The aims are to evaluate: (1) the effectiveness of written self-disclosure (WSD) on health
status of youth ages 12-18 with functional recurrent abdominal pain (RAP); (2) whether
effectiveness of WSD is similar for younger (12-14) and older (15-18) youth with functional
RAP; and (3) the feasibility and acceptability of WSD when extended to the pediatric health
care setting.We will implement a randomized, controlled trial (RCT) designed to compare
health status in 140 youths (ages 12-18) with functional RAP assigned either to standard
medical care (SMC) or WSD provided in the health care setting in addition to SMC. Health
status will be measured at Baseline and 3- and 6-months thereafter. Primary measures of
health status are symptom severity and episode frequency, consistent with the definition of
RAP. Secondary measures of health are functional health, psychological distress,
health-related quality of life, and health care utilization. Total use and diagnostic tests
will index health care utilization, collected for the 6-mos prior to and following Baseline.
Mixed model ANOVA or MANOVA will be used to test directional hypotheses corresponding to the
- Ages 12-18.
- Diagnosis of RAP by the examining pediatric gastroenterologist using Apley's (1975)
criteria: (a) 3 episodes of abdominal pain, (b) severe enough to interrupt activities
and occurring, (c) over a period of at least 3 months, (d) without an identifiable
organic cause (If an organic cause is identified during participation in protocol,
then participant is withdrawn from database prior to analysis).
- Free of a known chronic health condition.
- Physical and mental ability to complete the procedures, as judged by Dr. Madan-Swain.
- Consents to complete the protocol over the next 6 months.
- Parent(s) consents to participate and agrees to support the youth in completing the
- Access to a phone on the days writing sessions are to be completed at home.