaca; Alberto Marcos Heredia-Rizo; Pedro Montoya Journal: Int J Environ Res Public Health Date: 2021-04-27 Impact factor: 3.390
Authors: Maximilian Kutschera; Thomas Waldhör; Gottfried Novacek; Wolfgang Miehsler; Hans Peter Gröchenig; Thomas Haas; Heimo Wenzl; Pius Steiner; Robert Koch; Thomas Feichtenschlager; Gerald Eckhardt; Andreas Mayer; Andreas Kirchgatterer; Othmar Ludwiczek; Reingard Platzer; Pavol Papay; Johanna Gartner; Harry Fuchssteiner; Paul-Gerhard Peters; Gerhard Reicht; Gabriele Moser; Clemens Dejaco; Harald Vogelsang; Christian Primas Journal: United European Gastroenterol J Date: 2021-02-18 Impact factor: 4.623
Authors: John M Hollier; Danita I Czyzewski; Mariella M Self; Yan Liu; Erica M Weidler; Miranda A L van Tilburg; James W Varni; Robert J Shulman Journal: J Clin Gastroenterol Date: 2021 May-Jun 01 Impact factor: 3.174