Anxiety Sensitivity and Health-Related Quality of Life in Children With Chronic Pain

Abstract

Anxiety sensitivity (AS), or the fear of anxiety sensations has been shown to independently predict poorer health-related quality of life (HRQOL) in adults with chronic pain. Specifically, AS was found to contribute to decrements in psychological well-being and social functioning but not to decrements in physical functioning. Existing studies have not examined the relationship between AS and HRQOL in children with chronic pain. The present study used multivariate regression analysis to test the association between AS and self-reported HRQOL in 87 children (62 girls; mean age = 14.4 years ± 2.3) presenting for treatment at a tertiary, multidisciplinary clinic specializing in pediatric chronic pain. After controlling for key sociodemographic and pain-related characteristics, higher AS was associated with poorer perceived general and mental health, greater impairment in family activities, lower self-esteem, increased behavior problems, and more social/academic limitations due to emotional problems. AS accounted for 4% -28% of incremental variance in these HRQOL domains above and beyond the demographic and pain-related variables. However, AS was not significantly associated with physical functioning or with academic/social limitations due to physical health. Additional research is required to delineate possible mechanisms by which AS may influence certain aspects of children's HRQOL but not others.Perspective-The present findings support the evaluation of AS in pediatric chronic pain patients as part of a comprehensive assessment battery. The links between AS and multiple HRQOL domains suggests that treatment components aimed at reducing AS may lead to enhanced psychosocial wellbeing in children with chronic pain.

Pain-related quality of life related to mental health and sociodemographic indicators in adolescents

“…We observed that a high level of satisfaction with pain-related QOL was significantly associated with a decreased risk of anxiety. Although several studies 53,54 have explored pain and anxiety in adolescents, extremely few studies have focused on pain-related QOL. A study reported that higher anxiety sensitivity correlates with a higher fear of pain, which is associated with increased pain disability 55 .…”

Living with pain: the experience of children and adolescents in palliative care

“…Despite the fact that the literature notes that chronic pain in children and adolescents causes school truancy, inability take part in physical activities, sleep disturbances and problems relating to people in the same age group (7,9,27) , these aspects were not identified in this study. Analysis of the accounts showed that children and adolescents kept a social support network through their school friends, neighbors and family members, who helped them have a life that is closer to normality.…”

“…Many children and adolescents with chronic diseases and/or in the end-of-life phase live with pain daily, in addition to other signs and symptoms, such as: fatigue, dyspnea, anorexia, nausea, vomiting, insomnia, anxiety, despair, frustration and impotence when managing daily situations (7)(8)(9) .…”

The Role of Peripheral Nerve Blocks in the Interdisciplinary Care of Children with Chronic Pain: A Case Series and Review of the Literature

“…Anxiety also plays a complex role in moderating the relationship between pain and function. Tsao et al (2007) studied anxiety sensitivity, or the fear of anxiety sensations, in 87 children aged 10-18 presenting at a US chronic pain clinic. Anxiety sensitivity was found to be linked with academic and/or social limitations, where those limitations arose from emotional rather than physical difficulties.…”