TY - JOUR A1 - Calvano, Claudia A1 - Warschburger, Petra T1 - Quality of life among parents seeking treatment for their child's functional abdominal pain JF - Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation N2 - Purpose: Dealing with a child who suffers from functional abdominal pain (FAP) is a major challenge for the child's parents. However, little is known about the quality of life (QoL) of this group of parents. Therefore, this cross-sectional study aimed to provide a comprehensive analysis of parental QoL among parents seeking treatment for their child's abdominal pain. Methods: 133 parents of 7-13-year-old children diagnosed with FAP reported on their health-related QoL (HRQoL), as assessed by the SF-12, and on caregiver-related QoL, as assessed by two CHQ-PF50 scales (emotional impact, time impact). T tests were used to compare the parents' scores on these measures with reference scores. Subgroups which were at risk of impairment were defined by cut-off scores. Determinants of parental QoL were identified by hierarchical regression analyses. Results: While the parents showed significantly poorer mental health compared to population-based reference samples (d = 0.33-0.58), their physical health did not differ. However, parents were severely strained with respect to the time impact and emotional impact of their child's health (d = 0.33-1.58). While 12.7-27.9% of the parents were at risk of poor HRQoL, 60.6-70.1% were highly strained due to the demands of their role as caregivers. Physical and mental health were best explained by parents' psychiatric symptoms, while parents' perception of their child's impairment additionally determined the high time and emotional impact. Conclusions: Physical HRQoL is not impaired in the majority of parents seeking treatment for their child's functional abdominal pain. However, the time demands and worries due to the child's pain deserve specific attention. Psychosocial interventions for a child's FAP should include information provided to the parents about coping with time constraints and emotional impact. Further prospective studies are warranted. KW - Quality of life KW - Parents KW - SF-12 KW - CHQ-PF50 KW - Functional abdominal pain Y1 - 2018 U6 - https://doi.org/10.1007/s11136-018-1916-2 SN - 0962-9343 SN - 1573-2649 VL - 27 IS - 10 SP - 2557 EP - 2570 PB - Springer CY - Dordrecht ER - TY - JOUR A1 - Posovszky, Carsten A1 - Roesler, Vreni Helen A1 - Becker, Sebastian A1 - Iven, Enno A1 - Hudert, Christian A1 - Ebinger, Friedrich A1 - Calvano, Claudia A1 - Warschburger, Petra T1 - Roles of Lactose and Fructose Malabsorption and Dietary Outcomes in Children Presenting with Chronic Abdominal Pain JF - Nutrients N2 - Intolerance to lactose or fructose is frequently diagnosed in children with chronic abdominal pain (CAP). However, the causal relationship remains a matter of discussion. A cohort of 253 patients, aged 7-12 years, presenting with unexplained CAP received standardized diagnostics. Additional diagnostic tests were performed based on their medical history and physical and laboratory investigations. Fructose and lactose hydrogen breath tests (H2BT) as well as empiric diagnostic elimination diets were performed in 135 patients reporting abdominal pain related to the consumption of lactose or fructose to evaluate carbohydrate intolerance as a potential cause of CAP. Carbohydrate malabsorption by H2BT was found in 55 (41%) out of 135 patients. An abnormal increase in H2BT was revealed in 30% (35/118) of patients after fructose consumption and in 18% (20/114) of patients after lactose administration. Forty-six percent (25/54) reported pain relief during a diagnostic elimination diet. In total, 17 patients had lactose malabsorption, 29 fructose malabsorption, and nine combined carbohydrate malabsorption. Carbohydrate intolerance as a cause of CAP was diagnosed at follow-up in only 18% (10/55) of patients with malabsorption after the elimination of the respective carbohydrate. Thus, carbohydrate malabsorption appears to be an incidental finding in children with functional abdominal pain disorders, rather than its cause. Therefore, testing of carbohydrate intolerance should only be considered in children with a strong clinical suspicion and with the goal to prevent long-term unnecessary dietary restrictions in children suffering from CAP. KW - chronic abdominal pain KW - children KW - fructose malabsorption KW - lactose intolerance KW - hydrogen breath test KW - functional abdominal pain disorders Y1 - 2019 U6 - https://doi.org/10.3390/nu11123063 SN - 2072-6643 VL - 11 IS - 12 PB - MDPI CY - Basel ER - TY - JOUR A1 - Warschburger, Petra A1 - Calvano, Claudia A1 - Becker, Sebastian A1 - Friedt, Michael A1 - Hudert, Christian A1 - Posovszky, Carsten A1 - Schier, Maike A1 - Wegscheider, Karl T1 - Stop the pain: study protocol for a randomized-controlled trial JF - Trials N2 - Background: Functional abdominal pain (FAP) is not only a highly prevalent disease but also poses a considerable burden on children and their families. Untreated, FAP is highly persistent until adulthood, also leading to an increased risk of psychiatric disorders. Intervention studies underscore the efficacy of cognitive behavioral treatment approaches but are limited in terms of sample size, long-term follow-up data, controls and inclusion of psychosocial outcome data. Methods/Design: In a multicenter randomized controlled trial, 112 children aged 7 to 12 years who fulfill the Rome III criteria for FAP will be allocated to an established cognitive behavioral training program for children with FAP (n = 56) or to an active control group (focusing on age-appropriate information delivery; n = 56). Randomization occurs centrally, blockwise and is stratified by center. This study is performed in five pediatric gastroenterology outpatient departments. Observer-blind assessments of outcome variables take place four times: pre-, post-, 3- and 12-months post-treatment. Primary outcome is the course of pain intensity and frequency. Secondary endpoints are health-related quality of life, pain-related coping and cognitions, as well as selfefficacy. Discussion: This confirmatory randomized controlled clinical trial evaluates the efficacy of a cognitive behavioral intervention for children with FAP. By applying an active control group, time and attention processes can be controlled, and long-term follow-up data over the course of one year can be explored. KW - FAP KW - Randomized controlled trial KW - Cognitive behavioral intervention KW - Children KW - Pain Y1 - 2014 U6 - https://doi.org/10.1186/1745-6215-15-357 SN - 1745-6215 VL - 15 PB - BioMed Central CY - London ER - TY - JOUR A1 - Warschburger, Petra A1 - Haenig, Johanna A1 - Friedt, Michael A1 - Posovszky, Carsten A1 - Schier, Maike A1 - Calvano, Claudia T1 - Health-Related quality of life in children with abdominal pain due to functional or organic gastrointestinal disorders JF - Journal of pediatric psychology KW - abdominal pain KW - catastrophizing KW - chronic illness KW - coping KW - quality of life Y1 - 2014 U6 - https://doi.org/10.1093/jpepsy/jst070 SN - 0146-8693 SN - 1465-735X VL - 39 IS - 1 SP - 45 EP - 54 PB - Oxford Univ. Press CY - Cary ER - TY - JOUR A1 - Calvano, Claudia A1 - Warschburger, Petra T1 - Chronic Abdominal Pain in Children and Adolescents: Parental Threat Perception Plays a Major Role in Seeking Medical Consultations JF - Journal of the International Society of Sports Nutrition N2 - Background. Pain symptoms, associated impairment, and parental perception of threat are reported to be predictors of health care utilization (HCU) in childhood chronic abdominal pain (CAP). However, mediating variables and their interrelations have not yet been systematically studied. Objectives. This study aims to identify mediating pathways of influence between child’s abdominal pain and the number of pain-related medical visits. Methods. In a multicenter study, we recruited N = 151 parent-child dyads with children aged 6–17 years suffering from CAP. A composite measure of pain symptoms was defined as predictor and the number of pain-related medical visits as outcome variable. This relation was analyzed by serial mediation, including child- and parent-reported impairment and parental threat perception as mediators. Results. Only parental threat perception significantly linked child’s pain symptoms to the number of medical visits. Measures of impairment did not have a significant effect. Conclusions. Parental pain-related threat perception is strongly related to health care seeking in childhood CAP. Addressing threat perception might be a fruitful parent-centered approach in clinical practice. Y1 - 2016 U6 - https://doi.org/10.1155/2016/3183562 SN - 1203-6765 SN - 1918-1523 SP - 1 EP - 10 PB - Hindawi Publishing Corp. CY - New York ER - TY - GEN A1 - Warschburger, Petra A1 - Calvano, Claudia A1 - Becker, Sebastian A1 - Friedt, Michael A1 - Hudert, Christian A1 - Posovszky, Carsten A1 - Schier, Maike A1 - Wegscheider, Karl T1 - Stop the pain : study protocol for a randomized-controlled trial N2 - Background: Functional abdominal pain (FAP) is not only a highly prevalent disease but also poses a considerable burden on children and their families. Untreated, FAP is highly persistent until adulthood, also leading to an increased risk of psychiatric disorders. Intervention studies underscore the efficacy of cognitive behavioral treatment approaches but are limited in terms of sample size, long-term follow-up data, controls and inclusion of psychosocial outcome data. Methods/Design: In a multicenter randomized controlled trial, 112 children aged 7 to 12 years who fulfill the Rome III criteria for FAP will be allocated to an established cognitive behavioral training program for children with FAP (n = 56) or to an active control group (focusing on age-appropriate information delivery; n = 56). Randomization occurs centrally, blockwise and is stratified by center. This study is performed in five pediatric gastroenterology outpatient departments. Observer-blind assessments of outcome variables take place four times: pre-, post-, 3- and 12-months post-treatment. Primary outcome is the course of pain intensity and frequency. Secondary endpoints are health-related quality of life, pain-related coping and cognitions, as well as selfefficacy. Discussion: This confirmatory randomized controlled clinical trial evaluates the efficacy of a cognitive behavioral intervention for children with FAP. By applying an active control group, time and attention processes can be controlled, and long-term follow-up data over the course of one year can be explored. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 363 KW - FAP KW - randomized controlled trial KW - cognitive behavioral intervention KW - children KW - pain Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-401451 ER - TY - THES A1 - Calvano, Claudia T1 - Funktionelle Bauchschmerzen im Kindesalter BT - die Rolle der Eltern aus Perspektiven der Belastungs- und Interventionsforschung N2 - Funktionelle Bauchschmerzen des Kindes betreffen die ganze Familie, wobei die Literatur insbesondere die Rolle der Eltern hervorhebt. Bisher wurden die Eltern jedoch primär als „critical behavioral agents“ (Palermo & Eccleston, 2009) gesehen, die einen Einfluss auf die Bauchschmerzen und Beeinträchtigung des Kindes ausüben. Untersuchungen der psychosozialen Auswirkungen der Bauchschmerzen und der Beeinträchtigung des Kindes auf die Eltern wurden bislang vernachlässigt (Palermo & Eccleston, 2009). Die Dissertation hatte daher zum Ziel, die Rolle der Eltern bei funktionellen Bauchschmerzen umfassend zu betrachten, indem sowohl schmerzbezogene Reaktionen der Eltern, als auch die psychosoziale Belastung der Eltern berücksichtigt und systematisch in Zusammenhang zu den Bauchschmerzen und der Beeinträchtigung des Kindes untersucht wurden. Zum anderen sollten durch Interventionsstudien Aussagen über die Veränderbarkeit spezifischer Belastungsmerkmale der Eltern und über das Wechselspiel zwischen der Ebene der Eltern und der Ebene des Kindes ermöglicht werden. Anhand von vier Studien sollten die Fragen beantworten werden 1) welche Faktoren die ärztliche Inanspruchnahme beeinflussen und welche besondere Relevanz dabei die Bewertungsprozesse der Eltern besitzen, 2) wie die psychosoziale Belastung der Eltern charakterisiert ist und durch welche Faktoren sie beeinflusst wird, 3) welche Veränderungen im Rahmen einer kindzentrierten verhaltenstherapeutischen Intervention auf Seiten der Eltern zu beobachten sind und 4) wie sich diese Veränderungen seitens der Eltern und seitens des Kindes gegenseitig beeinflussen. KW - Funktionelle Bauchschmerzen KW - Eltern KW - Chronische Schmerzen KW - functional abdominal pain KW - parents KW - chronic pain Y1 - 2018 ER - TY - GEN A1 - Warschburger, Petra A1 - Calvano, Claudia A1 - Richter, Eike M. A1 - Engbert, Ralf T1 - Analysis of Attentional Bias towards Attractive and Unattractive Body Regions among Overweight Males and Females BT - an Eye-Movement Study N2 - Background Body image distortion is highly prevalent among overweight individuals. Whilst there is evidence that body-dissatisfied women and those suffering from disordered eating show a negative attentional bias towards their own unattractive body parts and others’ attractive body parts, little is known about visual attention patterns in the area of obesity and with respect to males. Since eating disorders and obesity share common features in terms of distorted body image and body dissatisfaction, the aim of this study was to examine whether overweight men and women show a similar attentional bias. Methods/Design We analyzed eye movements in 30 overweight individuals (18 females) and 28 normalweight individuals (16 females) with respect to the participants’ own pictures as well as gender- and BMI-matched control pictures (front and back view). Additionally, we assessed body image and disordered eating using validated questionnaires. Discussion The overweight sample rated their own body as less attractive and showed a more disturbed body image. Contrary to our assumptions, they focused significantly longer on attractive compared to unattractive regions of both their own and the control body. For one’s own body, this was more pronounced for women. A higher weight status and more frequent body checking predicted attentional bias towards attractive body parts. We found that overweight adults exhibit an unexpected and stable pattern of selective attention, with a distinctive focus on their own attractive body regions despite higher levels of body dissatisfaction. This positive attentional bias may either be an indicator of a more pronounced pattern of attentional avoidance or a self-enhancing strategy. Further research is warranted to clarify these results. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 281 Y1 - 2015 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-86570 ER - TY - JOUR A1 - Warschburger, Petra A1 - Calvano, Claudia A1 - Richter, Eike M. A1 - Engbert, Ralf T1 - Analysis of Attentional Bias towards Attractive and Unattractive Body Regions among Overweight Males and Females BT - an Eye-Movement Study JF - PLoS one N2 - Background Body image distortion is highly prevalent among overweight individuals. Whilst there is evidence that body-dissatisfied women and those suffering from disordered eating show a negative attentional bias towards their own unattractive body parts and others’ attractive body parts, little is known about visual attention patterns in the area of obesity and with respect to males. Since eating disorders and obesity share common features in terms of distorted body image and body dissatisfaction, the aim of this study was to examine whether overweight men and women show a similar attentional bias. Methods/Design We analyzed eye movements in 30 overweight individuals (18 females) and 28 normalweight individuals (16 females) with respect to the participants’ own pictures as well as gender- and BMI-matched control pictures (front and back view). Additionally, we assessed body image and disordered eating using validated questionnaires. Discussion The overweight sample rated their own body as less attractive and showed a more disturbed body image. Contrary to our assumptions, they focused significantly longer on attractive compared to unattractive regions of both their own and the control body. For one’s own body, this was more pronounced for women. A higher weight status and more frequent body checking predicted attentional bias towards attractive body parts. We found that overweight adults exhibit an unexpected and stable pattern of selective attention, with a distinctive focus on their own attractive body regions despite higher levels of body dissatisfaction. This positive attentional bias may either be an indicator of a more pronounced pattern of attentional avoidance or a self-enhancing strategy. Further research is warranted to clarify these results. Y1 - 2015 U6 - https://doi.org/10.1371/journal.pone.0140813 SN - 1932-6203 IS - 10 PB - Public Library of Science CY - Lawrence, Kan. ER - TY - JOUR A1 - Warschburger, Petra A1 - Calvano, Claudia A1 - Richter, Eike M. A1 - Engbert, Ralf T1 - Analysis of Attentional Bias towards Attractive and Unattractive Body Regions among Overweight Males and Females: An Eye-Movement Study JF - PLoS one N2 - Background Body image distortion is highly prevalent among overweight individuals. Whilst there is evidence that body-dissatisfied women and those suffering from disordered eating show a negative attentional bias towards their own unattractive body parts and others' attractive body parts, little is known about visual attention patterns in the area of obesity and with respect to males. Since eating disorders and obesity share common features in terms of distorted body image and body dissatisfaction, the aim of this study was to examine whether overweight men and women show a similar attentional bias. Methods/Design We analyzed eye movements in 30 overweight individuals (18 females) and 28 normal-weight individuals (16 females) with respect to the participants' own pictures as well as gender- and BMI-matched control pictures (front and back view). Additionally, we assessed body image and disordered eating using validated questionnaires. Discussion The overweight sample rated their own body as less attractive and showed a more disturbed body image. Contrary to our assumptions, they focused significantly longer on attractive compared to unattractive regions of both their own and the control body. For one's own body, this was more pronounced for women. A higher weight status and more frequent body checking predicted attentional bias towards attractive body parts. We found that overweight adults exhibit an unexpected and stable pattern of selective attention, with a distinctive focus on their own attractive body regions despite higher levels of body dissatisfaction. This positive attentional bias may either be an indicator of a more pronounced pattern of attentional avoidance or a self-enhancing strategy. Further research is warranted to clarify these results. Y1 - 2015 U6 - https://doi.org/10.1371/journal.pone.0140813 SN - 1932-6203 VL - 10 IS - 10 PB - PLoS CY - San Fransisco ER - TY - JOUR A1 - Calvano, Claudia A1 - Warschburger, Petra T1 - Treatment for pediatric functional abdominal pain BT - an initial examination of reciprocal associations between pain, functional impairment, and parental distress JF - Journal of pediatric psychology N2 - Objective While cross-sectional studies underline that child and parent factors in pediatric chronic pain are reciprocally related, so far, little is known on their prospective relationship, especially in treatment contexts. This study aims to analyze directions of influence between child and parental outcomes using data from an intervention study. Methods The sample covered 109 families with children aged 7-13 years diagnosed with functional abdominal pain (FAP). Child outcomes included pain and impairment, and parental outcomes covered caregiver-specific distress including both parental personal time burden (i.e., less time available for personal needs) and emotional burden due to child's pain (i.e., increased worries). Cross-lagged panel analyses examined the directions of the relations between child and parental outcomes across time (pretreatment T1, post-treatment T2, and 3-month follow-up and 12-month follow-up T3/T4). Results First, a significant improvement over time in all measures was observed. Cross-lagged effects were found for less parental personal time burden at T2, predicting both less pain (beta = -0.254, p = .004) and less impairment (beta = -0.150, p = .039) at T3. Higher baseline pain was predictive for higher parental emotional burden after treatment (beta = -0.130, p = .049) and, reversely, for less emotional burden at 12-month follow-up (beta = 0.261, p = .004). Conclusions Addressing parental personal time burden in FAP treatment might possibly support the improvement on the child level. Replication of results in larger samples is warranted to gain more insight into the directions of influence and, in that way, to optimize treatment for pediatric FAP. KW - chronic or recurrent pain KW - intervention outcome KW - parent psychosocial KW - functioning KW - parents Y1 - 2022 U6 - https://doi.org/10.1093/jpepsy/jsac011 SN - 0146-8693 SN - 1465-735X VL - 47 IS - 4 SP - 483 EP - 496 PB - Oxford Univ. Press CY - Oxford ER -