Highlights
- •Parent and child post-traumatic stress disorder (PTSD) symptoms influence children’s pain.
- •Child pain catastrophizing mediated the relationship between child PTSD symptoms and child pain.
- •Child pain catastrophizing mediated the relationship between parent PTSD symptoms and child pain.
- •Child chronic pain treatment should address parent/child mental health symptoms.
Abstract
Clinically elevated rates of post-traumatic stress disorder (PTSD) symptoms are found
among many youth with chronic pain and their parents and are linked to worse child
pain outcomes. Conceptual models of mutual maintenance in pediatric PTSD and chronic
pain posit that child and parent pain catastrophizing are key mechanisms underlying
this co-occurrence. To our knowledge, the current study is the first to examine child
and parent pain catastrophizing as potential mediators in the child PTSD-child pain
and parent PTSD-child pain relationships among a cohort of youth with chronic pain.
One hundred two children (72.5% female, mean age = 13.5 years), recruited from a tertiary level chronic pain program, and 1 of their
parents participated. At intake, parents completed psychometrically sound self-report
measures of PTSD symptoms and catastrophizing about child pain. Children completed
self-report measures of PTSD symptoms, pain catastrophizing, pain interference, and
pain intensity. Findings revealed that relationships between child PTSD and child
pain as well as parent PTSD and child pain were mediated by child (but not parent)
pain catastrophizing. This suggests that children's catastrophic thinking about pain
may explain how child and parent PTSD symptoms influence children's experience of
chronic pain and is a potential target in family-based interventions to improve pain
and mental health outcomes.
Perspective
Consistent with conceptual models of co-occurring PTSD and chronic pain, children's
catastrophic thinking about child pain mediated relationships between parent and child
PTSD symptoms and child chronic pain outcomes. Child pain catastrophizing may be a
fruitful target in interventions to improve children's chronic pain and mental health
outcomes.
Key words
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Article info
Publication history
Published online: October 25, 2017
Accepted:
October 17,
2017
Received in revised form:
October 7,
2017
Received:
May 20,
2017
Footnotes
This work was supported by funding awarded to Melanie Noel by the Vi Riddell Pediatric Pain Initiative and the Alberta Children's Hospital Research Institute.
The authors have no conflicts of interest to declare.
Identification
Copyright
© 2017 by the American Pain Society
