Positive Schemas, Coping, and Quality of Life in Pediatric Recurrent Abdominal Pain

Abstract

Pediatric recurrent abdominal pain is commonly associated with negative impacts on quality of life (QOL). Positive schemas (core beliefs about the self with subthemes of self-efficacy, optimism, trust, success, and worthiness) are a resilience factor that has not yet been examined within a pediatric recurrent pain context. This cross-sectional study examined (a) associations between positive schemas, pain coping, and youth QOL, and (b) exploratory analyses to investigate whether specific positive schema subthemes predicted QOL outcomes in youth with recurrent abdominal pain. Participants were 98 youth with recurrent abdominal pain (i.e., pain related to a disorder of gut–brain interaction [DGBI] or organic cause) who completed measures on positive schemas, QOL, and pain coping. Age and diagnostic status were controlled for in analyses. Positive schemas were significantly positively correlated with emotional, social, school, and overall QOL, as well as with approach and problem-focused avoidant coping, and significantly negatively correlated with emotion-focused coping. Worthiness was the strongest and only significant predictor of youth social functioning. Positive schemas may be an important cognitive resilience factor to consider within interventions for pediatric recurrent pain.

Full text

Vol.:(0123456789)
1 3
Journal of Clinical Psychology in Medical Settings (2024) 31:37–47
https://doi.org/10.1007/s10880-023-09952-6
Positive Schemas, Coping, andQuality ofLife inPediatric Recurrent
Abdominal Pain
SoeunLee1 · RachelTomlinson1· MargaretN.Lumley1· KevinC.Bax2· DhandapaniAshok2·
C.MeghanMcMurtry1,2,3,4,5
Accepted: 24 February 2023 / Published online: 23 March 2023
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2023
Abstract
Pediatric recurrent abdominal pain is commonly associated with negative impacts on quality of life (QOL). Positive schemas
(core beliefs about the self with subthemes of self-efficacy, optimism, trust, success, and worthiness) are a resilience factor
that has not yet been examined within a pediatric recurrent pain context. This cross-sectional study examined (a) associations
between positive schemas, pain coping, and youth QOL, and (b) exploratory analyses to investigate whether specific posi-
tive schema subthemes predicted QOL outcomes in youth with recurrent abdominal pain. Participants were 98 youth with
recurrent abdominal pain (i.e., pain related to a disorder of gut–brain interaction [DGBI] or organic cause) who completed
measures on positive schemas, QOL, and pain coping. Age and diagnostic status were controlled for in analyses. Positive
schemas were significantly positively correlated with emotional, social, school, and overall QOL, as well as with approach
and problem-focused avoidant coping, and significantly negatively correlated with emotion-focused coping. Worthiness was
the strongest and only significant predictor of youth social functioning. Positive schemas may be an important cognitive
resilience factor to consider within interventions for pediatric recurrent pain.
Keywords Pediatric abdominal pain· Positive schemas· Quality of life· Coping
Introduction
Pediatric gastrointestinal (GI) disorders encompass a range
of abdominal and digestive disorders experienced by chil-
dren and adolescents (herein “youth”). The cause of pediat-
ric GI disorders varies and can be conceptualized as a dis-
order of gut–brain interaction (DGBI), previously referred
to as ‘functional’ gastrointestinal disorders, or those that
cannot be fully explained by a pathologic cause, including
functional abdominal pain and irritable bowel syndrome;
(Hyams etal., 2016; Sayuk, 2021) or ‘organic’ in nature
(can be identified by pathologic abnormalities in the GI tract,
such as Inflammatory Bowel Disease (IBD); Diefenbach &
Breuer, 2006). Regardless of cause, youth with GI disorders
commonly report recurrent abdominal pain as a symptom
(Diefenbach & Breuer, 2006; Hyams etal., 2016). Moreover,
youth with IBD can also experience IBS-related symptoms
(e.g., pain) while in remission (Teruel etal., 2016), sug-
gesting that recurrent abdominal pain may be a common
experience for youth with both DGBI and ‘organic’ abdomi-
nal disorders. The maintenance of pediatric GI symptoms,
such as recurrent pain, is best conceptualized by a biopsy-
chosocial approach, which emphasizes the importance of
psychological (e.g., cognitions, emotions) and social factors
(e.g., environmental stressors, parents/family), in addition to
the biological ones (Reed-Knight etal., 2017). Youth with
recurrent abdominal pain report significantly lower physi-
cal, emotional, social, and academic quality of life (QOL)
compared to youth with other chronic conditions (Warsch-
burger etal., 2014), and are at risk of experiencing chronic
pain in adulthood (Jawaid etal., 2019; Walker etal., 2010).
* Soeun Lee
soeun@uoguelph.ca
1 Pediatric Pain, Health, andCommunication Lab,
Department ofPsychology, University ofGuelph, Guelph,
ONN1G2W1, Canada
2 Department ofPaediatrics, Western University, London, ON,
Canada
3 Pediatric Chronic Pain Program, McMaster Children’s
Hospital, Hamilton, ON, Canada
4 Department ofAnesthesia, McMaster University, Hamilton,
ON, Canada
5 Children’s Health Research Institute, London, ON, Canada
Content courtesy of Springer Nature, terms of use apply. Rights reserved.