Verena Neß

Background: Functional abdominal pain (FAP) is a severely debilitating condition affecting approximately 11.7% of children and adolescents worldwide, often persisting into adulthood and significantly restricting daily life. Health literacy is essential for treatment success. To improve knowledge about the biopsychosocial factors influencing FAP and support its management, we developed an educational multimedia website ( https://meine‐bauchstelle.com ). Methods: In a multicenter randomised controlled trial (RCT), patients with FAP ( N = 166, age 5–17 years, M = 10.8, SD = 3.31; 53.6% female) and their parents were randomly assigned to an intervention group (IG: access to the website before the first measurement) or a control group (CG: no access to the website during data collection). The primary outcome was health literacy (knowledge and health behaviour) and secondary outcomes were abdominal pain symptoms and the physician‐patient/parent interactions. Group differences were analysed using t ‐tests and multilevel models. Results: Patients in the IG who visited the website demonstrated significantly higher initial knowledge scores compared to the CG. Moreover, they reported significantly less pain‐related disability across three assessments over 3 months. Parents who visited the website rated the physician‐parent interaction significantly more positively than those in the CG. Conclusions: The educational website efficiently increased patient knowledge about FAP and improved certain pain‐related behaviours. It serves as an effective tool in conveying information about FAP in clinical practice. Future applications could extend to preventive measures in schools and other settings. Significance Statement: The educational website about functional abdominal pain is effective in transferring knowledge, reducing pain‐related disability, and improving physician‐parent interactions. It can support physicians in day‐to‐day clinical practice by referring patients to the website for further information and might be extended as a preventive measure in schools.

Background/Objectives: The use of digital media, and especially social media, has been increasing over recent years. Previous research has reported a negative impact of media use on headaches; however, most of these studies are cross-sectional. Therefore, we conducted a longitudinal study to explore the relationship between different types of media usage (watching videos, gaming, and social media) and headache frequency and headache intensity over time. Methods: School-aged children from five German schools completed five assessments between 2017 and 2018. In total, N = 575 (72.9% female; M_age = 13.3, SD_age = 1.86) children and adolescents reporting consistent headaches across all assessments were analyzed. Multilevel linear modeling was used to assess the relationships between media use and headache frequency and intensity over time. Results: There were only minor associations between media use and headache intensity or frequency. Notably, only high social media usage was linked with worse headache intensity (t(1989) = 4.109, p < 0.001). Conclusions: The impact of media use on headaches seems to be less harmful than previous research might suggest. We believe that increased time spent consuming media should not be considered a risk factor for pain conditions but rather a helpful resource for pain management.

Background: Abdominal pain is a common and often debilitating issue for children and adolescents. In many cases, it is not caused by a specific somatic condition but rather emerges from a complex interplay of bio-psycho-social factors, leading to functional abdominal pain (FAP). Given the complex nature of FAP, understanding its origins and how to effectively manage this condition is crucial. Until now, however, no questionnaire exists that targets knowledge in this specific domain. To address this, the Abdominal Pain Knowledge Questionnaire (A-PKQ) was developed. Methods: Two versions were created (one for children and one for parents) and tested in four gastroenterology clinics and one specialized pain clinic in Germany between November 2021 and February 2024. Children between 8 and 17 years of age (N = 128) and their accompanying parents (N = 131) participated in the study. Rasch analysis was used to test the performance of both versions of the questionnaire. Results: The original questionnaires exhibited good model and item fit. Subsequently, both questionnaires were refined to improve usability, resulting in final versions containing 10 items each. These final versions also demonstrated good model and item fit, with items assessing a variety of relevant domains. Conclusion: The A-PKQ is an important contribution to improving assessment in clinical trials focused on pediatric functional abdominal pain.

Chronic noncancer pain in children and adolescents can be impairing and results in substantial health care costs. Intensive interdisciplinary pain treatment (IIPT), an inpatient or day hospital treatment delivered by a team of 3 or more health professionals, may be an effective intervention for these children and adolescents. Based on previous reviews and meta-analyses, we updated findings regarding the description of available treatments and estimated the effectiveness of IIPT, overcoming methodological shortcomings of previous work by requesting and analyzing individual participant data. On June 26, 2021, we searched 5 literature databases (PubMed, PsycINFO, Web of Science, Cochrane Library, and PubPsych) for studies examining the effectiveness of IIPT. Included studies used a pre–post design, assessed patients younger than 22 years, and presented their results in English, German, French, or Spanish. We used standard methodological procedures expected by Cochrane to pool treatment effects and assess risk of bias. We identified 13 different treatment sites with similar treatment inclusion criteria and treatment components, but the descriptions of those treatments varied widely. Regarding treatment effectiveness, IIPT may result in large improvements in the mean pain intensity (g = −1.28), disability (g = −1.91), and number of missed school days at the 12-month follow-up (g = −0.99), as well as moderate improvements in anxiety (g = −0.77) and depression (g = −0.76). The certainty of the evidence, however, was graded from very low to low. We recommend that future researchers use more scientific rigor to increase the certainty of the evidence for IIPT and standardize treatment outcomes for children and adolescents with chronic pain.

More than one-third of adolescents experience recurrent headaches. Usually, these headaches are of primary origin and modulated by different biological and psychosocial factors. While parents are often consulted in scientific research and medical care about the nature of their child’s headache, it is unclear to what extent parents and their children agree upon the factors that cause them. Adolescents’ own attributions of headaches have rarely been investigated, and it is unclear how those attributions affect behavioral and emotional outcomes. In the present study, adolescents with chronic headaches (N = 248) and their parents (N = 120) rated the influence of various biological and psychosocial factors on the adolescents’ headaches. Associations between these factors and several behavioral and emotional outcomes were examined. The most frequently reported factor by both samples was stress; however, concordance between parents and adolescents was generally low. The factor “other disease” was significantly associated with medication consumption and school absence. This study is one of the first to provide insights into adolescents’ own attributions of headaches. Furthermore, the significant associations of the factor with behavioral outcomes reveal the importance of understanding personal explanatory models of headache. Future studies should examine associations between subjective headache causes and the individual’s experience of the disorder to improve headache interventions.