Cognitive-behavioral treatment of persistent functional somatic complaints and pediatric anxiety: an initial controlled trial
Open accessAbstract
BACKGROUND: Children and adolescents who seek medical treatment for persistent physical distress often suffer from co-occurring anxiety disorders. Treatment options for this impaired population are limited. This study tests the feasibility and potential efficacy of a cognitive-behavioral intervention targeting pain and anxiety for youth with impairing functional physical symptoms and anxiety disorders presenting to pediatricians for medical care. METHODS: Children and adolescents (aged 8-16) experiencing somatic complaints, without an explanatory medical disorder (i.e., functional), were recruited from primary care and specialty (gastroenterologists and cardiologists) pediatricians. Forty children, primarily with gastrointestinal symptoms, who met criteria for a co-occurring anxiety disorder, were randomly assigned to a cognitive-behavioral treatment addressing pain and anxiety, Treatment of Anxiety and Physical Symptoms (TAPS), or to a waiting list control. RESULTS: TAPS was found to be an acceptable treatment for this population and was superior to the waiting list condition. Eighty percent of children in TAPS were rated as treatment responders by independent evaluators compared with none of the controls. Overall, self- and parent ratings indicated reductions in children's somatic discomfort and anxiety following intervention. TAPS participants maintained clinical gains 3 months following treatment. CONCLUSIONS: The study supports the feasibility and preliminary efficacy of a cognitive-behavioral intervention targeting co-occurring physical distress and anxiety in youth presenting for medical treatment. Such an approach has the potential to exert broad impact on children's dysfunction and to minimize exposure to invasive, ineffective, and costly medical procedures and treatments.
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School-based interventions have been shown to be effective in reducing social anxiety and improving social skills in both the short and long term.
“These interventions have been shown to be effective in reducing social anxiety and improving social skills in both the short and long term [90,92,93].”
From The risks versus the benefits of pharmacological intervention in social anxiety disorder in children (2025) · cites this paper as [90]
The Results (Posttreatment Outcomes; Three-month Follow-up, pages unavailable) report reduced anxiety after treatment and maintained clinical gains at three months. But this was an intervention for children presenting for pediatric medical care, not a school-based intervention; the paper does not report improved social skills or establish long-term effects beyond three months. (LLM, conf=0.87)
Experimental — accuracy not yet measuredRecent research supports cognitive behavioral therapy interventions that target both pain and anxiety in children with co-occurring anxiety disorders and functional gastrointestinal symptoms.
“Recent studies also provide support for CBT interventions targeting both pain and anxiety for children with comorbid anxiety disorders and functional gastrointestinal symptoms.8,9”
From Provider Communication Regarding Psychosocial Factors Predicts Pain Beliefs in Parent and Child (2016) · cites this paper as [8]
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- Authors
- Warner, C. M., Colognori, D., Kim, R. E., Reigada, L. C., Klein, R. G., Browner-Elhanan, K. J., Saborsky, A., Petkova, E., Reiss, P., Chhabra, M., McFarlane-Ferreira, Y. B., Phoon, C. K., Pittman, N., & Benkov, K.
- Affiliations
- Nathan Kline Institute for Psychiatric Research (US)
- New York University (US)
- Brooklyn College (US)
- NewYork–Presbyterian Brooklyn Methodist Hospital (US)
- Mount Sinai Hospital (US)
- NYU Langone Health (US)
- Corresponding author
- Warner, Carrie Masia
- Venue
- Depression and Anxiety
- Publisher
- Wiley
- Published
- 2011-06-16
- Volume
- 28
- Issue
- 7
- Pages
- 551-559
- ISSN
- 1091-4269 (ISSN-L)
- PMC
- PMC3128648
- OpenAlex
- W2117886757
- Cited by
- 75
- References
- 54
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 8 · 2023: 4 · 2022: 1 · 2021: 3 · 2020: 2 · 2019: 4 · 2018: 3 · 2017: 13 · 2016: 6 · 2015: 9 · 2014: 8 · 2013: 8 · 2012: 1
- FWCI
- 3.72
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Depression and Anxiety (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Temple University
- National Institute of Mental Health (MH073554, R34MH073554)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Keywords
- cognitive behavioral therapy, functional somatic symptoms, childhood anxiety, gastrointestinal symptoms, children and adolescents, treatment feasibility, pain and anxiety
- MeSH terms
- Adolescent, Anxiety Disorders, Anxiety, Separation, Child, Chronic Disease, Combined Modality Therapy, Feasibility Studies, Female, Follow-Up Studies, Gastrointestinal Diseases, Humans, Male, Phobic Disorders, Somatoform Disorders, Cognitive Behavioral Therapy
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