Topical Review: Resilience Resources and Mechanisms in Pediatric Chronic Pain

Cousins, Laura A.; Kalapurakkel, Sreeja; Cohen, Lindsey L.; Simons, Laura E.

doi:10.1093/jpepsy/jsv037

Cited by 112 publications

(122 citation statements)

References 31 publications

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“…Future research employing larger samples is needed to examine relationships between narrative typologies and parent, child, and family functioning. In particular, inclusion of more resilience-based measures (as emphasized in a recent topical review on this topic 37 ) will be important. A longitudinal perspective will provide particularly valuable information on how narrative typologies may predict changes in pain-related functioning over time.…”

Section: Discussionmentioning

confidence: 99%

Characterizing the Pain Narratives of Parents of Youth With Chronic Pain

Noel

Beals-Erickson²,

Law

et al. 2016

The Clinical Journal of Pain

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Objectives Questionnaire-based research has shown that parents exert a powerful influence on and are profoundly influenced by living with a child with chronic pain. Examination of parents' pain narratives through an observational lens offers an alternative approach to understanding the complexity of pediatric chronic pain; however, the narratives of parents of youth with chronic pain have been largely overlooked. The present study aimed to characterize the vulnerability- and resilience-based aspects of the pain narratives of parents of youth with chronic pain. Methods Pain narratives of 46 parents were recorded during the baseline session as part of two clinical trials evaluating a behavioral intervention for parents of youth with chronic pain. The narratives were coded for aspects of pain-related vulnerability and resilience. Results Using exploratory cluster analysis, two styles of parents’ pain narratives were identified. Distress narratives were characterized by more negative affect and an exclusively unresolved orientation towards the child’s diagnosis of chronic pain whereas resilience narratives were characterized by positive affect and a predominantly resolved orientation towards the child’s diagnosis. Preliminary support for the validity of these clusters was provided through our finding of differences between clusters in parental pain catastrophizing about child pain (helplessness). Discussion Findings highlight the multidimensional nature of parents’ experience of their child’s pain problem. Clinical implications in terms of assessment and treatment are discussed.

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Section: Discussionmentioning

confidence: 99%

Characterizing the Pain Narratives of Parents of Youth With Chronic Pain

Noel

Beals-Erickson²,

Law

et al. 2016

The Clinical Journal of Pain

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“…Accumulating evidence shows that the social environment of patients (e.g., partners, parents, health care providers) can heighten an individual's risk for disability (Yeung et al, 2012;Cousins et al, 2015), for example through the protective or solicitous behaviour of social agents (Newton-John, 2002;Goubert and Simons, 2013). There is much less research on the social context as a possible source of resilience.…”

Section: Future Challengesmentioning

confidence: 99%

“…Other studies have looked at psychological flexibility in parents (McCracken and Gauntlett-Gilbert, 2011;Wallace et al, 2015) and teacher support (Vervoort et al, 2014) as a buffer against negative outcomes in children with pain. The recently proposed dual-factor model of risk and resilience in the context of pediatric pain, the Ecological Resilience-Risk Model may promote future research endeavors in this area (Cousins et al, 2015).…”

Section: Future Challengesmentioning

confidence: 99%

“…Consideration of both risk and resilience mechanisms may therefore explain better than a sole focus on risk mechanisms why some individuals who experience high levels of pain may keep on functioning well in the presence of pain. A dual-factor model of risk and resilience in the context of chronic pain has been recently proposed in the context of adult pain (Sturgeon and Zautra, 2010;Yeung et al, 2012) and pediatric pain (Cousins et al, 2015). In these models, mechanisms that are related to resilience are distinguished from mechanisms related to risk and vulnerability.…”

Section: Introductionmentioning

confidence: 99%

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

Goubert

Trompetter

2017

European Journal of Pain

128

135

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. Electronic mail may be sent to Liesbet.Goubert@UGent.be. Conflicts of interestThe authors declare to have no conflicts of interest. 2 Statement of "significance":What does this review add? The resilience approach put forward in this review spotlights sustainability of positive outcomes (e.g. engagement in meaningful activities) in the presence of pain as an outcome to pursue beyond recovery of negative outcomes. We illuminate the evidence-base and practical application of promising resilience mechanisms (positive emotions, psychological flexibility, needs satisfaction).3 Abstract Background and Objective: The primary objective of this paper is to discuss how a resilience approach to (chronic) pain may advance our current understanding of (mal)adaptation to pain. Different resilience perspectives are described, and future challenges for research, prevention and treatment of (chronic) pain are discussed. Databases and Data Treatment:Literature searches were performed in Web of Science and PubMed to identify relevant literature on risk and resilience in the context of pain. Results:Resilience can be best defined as the ability to restore and sustain living a fulfilling life in the presence of pain. The Psychological Flexibility Model, the Broaden-and-Build Theory, and Self-Determination Theory are described as theories that may provide insight into resilience within the context of (chronic) pain. Conclusions:We describe how a resilience paradigm shifts the outcomes to pursue in pain research and intervention and argue the need for including positive outcomes in addition to negative outcomes. Psychological flexibility, positive affect and basic psychological needs satisfaction are described as potentially important resilience mechanisms with the potential to target both sustainability and recovery from pain. A resilience approach to chronic pain may have important implications for the prevention and treatment of chronic pain problems, as it may give specific indications on how to empower patients to continue living a fulfilling life (in the presence of pain).4

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“…24 However, children characterized by high levels of negative affectivity, which is often linked with neuroticism, tend to experience higher levels of fear, anger, and sadness and have more difficulty engaging in coping efforts to modulate their own affect intensity in the face of challenges, such as pain. 21 Pediatric patients with chronic pain experience higher rates of lifetime anxiety and depressive disorders than pain-free individuals 122 suggesting higher levels of negative affectivity may confer greater risk for pediatric chronic pain, but whether these factors result from or contribute to the development of chronic pain in children is unknown.…”

Section: Potential Moderators Of Riskmentioning

confidence: 99%

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

Stone

Wilson

2016

Pain

121

135

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Offspring of parents with chronic pain are at increased risk for pain and adverse mental and physical health outcomes (Higgins et al, 2015). Although the association between chronic pain in parents and offspring has been established, few studies have addressed why or how this relation occurs. Identifying mechanisms for the transmission of risk that leads to the development of chronic pain in offspring is important for developing preventive interventions targeted to decrease risk for chronic pain and related outcomes (eg, disability and internalizing symptoms). This review presents a conceptual model for the intergenerational transmission of chronic pain from parents to offspring with the goal of setting an agenda for future research and the development of preventive interventions. Our proposed model highlights 5 potential mechanisms for the relation between parental chronic pain and pediatric chronic pain and related adverse outcomes: (1) genetics, (2) alterations in early neurobiological development, (3) pain-specific social learning, (4), general parenting and family health, and (5) exposure to stressful environment. In addition, the model presents 3 potential moderators for the relation between parent and child chronic pain: (1) the presence of chronic pain in a second parent, (2) timing, course, and location of parental chronic pain, and (3) offspring’s characteristics (ie, sex, developmental stage, race or ethnicity, and temperament). Such a framework highlights chronic pain as inherently familial and intergenerational, opening up avenues for new models of intervention and prevention that can be family centered and include at-risk children.

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Topical Review: Resilience Resources and Mechanisms in Pediatric Chronic Pain

Abstract: The examination of pediatric chronic pain from a strengths-based approach might lead to novel clinical avenues to empower youth to positively adapt and live beyond their pain.

Cited by 112 publications

References 31 publications

Characterizing the Pain Narratives of Parents of Youth With Chronic Pain

Characterizing the Pain Narratives of Parents of Youth With Chronic Pain

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

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

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