Highlights
- •Parents' distress and behavior can longitudinally affect a child's chronic pain.
- •Parent avoidance and protective behavior are predictors of child functioning.
- •Pediatric chronic pain treatment should also address parent distress and behavior.
Abstract
Accumulating evidence supports the concurrent association between parent distress
and behavior and child functioning in the context of chronic pain, with existing longitudinal
studies limited to a pediatric surgical context that identify parent catastrophizing
as influential. In this study, we examined how parent factors assessed at a multidisciplinary
pediatric pain clinic evaluation affect child psychological and functional outcomes
over time. A cohort of 195 patients with chronic pain (ages 8–17 years) and their
parents who presented for a multidisciplinary evaluation completed measures at baseline
and at 4-month follow-up. Patients completed measures of pain catastrophizing, pain-related
fear and avoidance, generalized anxiety, depressive symptoms, and functional disability.
Parents completed measures of pain catastrophizing, pain-related fear and avoidance,
and protective responses to child pain. Parent-reported child school functioning was
also collected. Parent distress and behavior was concurrently associated with child
distress and functioning at evaluation. After controlling for baseline child functioning,
baseline parent avoidance and protective behavior emerged as significant predictors
of child functioning at 4-month follow-up. Parent distress and behavior influence
child distress and functioning over time and these findings identify key parent domains
to target in the context of a child's pain treatment.
Perspective
Parent behavior, specifically avoidance and protective responses, influence child
distress and functioning over time. Child pain treatment interventions should include
influential parent factors to ensure successful outcomes.
Key words
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Article info
Publication history
Published online: March 15, 2016
Accepted:
February 23,
2016
Received in revised form:
February 2,
2016
Received:
October 24,
2015
Footnotes
This investigation was supported by a K23 award (HD067202), the Harvard Catalyst Clinical and Translational Research Center (NCATS grant #8ULTR000170), the Sara Page Mayo Endowment for Pediatric Pain Research and Treatment, and the Department of Anesthesiology, Perioperative and Pain Medicine at Boston Children's Hospital. No conflicts of interest exist for any of the authors.
Identification
Copyright
© 2016 by the American Pain Society
