Screening for anxiety in youth with functional abdominal pain based on parent and child reports

Functional abdominal pain (FAP) is a common pain condition associated with poor outcomes in youth including pain-related disability, school absences, and peer issues. Anxiety is highly prevalent in youth with FAP. There is less research on rates and types of anxiety most common to this population. It is unknown if child anxiety rates/types differ based on parent or child report. The current study investigated the rates and types of anxiety in a sample of youth with FAP. We hypothesized parent and child reported child anxiety would predict pain and impairment in youth. Participants (n =34 dyads, data collection ongoing) were youth ages 8-18 diagnosed with FAP by a pediatric gastroenterologist and their primary caregiver. Participants completed measures of anxiety, pain levels, and functional disability during their clinic visit. In contrast to previous studies that have assessed broader anxiety symptoms in this population, we used the Screen for Child Anxiety and Related Disorders (SCARED), a measure of anxiety that corresponds to DSM-IV diagnoses. We found that 52.5% of youth and 29.4% of parents reported clinically significant levels of overall child anxiety. The most commonly occurring anxiety types based on child report included: school avoidance (55.9%), generalized anxiety (32.4%), and separation anxiety (20.6%). For parents, they were: school avoidance (35.3%), generalized anxiety (44.1%), and separation anxiety (35.3%). Co-morbidity of two or more anxiety disorders was 64.7% for child reports and 29.4% for parent reports. Further, both parent and child anxiety were found to predict increased pain intensity (t parent = -3.08, p<0.01 and t child= -2.80, p<0.01), and functional disability (t parent= -3.91, p<0.001; and t child =-3.97, p <0.001). These findings suggest children reported higher rates of child anxiety than their parents. With greater knowledge about the specific anxiety issues in the children, more tailored treatments can be designed.