Feeling and Body Investigators

Not Applicable

Interventions: Behavioral: Feeling and Body Investigators with Functional Abdominal Pain
Behavioral: Treatment Strategies

Brief Summary: This study will provide tools to develop and pilot an intervention for Functional Abdominal Pain (FAP) using a ten session intervention with children ages 5-8. Investigators will train the subjects to be "Feeling and Body Investigators". During treatment phases the following will occur 1) gather clues (learn), 2) investigate (experience: perform interoceptive mystery missions to explore a body sensation), 3) organize body clues (contextualize: recall other contexts that evoke similar sensations), and 4) go on increasingly daring missions (challenge: decrease avoidance and safety behaviors). The FBI intervention will be developed and refined in 26 child-caregiver dyads during the current R21 phase. In the R33 phase investigators will randomize 100 subjects with FAP to FBI or an active control group in order to conduct a pilot-test of the feasibility, acceptance, and clinical significance of FBI. Young children with FAP who complete the FBI early intervention will learn to experience changes in the viscera as fun and fascinating, rather than scary, and will develop new capacities for pain management, adaptive functioning, and emotion regulation. For the R21 Phase (assessing initial feasibility) investigators hypothesize that ≥ 80% of participants enrolled in FBI will complete treatment and that ≥ 80% of participants will complete home-based practice assignments.

Recruitment & Eligibility

Inclusion Criteria

Child is between 60 and 107 months old.
Parent/legal guardian is present at the clinic visit who speaks English
Child screens positive for recurrent abdominal pain by having: 1) 8 episodes of abdominal pain over 2 months (based on Rome III criteria), or 2) 2 or more episodes of abdominal pain which are causing an incapacity greater than or equal to 25% of the time in the past two months).
Based on pediatric medical assessment, child meets criteria for functional abdominal pain (FAP) based on absence of other organic causes of recurrent abdominal pain.
Consent given by caregiver and assent by child to participate.
Presence of internet access, including that accessed by cell phone with video capabilities.

Exclusion Criteria

The index child being known to have mental retardation (IQ < 70) or other pervasive developmental disorders.
Subject has a sibling who is already enrolled in our study. ***Possible Exclusion***
Parent/ guardian who would be participating in the study is pregnant.

Arm && Interventions

Group	Intervention	Description
Functional Abdominal Pain (FAP)	Treatment Strategies	To access (FAP) subjects will participate in: 10 therapy sessions; and the following treatments: 1) identify strategies with unique patterns of neural circuit maturation associated with early visceral pain on the gut-brain axis: 2) adapt acceptance-based behavioral strategies used to address psychopathology in older children to younger children; and 3) incorporate caregivers as role models and facilitators based on attachment research.
Functional Abdominal Pain (FAP)	Feeling and Body Investigators with Functional Abdominal Pain	To access (FAP) subjects will participate in: 10 therapy sessions; and the following treatments: 1) identify strategies with unique patterns of neural circuit maturation associated with early visceral pain on the gut-brain axis: 2) adapt acceptance-based behavioral strategies used to address psychopathology in older children to younger children; and 3) incorporate caregivers as role models and facilitators based on attachment research.

Primary Outcome Measures

Name	Time	Method
Percentage of Participants Who Complete Treatment	1.5 Years	Treatment in this study refers to10 treatment sessions (4 via webcam or over cell phone video chat from the subject's home and 6 in the investigator's lab) using an acceptance-based behavioral treatment for children 5 through 8 years old with impairing functional abdominal pain. This intervention is rooted in a biopsychosocial framework incorporating advances in neurodevelopment, behavioral learning theory, and attachment theory.
Percentage of Participants Completing Homework Assignment	1.5 Years	Enrollees will engage in assigned home-based practice sessions for at least nine of the ten treatment weeks. Completion of assigned practice sessions within a given week is defined as success.

Secondary Outcome Measures

Name	Time	Method

Locations (2): Duke University Young Child Lab at Brightleaf Square
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Durham, North Carolina, United States
Duke Children's Primary Care Picket Road
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Durham, North Carolina, United States