• Matthew C Morris, Lynn S Walker, Stephen Bruehl, Amanda L Stone, Alyssa S Mielock, and Uma Rao.
• aDepartment of Family and Community Medicine, Meharry Medical College, Nashville, TN, USA bCenter for Molecular and Behavioral Neuroscience, Meharry Medical College, Nashville, TN, USA cDepartment of Psychology, Vanderbilt University, Nashville, TN, USA dDepartment of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, USA eVanderbilt Kennedy Center, Nashville, TN, USA fDepartment of Anesthesiology, Vanderbilt University School of Medicine, Nashville, TN, USA gDepartment of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA hCenter for Behavioral Health Research, University of Tennessee, Knoxville, TN, USA.
• Pain. 2016 Oct 1; 157 (10): 2375-81.

AbstractFunctional abdominal pain (FAP) is associated with enhanced pain responsiveness. Although impaired conditioned pain modulation (CPM) characterizes adults with a variety of chronic pain conditions, relatively little is known about CPM in youth with FAP. This study assessed CPM to evoked thermal pain in 140 youth (ages 10-17), 63 of whom had FAP and 77 of whom were healthy controls. Multilevel models demonstrated weaker CPM effects in youth with FAP than in healthy youth, as evident in slower within-person decreases in pain ratings during the conditioning phase. Weaker CPM effects were associated with greater somatic symptom severity and functional disability. Pain responses in youth with FAP were heterogeneous, with 43% of youth showing an unexpected increase in pain ratings during the conditioning phase, suggesting sensitization rather than CPM-related pain inhibition. These findings highlight directions for future research on the emergence and maintenance of FAP in youth.

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