Potential biobehavioral mechanisms of recurrent abdominal pain in children

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Abstract
To explain why otherwise healthy children experience recurrent episodes of abdominal pain (the recurrent abdominal pain syndrome, or RAP), it was hypothesized that the child with RAP demonstrates a deficit in autonomic nervous system recovery to stress and/or an enhanced behavioral and subjective response to pain. To evaluate the validity of these assumptions, children with RAP (9-14 yr) and hospital and healthy controls matched for age, sex, ethnicity and SES [socioeconomic-status] were exposed to a cold pressor stimulus (0 .+-. 1.degree. C). Autonomic (peripheral vasomotor and heart rate), somatic (forearm EMG [electromyogram]), subjective (pain intensity and distress) and behavioral (facial expression) responses were recorded during baseline, stressor and recovery periods. At all 4 levels of observation, the cold pressor stimulus resulted in significant autonomic, somatic, subjective and behavioral arousal. No significant differential response across the 3 groups was noted for any measure and, in particular, no recovery deficit in autonomic arousal was demonstrated. These findings do not support the assumption of a differential response to an acute laboratory induced stress in children with RAP compared to control children.