Caregiver–Child Discrepancies in Reports of Child Emotional Symptoms in Pediatric Chronic Pain

Abstract

Objective Pediatric chronic pain evaluation includes self-reports and/or caregiver proxy-reports across biopsychosocial domains. Limited data exist on the effects of caregiver–child discrepancies in pediatric pain assessment. In children with chronic pain, we examined associations among discrepancies in caregiver–child reports of child anxiety and depressive symptoms and child functional impairment. Methods Participants were 202 children (Mage=14.49 ± 2.38 years; 68.8% female) with chronic pain and their caregivers (95.5% female). Children and caregivers completed the Revised Child Anxiety and Depression Scale (RCADS) and RCADS-Parent, respectively. Children also completed the Functional Disability Inventory. Mean difference tests examined caregiver–child discrepancies. Moderation analyses examined whether associations between child self-reported anxiety and depressive symptoms and functional impairment varied as a function of caregiver proxy-report. Results Children reported more anxiety and depressive symptoms compared with their caregivers’ proxy-reports (Z = −4.83, p < .001). Both informants’ reports of child anxiety and depressive symptoms were associated with child functional impairment (rs = .44, rs = .30, p < .001). Caregiver proxy-report moderated associations between child-reported anxiety and depressive symptoms and functional impairment (B = −0.007, p = .003). When caregiver proxy-report was low, child self-reported anxiety and depressive symptoms were positively related to functional impairment (B = 0.28, SE = 0.07, 95% CI [0.15, 0.41], p < .001). Conclusions Discrepant caregiver–child perceptions of child anxiety and depressive symptoms may be associated with functioning in children with chronic pain, especially when caregivers report less child internalizing symptoms. These findings highlight the need for further examination of the effects of caregiver–child discrepancies on pediatric chronic pain outcomes and may indicate targets for intervention.

Weight status and meeting the physical activity, sleep, and screen-time guidelines among Texas children: results from a population based, cross-sectional analysis

“…This study is not without limitations. First, the measures for the primary outcomes of interest, adherence to the PA, screen-time, and sleep guidelines, were reported by the child’s primary caregiver, which has mixed evidence of agreement compared to self-report in children [ 35 , 36 ]. However, children in our study were very young (2nd grade) and the child’s primary caregiver report might be preferable in this age group.…”

Transnasal Sphenopalatine Ganglion Block for the Preventive Treatment of Chronic Daily Headache in Adolescents

“…The secondary endpoints measured were anxiety and depression assessed with the Revised Children's Anxiety and Depression Scale (RCADS), physical function assessed with the Functional Disability Inventory (FDI), and sleep quality assessed with the Pittsburgh Sleep Quality Index (PSQI). The RCADS is a valid self-report Likert scale questionnaire that measures the frequency of anxiety and depression symptoms in pediatric patients [15]. Its five subscales are separation anxiety disorder, social phobia, generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, and depression.…”

“…A total of 17 patients completed the SPG block series, including 14 (82%) females and three males. The mean age at the start of treatment was 14 (11)(12)(13)(14)(15)(16)(17) years. Fifteen (88%) patients had a diagnosis of chronic primary headache or migraine, and two patients had chronic headache secondary to concussion.…”

Hypermobile Ehlers-Danlos syndrome: Caregiver–child concordance across challenges, readiness to change, and coping.

“…Second, given previous findings (Guite et al, 2011), we hypothesize that there will be moderate dyadic concordance on primary PSOC stage. Third, given that discordance in dyadic reports of depression is suggested to impact child functioning (Martin et al, 2020), we hypothesize that greater concordance on readiness to change will be associated with decreased functional disability and depressive symptoms for the child.…”

“…Estimation errors are associated with worse functional outcomes (Cohen et al, 2010; Martin et al, 2020). Caregivers may also misattribute signs of child psychological distress as symptoms of the condition (Martin et al, 2020), like thinking a stomachache is due to GI symptoms when it is the result of anxiety. Misattributions may result in symptom management or treatment that is not in line with the actual cause of the symptoms.…”