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The Influence of Anxiety and Pain Catastrophizing on Pain-Related Impairment in Youth With Functional Abdominal Pain

Taylor Abounader¹, Samantha L Ely², Susan Tran³

¹Department of Child and Adolescent Psychiatry and Psychology, MetroHealth Medical Center, Cleveland, OH.

The Clinical Journal of Pain

|June 9, 2025

Abstract

Objectives:

The current study investigated the concurrent impact of anxiety and pain catastrophizing on both pain-related impairment (ie, functional disability and pain intensity) and on pain-related psychological treatment outcomes in youth with Functional Abdominal Pain Disorders (FAPD).

Method:

This is a secondary analysis of data from a psychological treatment study (Aim to Decrease Anxiety and Pain Treatment; ADAPT) for youth with FAPD. Participants completed 6 weeks of ADAPT (psychological intervention) and treatment as usual or treatment as usual alone. Regressions and analysis of covariance models examined the relationship between baseline pain catastrophizing and anxiety on baseline functional disability and pain intensity, while analysis of covariance models assessed the effect of these baseline psychological factors on pain-related outcomes at postassessment (8 wks later) while accounting for group assignment. The effects of ADAPT on postassessment pain catastrophizing and anxiety, as well as their moderating effects on pain-related outcomes were also explored.

Results:

Results indicated that baseline pain catastrophizing, but not anxiety, predicted baseline functional disability and pain intensity, as well as postassessment functional disability. Participants in the ADAPT group also demonstrated significantly lower pain catastrophizing at postassessment. However, there were no moderating effects of postassessment pain catastrophizing or anxiety on pain-related outcomes.

Discussion:

Findings suggest that assessment of pain catastrophizing is important to better understand pain-related impairment in FAPD in youth.

Keywords:

anxiety catastrophizing cognitive behavioral therapy functional abdominal pain

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