Cognitive-behavioral treatment of persistent functional somatic complaints and pediatric anxiety: An initial controlled trial

Carrie Masia Warner, Daniela Colognori, Rachel E. Kim, Laura C. Reigada, Rachel G. Klein, Karen J. Browner-Elhanan, Amy Saborsky, Eva Petkova, Philip Reiss, Manoj Chhabra, Yvonne B. McFarlane-Ferreira, Colin K. Phoon, Nanci Pittman, Keith Benkov

Research output: Contribution to journalArticlepeer-review

52 Scopus citations


Background: Children and adolescents who seek medical treatment for persistent physical distress often suffer from co-occurring anxiety disorders. Treatment options for this impaired population are limited. This study tests the feasibility and potential efficacy of a cognitive-behavioral intervention targeting pain and anxiety for youth with impairing functional physical symptoms and anxiety disorders presenting to pediatricians for medical care. Methods: Children and adolescents (aged 8-16) experiencing somatic complaints, without an explanatory medical disorder (i.e., functional), were recruited from primary care and specialty (gastroenterologists and cardiologists) pediatricians. Forty children, primarily with gastrointestinal symptoms, who met criteria for a co-occurring anxiety disorder, were randomly assigned to a cognitive-behavioral treatment addressing pain and anxiety, Treatment of Anxiety and Physical Symptoms (TAPS), or to a waiting list control. Results: TAPS was found to be an acceptable treatment for this population and was superior to the waiting list condition. Eighty percent of children in TAPS were rated as treatment responders by independent evaluators compared with none of the controls. Overall, self- and parent ratings indicated reductions in children's somatic discomfort and anxiety following intervention. TAPS participants maintained clinical gains 3 months following treatment. Conclusions: The study supports the feasibility and preliminary efficacy of a cognitive-behavioral intervention targeting co-occurring physical distress and anxiety in youth presenting for medical treatment. Such an approach has the potential to exert broad impact on children's dysfunction and to minimize exposure to invasive, ineffective, and costly medical procedures and treatments. Depression and Anxiety, 2011.

Original languageEnglish
Pages (from-to)551-559
Number of pages9
JournalDepression and Anxiety
Issue number7
StatePublished - Jul 2011


  • anxiety
  • children
  • functional
  • somatic symptoms
  • treatment


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