The Longitudinal Impact of Parent Distress and Behavior on Functional Outcomes Among Youth With Chronic Pain

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 impact child psychological and functional outcomes over time. A cohort of 195 patients with chronic pain (ages 8–17) and their parents who presented for a multidisciplinary evaluation completed measures at baseline and at four-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 four-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.

Longitudinal change in parent and child functioning after internet-delivered cognitive-behavioral therapy for chronic pain

“…Recently, Chow, Otis and Simons [6] examined parental distress and behavior at the start of multidisciplinary pediatric pain clinic treatment as a predictor of child disability at four-month follow-up. While there were no direct associations identified between baseline parental functioning and children’s disability at follow-up, mediational analyses revealed that children’s disability at follow-up was predicted by the interaction between baseline measures of parent and child functioning.…”

Maternal distress in the context of their child’s type 1 diabetes: exploring the role of adaptive maternal emotion regulation on child outcomes

“…Both the observation of distress in their parents as well as the effect of protective behaviors themselves (e.g., keeping child home from social activities) may induce child anxiety and depressive symptoms (Chow, Otis, & Simons, 2016).…”

A Preliminary Study on the Effects of Parental Accommodations on Frequency of Sickness in Children

“…In fact, several studies have found that parental worry and stress have been shown to increase the number of somatic complaints in children and reduces children's ability to deal with common childhood aches [15][16][17][18]. Further, attachment has shown to have an effect of the development and maintenance of certain chronic conditions in children [19,20]. More specifically, secure attachment to parents is associated with lower levels of pain severity and pain catastrophizing, as well as anxiety and depression [21][22][23].…”

“…It may be that the more parents worry in general, the more they attend to each physical symptom or complaint from their child [19,42]. It may be that the extra attention is reinforcing the symptom or complaint in that child, causing it to occur more frequently.…”