Researchers from the University of North Carolina School of Medicine and the University of Washington recently tested fear-avoidance responses in 129 children with Inflammatory Bowel Disease (IBD) in remission, and 200 children with Functional Abdominal Pain (FAP). The lead author, Miranda van Tilburg, PhD, associate professor of medicine in UNC’s Division of Gastroenterology and Hepatology, presented the study on the 13th March at the annual meeting of the American Psychosomatic Society in San Francisco.
Fear-avoidance is part of children’s behavioral development that leads to learning to fear pain and avoid certain activities. However, while confronting the pain could resolve the pain in children, fear-avoidance often leads to chronic pain and disability, which can disrupt normal childhood activities and quality of life.
“Chronic abdominal pain is very common among children,” said van Tilburg. “How a child feels about and reacts to the pain is as important as the severity of pain in determining how much the pain will affect a child’s life.”
Researchers found that fear-avoidance is associated with disability only in children with FAP. Among them, more increased fear to pain (catastrophizing) was related to more severe pain. This supports the concept of the fear-avoidance model: when children experience helplessness and fear against pain, they may avoid activities such as going to school or participating in sports, disrupting their normal activities. However, they did not find this feature in children with IBD in remission.
“Children with FAP and IBD in remission are thought to have similar causes for their pain,” van Tilburg said. “We hypothesized that fear avoidance would also have a similar influence on pain outcomes in both disorders, but this is not what we found.”