Teenagers and Stomach Pain Focus of New Study at UAB

The University of Alabama at Birmingham (UAB) has received a two-year, $290,000 grant from the National Institute of Diabetes and Digestive and Kidney Diseases, a division of the National Institutes of Health, to investigate what affect writing about past distressing events can have on relieving recurrent abdominal pain in teenagers.

May 6, 2003

BIRMINGHAM, AL — The University of Alabama at Birmingham (UAB) has received a two-year, $290,000 grant from the National Institute of Diabetes and Digestive and Kidney Diseases, a division of the National Institutes of Health, to investigate what affect writing about past distressing events can have on relieving recurrent abdominal pain in teenagers.

Between 10 and 15 percent of teenagers report suffering from recurrent stomach pain. For some, the pain has a diagnosed organic cause. However, many others complain of stomach pain that cannot be attributed to a particular organic problem. One example is irritable bowel syndrome.

“Research studies have shown that children with recurrent stomach complaints have experienced more stress than other children,” said UAB psychologist Jan Wallander, Ph.D., the lead investigator on the study.

Distressing experiences create negative thoughts and emotions, requiring both physiological and psychological effort to suppress the negative emotions, Wallander said. Memories of distressing events can cause changes in the immune system and autonomic neurohormonal functioning. Over time, these changes can result in physical complaints such as stomach pain and exacerbate existing physical conditions.

Studies have shown that writing about past traumatic events improves the health and psychological well being of adults suffering from asthma, rheumatoid arthritis and cystic fibrosis, Wallander said.

“We don’t know why exactly this happens but we believe it has to do with the mind-body connection,” Wallander said. “Written self-disclosure is a language activity wherein people translate their thoughts and emotions about the most distressing experiences of their lives into words, which then enables them to make sense of distressing experiences.

“This process allows people to weave a coherent story about their experiences and develop a sense of control over previously unpredictable thoughts and feelings. This may improve emotions and diminish a person’s need to actively suppress distressing memories.”

Because of this interaction between the mind and body, written self-disclosure may improve the functioning of biological systems such as the immune and the autonomic nervous systems and help alleviate stomach pain. More research on written self-disclosure and the mind-body connection is needed, Wallander said.

“We want to determine whether this particular intervention will helps teenagers suffering from gastrointestinal pain,” Wallander said. “If it is proven to be effective, we would have a low-cost intervention that would complement traditional medical procedures.”

UAB researchers will conduct randomized trials, beginning this spring, involving 140 teenagers between the ages of 12 and 18. Study participants will be asked to write about the most emotional, distressing period in their lives. The writing assignment will last for one week. Participants will write three times during the week for 20 minutes each time. The researchers will then monitor the participants for six months to determine what affect the writing exercise has on the participants’ health and quality of life.

The research team will include UAB clinical psychologist Joshua Klapow, Ph.D., Department of Psychology; UAB biostatistics Professor Charles Katholi, Ph.D., Department of Biostatistics; and Cary Cavender, M.D., and Avi Madam-Swain, P.D., of Children’s Hospital, Department of Pediatrics.