Abstract:
:Theoretical models and evidence increasingly identify chronic pain as a family issue. To date, much of this work has focused on risk conferred by parental chronic pain status despite evidence suggesting parent mental illness and non-pain-related chronic illness may also contribute to poorer chronic pain outcomes in children. This study is the first to test interpersonal fear avoidance processes as possible mechanisms through which parent health (mental and physical) influences pediatric chronic pain functioning. We used structural equation models to test such an integrative model using cross-sectional data from a large clinical registry of 448 dyads of patients aged between 8 and 18 years (M = 14.57 years; SD = 2.38; 327 females) with mixed chronic pain and their parents (403 mothers). As expected, poorer parent global health was indirectly related to greater child pain interference through higher parent pain catastrophizing, and then through greater parent protective behaviors and child pain catastrophizing. The model demonstrated excellent fit to the data (χ[5] = 5.04, ns; χ/df = 1.01; comparative fit index = 1.00, root mean square error of approximation = 0.004 [90% confidence interval = 0.000 to 0.066]). Exploratory multiple-group comparison structural equation model revealed moderation of specific model paths based on child age group (8- to 12-year-olds vs 13- to 18-year-olds) and parent pain status (present vs absent). This study integrates family models of pain with the interpersonal fear avoidance model to extend our mechanistic understanding of parental physical and mental health contributors to pediatric chronic pain.
journal_name
Painjournal_title
Painauthors
Birnie KA,Heathcote LC,Bhandari RP,Feinstein A,Yoon IA,Simons LEdoi
10.1097/j.pain.0000000000001820subject
Has Abstractpub_date
2020-06-01 00:00:00pages
1202-1211issue
6eissn
0304-3959issn
1872-6623pii
00006396-202006000-00009journal_volume
161pub_type
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