Parenting in the Context of Chronic Pain

Abstract

Objectives This study aims to describe what adults with chronic pain experience in their role as parents, utilizing quantitative and qualitative methods. The first aim is to compare parents with chronic pain to parents without chronic pain on perceptions of their adolescent’s pain, parental response to pain, and catastrophizing beliefs about pain. The study also examined predictors of parental protective behaviors, and examined whether these associations differed by study group. Methods Parents with chronic pain (n=58) and parents without chronic pain (n=72) participated, and completed questionnaire measures of pain characteristics and pain interference, as well as measures of parental catastrophizing and protective pain responses. Parents with chronic pain also completed a structured interview about their experience of being a parent. Interview responses were videotaped and subsequently coded for content. Results Compared to controls, parents with chronic pain endorsed more pain in their adolescents, and were more likely to catastrophize about their adolescent’s pain and respond with protective behaviors. Parent’s own pain interference and the perception of higher pain in their adolescent was associated with increased protective parenting in the chronic pain group. Qualitative coding revealed a number of areas of common impact of chronic pain on parenting. Discussion Chronic pain impacts everyday parenting activities and emotions, and impacts pain-specific parent responses that are known to be related to increased pain and pain catastrophizing in children and adolescents. Parents with chronic pain might benefit from interventions that address potential parenting difficulties, and might improve outcomes for their children.

A Clinical Pilot Study of Individual and Group Treatment for Adolescents with Chronic Pain and Their Parents: Effects of Acceptance and Commitment Therapy on Functioning

“…Future studies could include treatment content more specifically aimed at parent depressive or anxious symptoms, as such problems are commonly reported by parents of children with chronic pain [45,54] and potentially hamper effective parent behaviors for a subset of parents. Furthermore, chronic pain is common in parents of children with chronic pain [55], which is also seen in our sample, and the interference of parent chronic pain on parent behavior [56] and parent mental health should therefore be examined further.…”

Transmission of risk from parents with chronic pain to offspring: an integrative conceptual model

“…In a study comparing children of adult patients with chronic pain with children of adults without chronic pain, parents with chronic pain reported higher levels of catastrophizing about their children’s pain and protective responses to children’s pain. 158 Parental responses that are solicitous or protective (eg, letting their child stay home from school and giving their child special treats or gifts) are associated with higher levels of pain, disability, and catastrophizing in pediatric patients with chronic pain. 124 Children’s own levels of pain catastrophizing and emotional distress are associated with parents’ solicitous or protective responses to children’s pain and may drive the relation between parents’ responses to children’s pain and children’s symptoms and disability.…”

“…Parents with chronic pain may influence the development of chronic pain and other poor outcomes in their children through engaging in a number of general parenting behaviors often linked with adverse child outcomes (eg, permissive parenting, difficulties providing consistency and warmth, and difficulty responding effectively to child distress 43,158 ). Parental warmth is consistently associated with psychological outcomes for children, including lower levels of warmth being related to increased internalizing problems.…”

“…74,82 Maternal responsiveness to distress is positively associated with a child’s ability to regulate negative affect and emotions effectively. 29,75 Parents with chronic pain may be less able to respond to their child’s distress, 158 which can impact children’s ability to develop negative affect regulation. 76 Negative affect regulation has been tightly linked with pain in neuroanatomy 40,121 and is also associated with pain experiences on a day-to-day basis.…”

Towards a science and practice of resilience in the face of pain

“…Furthermore, preliminary evidence is available that parental catastrophizing cognitions and protective behaviours may be important in the intergenerational transmission of chronic pain. A recent study in parents with and without chronic pain for instance showed that parents with chronic pain were more likely to catastrophize about their child's pain and respond with protective behaviours than parents without chronic pain (Wilson and Fales, 2015). Observational learning of pain-related fear, catastrophizing thoughts and avoidance behaviours, has been suggested as a potential mechanism of intergenerational transmission of chronic pain problems Helsen et al, 2011;2013;.…”