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A pilot development trial of cognitive-behavioral interventions for gastroparesis
Dissertation   Open access

A pilot development trial of cognitive-behavioral interventions for gastroparesis

Helen Burton Murray
Doctor of Philosophy (Ph.D.), Drexel University
Jun 2020
DOI:
https://doi.org/10.17918/00001003
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Abstract

Ingestion Gastroparesis Cognitive therapy Indigestion Eating Disorders
Idiopathic gastroparesis is a gastrointestinal condition defined by delayed stomach in the absence of gross structural abnormalities, with symptoms such as nausea, abdominal pain, and early satiety. Existing medical interventions have largely been ineffective in decreasing patients' gastrointestinal symptoms. Some investigators have suggested gastroparesis is a similar to disorders of gut-brain interaction (formerly called functional gastrointestinal disorders) and may be best treated by interventions targeting biopsychosocial mechanisms. The current pilot study (N=6) examined the application of a protocol, Cognitive Behavioral Interventions for Gastroparesis (COBIG). The Primary Aims tested (1) feasibility, (2) acceptability, and (3) preliminary estimates of efficacy of the treatment. The Secondary Aim examined preliminary indicators of mechanisms of change. Treatment was feasible with 100% of participants completing treatment within 12 weeks and most participants (n=5) found treatment acceptable. There were large decreases in gastroparesis symptom severity (r=.90) and improvements in both upper gastrointestinal-specific (r=.81) and general quality of life (r=.90). Notably, individual change in clinical outcomes varied: full treatment response (n=2), partial treatment response (n=2), and no change (n=2). Improvements in possible targeted mechanisms included pain-related worry (n=3), pain self-efficacy (n=4), and gastrointestinal-specific anxiety (n=2). In sum, cognitive-behavioral interventions can be feasibly implemented and acceptable to individuals with gastroparesis, and are effective for some individuals. Further research is needed to elucidate potential differential maintenance mechanisms different interventions can target.

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