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Empowering adolescents and young adults with somatoform disorders: A longitudinal pilot randomized controlled trial
Alexander Lassner1, Rosemarie Ahnert2, Jenny Dahringer3
1Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, BKH Augsburg, Augsburg, Germany; DZPG (German Center for Mental Health), partner site München/Augsburg, Munich, Augsburg, Germany.
Background:
In childhood somatoform disorders develop and persist through bio-psycho-social processes including family variables, substantially impacting the development of children, their school attendance, and well-being. Although intensive interdisciplinary pain treatment (IIPT) has demonstrated effectiveness, maintaining long-term outcomes remains challenging, particularly given children's increased risk of developing affective disorders. Since family dynamics influence disorder development and persistence, this study aimed to investigate the potential added value of addressing parents within the therapeutic process.
Method:
This monocentric longitudinal pilot randomized controlled trial (RCT) (N = 31) investigated adjunct parent-focused interventions (mindfulness vs. support group) for families of children with somatoform disorders enrolled in IIPT. We assessed children's empowerment, pain related disability, affective pain perception, pain characteristics and parental catastrophizing at admission, discharge, and six-month follow-up. Regression models and repeated-measures ANOVAs evaluated intervention effects.
Results:
Multiple regression analysis identified older age as predictor of empowerment at baseline (β = 0.63, p < .01). IIPT plus parental intervention showed lasting treatment effects. Group allocation had no effect on empowerment, pain disability, affective pain perception, or parental catastrophizing, but allocation to the support group (B = -2.49, p = .009) and male sex (B = -2.29, p = .008) predicted greater reduction in average pain intensity.
Conclusions:
This pilot RCT showed no superiority of the parent-focused mindfulness group over the support group when combined with IIPT. Yet, both interventions may enhance treatment efficacy, with some evidence suggesting additional benefits of the support group intervention in reducing average pain intensity. Further research is needed to examine underlying mechanisms and establish optimal parent intervention approaches in paediatric pain treatment.
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