Social learning contributions to the etiology and treatment of functional abdominal pain and inflammatory bowel disease in children and adults

Table 1 Controlled trials of CBT in adults with irritable bowel syndrome

Authors	Design	Sample size	Outcome
Corney et al[62] (1991)	CBT vs SMT. FU at 4 & 9 mo	42	CBT = SMT
Greene et al[64] (1994)	CBT vs SMT. FU at 3 mo	20	CBT > SMT
Payne et al[65] (1995)	CBT vs Self-help support group vs SMT. FU at 3 mo	34	CBT > Self-help > SMT
Drossman et al[68] (2003)	CBT vs education, and desipramine vs placebo (parallel studies). No FU	431	CBT > education; desipramine: placebo
Boyce et al[61] (2003)	CBT vs relaxation training vs SMT. FU at 12 mo	105	CBT = Relaxation training = SMT
Blanchard et al[66] (2007)	Group CBT vs Self-help support group vs SMT. FU at 3 mo	210	CBT = Support group > SMT
Kennedy et al[63] (2006)	Multicenter primary care intervention by nurses. Open label. CBT + mebeverine vs mebeverine alone.	149	CBT + mebeverine > Mebeverine alone at 3 & 6 mo FU

SMT: standard medical care with symptom self-monitoring; FU = follow up; Mebeverine: anticholinergic for inhibition of smooth muscle contractions.

Table 2 Pediatric intervention studies for children with recurrent abdominal pain

Authors	Sample	Intervention	Design	# sessions	Comparison sample	Outcome for intervention group relative to comparison
Finney et al[71] (1989)	16 children with RAP (age 6-13)	1-5 components, tailored to each child: self- monitoring, limited reinforcement of illness behavior, relaxation training, prescribed dietary fiber, required school attendance	Case control	M = 2.5 visits plus 1-6 phone calls	16 untreated children with RAP matched for gender (age 4-18)	-improvement or resolution of pain symptoms (parent-report) -decreased school absences -decreased health care utilization1
Robins et al[72] (2005)	69 children with RAP (age 6-16)	CBT family including pain management, relaxation, distraction, parental encouragement of wellness behavior	RCT	5	Standard care (29 of the total 69)	-decreased pain (child- and parent-report) -fewer school absences
Sanders et al[69] (1989)	16 children with RAP (age 6-12)	CBT including self-monitoring, social learning, relaxation	RCT wait-list control	8	Wait-list control (8 of the total 16)	-decreased pain (child-report and maternal observation) -more pain-free days (child-report) -fewer pain behaviors (teacher observation) -fewer behavioral problems (parent-report)
Sanders et al[73] (1994)	44 children with RAP (age 7-14)	CBT including contingency management and self-management	RCT	6	Standard care (4-6 sessions)	-more pain-free days (child-report) -fewer pain behaviors (parental observation) -less pain-related interference (child- and parent-report)
Scharff & Blanchard (1996)[70] cited in Blanchard (2001)[52]	10 children with RAP (age 8-13)	Random assignment to social learning or stress management/relaxation	crossover	4	---	-decreased pain intensity (child-report) -decreased pain frequency (parent-report)

¹In this study, the comparison group was used only as a reference for health care utilization, not the other outcome variables.