Hope and Coping in Youth With Painful Disorders of Gut-Brain Interaction

Objective: Disorders of gut-brain interaction (DGBIs) are highly prevalent among children and adolescents in the United States and commonly associated with persistent pain. While the presence of a DGBI often impedes physical and emotional functioning, it is common for youth with painful conditions to remain hopeful about their futures. This study sought to evaluate associations among hope, pain-related coping strategy, depressive symptoms, and abdominal pain severity in youth with DGBIs. Methods: 115 youth with DGBIs and their caregivers participated in a cross-sectional study. Youth completed the Children’s Hope Scale, Pain Coping Questionnaire-Short Form, PROMIS Depressive Symptoms, and Pediatric Quality of Life Inventory core module, and provided a 7-day retrospective rating of average abdominal pain severity. Results: 75% of youth felt generally hopeful at least some of the time. Greater hope was significantly associated with less use of emotion-focused avoidance strategies, lower depressive symptoms, less abdominal pain severity, and greater overall health-related quality of life (HRQoL). Emotion-focused avoidance appears to mediate the relationships between hope and depressive symptoms and hope and HRQoL. Greater use of emotion-focused avoidance strategies was associated with greater depressive symptoms, greater abdominal pain severity, and lower HRQoL. Associations remained significant after controlling for covariates. Conclusions: Youth with DGBIs who reported having more hope had less severe pain and better emotional wellbeing. The use of emotion-focused avoidance strategies was associated with greater abdominal pain severity and worse emotional wellbeing. Interventions promoting hopefulness and the reduction of maladaptive emotional coping skills may be beneficial for this population.