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Role of Coping With Symptoms in Depression and Disability: Comparison Between Inflammatory Bowel Disease and
Miranda A L van Tilburg1, Robyn L Claar, Joan M Romano
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.
Insights
Children with functional abdominal pain (AP) use more coping strategies than those with inflammatory bowel disease (IBD). Maladaptive coping, like catastrophizing, is linked to depression and disability in both pediatric groups.
Area of Science:
- Pediatric Gastroenterology
- Child Psychology
- Health Outcomes Research
Background:
- Inflammatory bowel disease (IBD) and functional abdominal pain (AP) are prevalent pediatric gastrointestinal disorders.
- These conditions increase the risk of depression and disability in children.
- Symptom severity and coping mechanisms may influence these adverse outcomes.
Purpose of the Study:
- To compare coping strategies used by children with AP versus IBD.
- To investigate the relationship between coping strategies, depression, and functional disability, independent of symptom severity.
Main Methods:
- Secondary data analysis of two existing datasets.
- Included 200 children with AP and 189 children with IBD.
- Analyzed coping strategies, depression, and functional disability, controlling for symptom severity, age, and sex.
Main Results:
- Children with AP reported greater use of self-isolation, behavioral disengagement, catastrophizing, problem-solving, and social support seeking compared to IBD patients.
- Coping strategies were associated with depression and functional disability in both groups, independent of symptom severity.
- Catastrophizing specifically predicted depression and disability in both pediatric samples.
Conclusions:
- Children with AP utilize a wider range of coping strategies than those with IBD.
- Specific coping mechanisms, especially catastrophizing, are linked to increased depression and functional disability in both IBD and AP.
- Awareness of maladaptive coping is crucial for clinicians managing pediatric patients with these conditions.
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.
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