The relation between parental chronic pain, pain‐related attention and interpretation biases in pain‐free adolescents

Abstract

Background Children of chronic pain patients run greater risk for developing chronic pain themselves. Exposure to chronic pain of the parent might install cognitive (e.g., pain catastrophizing, interpretation and attentional bias) and affective (e.g., pain anxiety) vulnerability which increase the risk for the development of chronic pain complaints in offspring. This study examines whether pain‐free offspring of parents with chronic pain complaints make more health‐threatening interpretations and display a stronger pain‐related attentional bias compared to the offspring of pain‐free parents. We furthermore examined differences between both groups on pain catastrophizing, pain anxiety and somatic symptoms and explored the relations between parental pain catastrophizing and aforementioned pain vulnerability measures in offspring. Methods Offspring of parents with chronic pain complaints (n = 24) and pain‐free parents (n = 27) completed measures of attentional bias (i.e., pictorial dot probe), interpretation bias (i.e., ambiguous word association task), pain catastrophizing, pain anxiety and somatic symptoms. Parents completed measures of pain catastrophizing and psychological distress. Results No differences between offspring of parents with and without pain complaints were observed on pain catastrophizing, pain anxiety and somatic symptoms. Both groups of healthy adolescents predominantly showed benign, non‐health‐threatening interpretations. Children of pain‐free parents showed an attention bias for pain stimuli, while offspring of parents with pain complaints showed no such bias. Conclusions Future research is needed to further elucidate the precise role of parental pain in the development of pain‐related biases and the significance of these biases in the onset and/or maintenance of a chronic pain condition in children and adolescents. Significance Parental chronic pain may install psychological vulnerability for developing chronic pain and associated complaints in offspring. This study did not show differences in pain‐directed attentional and interpretation bias between offspring of parents with chronic pain complaints and offspring of pain‐free parents. Further (longitudinal) research is needed to elucidate the precise role of parental pain factors in the development of pain‐related vulnerability in offspring of chronic pain parents, thereby identifying important targets for the prevention and early intervention of chronic pain.

Pain Prevalence Among Children Visiting Pediatric Emergency Departments

“…On another note, there is the question of whether the presence of chronic disease or pain in the parents affects how they perceive their children's pain. A recent study 32 did not find that the adolescent children of parents with chronic pain had an increased perception of pain compared with those whose parents did not have pain. We also failed to encounter any association between the presence of chronic disease in the parents and the prevalence of pain in pediatric patients.…”

A meta‐analysis of the associations of elements of the fear‐avoidance model of chronic pain with negative affect, depression, anxiety, pain‐related disability and pain intensity

“…Finally, the current study focused on self-report measures of the Fear-Avoidance Model components. Whilst these are the most widely used measures of fear of pain, there is emerging evidence that suggests behavioural paradigms may capture different aspects of fear of pain, including pain-specific attention bias (Boselie et al, 2019), that may be relevant to its relation to pain outcomes. Future research is needed.…”

The Interplay of Parent and Child Coping Responses in Understanding Child Functioning in the Context of Living With a Parent With or Without Chronic Pain

“…Importantly, a heightened presence of child vulnerability factors may predispose currently pain-free children to develop CP or other adverse outcomes later in life. To our knowledge, only one previous study examined child vulnerability factors (i.e., pain-related cognitive biases) in pain-free children of parents with and without CP, but failed to find support for hypothesized differences between both groups of children 14 . We aim to extend these first results by examining another proposed critical child vulnerability factor (i.e., child pain coping behaviours) in pain-free children of parents with and without CP.…”

“…To the best of our knowledge, this is the first study to examine these interrelationships in a group of pain-free children of ICPs and pain-free children of mothers without CP. Moreover, only one previous study examined whether child vulnerabilities (i.e., painrelated cognitive biases) are affected by parental CP, but failed to find differences between children of parents with and without CP 14 . In contrast, moderated mediation analyses in the current study indicated that maternal pain catastrophizing was indirectly related with child functioning through child pain catastrophizing.…”