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Stress reactivity in childhood functional abdominal pain or irritable bowel syndrome
M D Gulewitsch1, K Weimer2, P Enck2
1Department of Psychology, Clinical Psychology and Psychotherapy, University of Tübingen, Germany.
Insights
Children with frequent abdominal pain show a down-regulated stress response in the hypothalamic-pituitary-adrenal (HPA) axis, not altered parasympathetic activity. This suggests a different stress reactivity pattern compared to healthy children and those with anxiety disorders.
Area of Science:
- Pediatric Gastroenterology
- Psychoneuroendocrinology
- Stress Physiology
Background:
- Childhood abdominal pain (AP) is linked to stress and coping deficits.
- Psychophysiological stress reactivity in children with AP is understudied.
Purpose of the Study:
- To investigate stress reactivity of the parasympathetic nervous system and HPA axis in children with frequent AP.
- To compare these reactions to healthy children and children with anxiety disorders.
Main Methods:
- Assessed parasympathetic nervous system and HPA axis responses during a laboratory social stress task.
- Measured saliva cortisol concentrations in children with frequent AP, healthy controls, and children with anxiety disorders.
Main Results:
- No significant differences in parasympathetic withdrawal were observed between groups.
- Children with frequent AP exhibited attenuated cortisol reactivity compared to both control groups.
Conclusions:
- Childhood AP is not associated with altered parasympathetic stress response.
- A down-regulated HPA axis reactivity appears related to childhood AP.
- This HPA axis pattern differs from that seen in anxiety disorders.
Background:
Frequent abdominal pain (AP) in childhood has been shown to be associated with elevated experience of stress and with deficits in stress coping, but psychophysiological stress reactivity has been studied rarely.
Methods:
We examined whether children with frequent AP show altered reactions of the parasympathetic nervous system and the hypothalamic-pituitary-adrenal (HPA) axis during and following an afternoon laboratory social stress task in comparison to healthy children and children with anxiety disorders. Twenty-four children with frequent AP (18 with functional AP and six with irritable bowel syndrome; M = 9.9 years), and 24 healthy controls underwent stressful free speech and arithmetic tasks. Twelve children with anxiety disorders served as second comparison sample. Groups were compared regarding parasympathetic reaction and saliva cortisol concentration.
Results:
We found no differences in parasympathetic withdrawal between the groups. Concerning the HPA axis, we detected an attenuated cortisol reactivity in children with AP compared to both other groups.
Conclusions:
This study provides preliminary evidence that childhood AP is not associated with altered parasympathetic withdrawal during stress. It seems to be related to a down-regulated reactivity of the HPA axis. This pattern was ascertained in comparison to healthy children and also in comparison to children with anxiety disorders.
Significance:
Childhood abdominal pain could be related to down-regulated HPA axis reactivity to stress but not to altered parasympathetic reaction. Children with abdominal pain and children with anxiety disorders exhibit a divergent stress-related HPA axis reaction.
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