Cited by 76Pediatric Pain Management TechniquesMusculoskeletal pain and rehabilitationFamily Support in Illness

The importance of the family environment in pediatric chronic pain

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Palermo, Tonya M., Holley, Amy Lewandowski·2013·JAMA Pediatrics

Abstract

The impact of chronic pain during childhood and adolescence has been well described (e.g., 1 ).A subset of youth with chronic pain has high levels of anxiety and depressive symptoms, poor quality of life, and impairment in school and activity participation ( 2-4 ).Moreover, pain impacts the entire family.Parents of children with chronic pain report increased parenting stress, anxiety and depressive symptoms, financial strain, and family dysfunction ( 5-6 ).Parents also play a critical role in their child's ability to adapt to living with chronic pain, both in terms of their child's emotional functioning as well as their child's ability to participate in activities of daily life.For example increased parent psychological distress is recognized as a risk factor for poorer outcomes in youth with chronic pain ( 5,7 ).A bidirectional relationship between parent and family factors (e.g., parental responses to pain behavior; family environment) and children's pain experience has been described where parent and family factors may increase risk for pain and disability, and in turn, pain and disability may impact parent and family life ( 8 ).Contemporary research in pediatric pain has focused on the identification of risk factors associated with presence and development of chronic pain as well as longitudinal risk.Such investigations have explored a range of biological, social, and psychological risk factors (e.g., [9][10] ).Findings from the study by Hoftun and colleagues published in this issue of Archives contribute to this body of literature.Using an innovative family linkage study design, their findings revealed that maternal and paternal chronic pain increased the odds of chronic pain in adolescents.Associations were even stronger when both parents reported chronic pain.Several family and psychosocial correlates were examined including the structure of the family living situation.Associations in chronic pain status were strongest among adolescents living exclusively with their mother, or their mother and her new partner.These findings raise important questions about the role of the family environment in pediatric pain.The family environment encompasses a range of variables including individual parent behaviors, dyadic interactions between family members, and the broader family system including socioeconomic conditions, family structure, family functioning, and culture.In their integrative model describing parent and family factors in pediatric pain, Palermo and Chambers 8 highlight the association between different levels of the family system and child pain and disability.For example, at the level of the individual parent, parental emotions, behaviors, and health may play a role in the child's pain experience with overly protective behaviors, increased distress, and history of chronic pain being important

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Authors
Palermo, T. M., & Holley, A. L.
Affiliations
  • Seattle Children's Hospital (US)
  • University of Washington (US)
Venue
JAMA Pediatrics
Published
2013-01-01
Volume
167
Issue
1
Pages
93
ISSN
  • 1072-4710 (ISSN-L)
  • 2168-6203
OpenAlex
W2036898238
Cited by
76
References
19
Citations by year
2025: 4 · 2024: 1 · 2023: 44 · 2022: 1 · 2021: 4 · 2020: 1 · 2019: 1 · 2018: 7 · 2017: 4 · 2016: 4 · 2015: 1 · 2013: 3 · 2012: 1
Type
journal article
Language
en
Open access
Locations
  • Archives of Pediatrics and Adolescent Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institute of Child Health and Human Development
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (K23HD071946, R21HD065180, K24HD060068)
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
  • Social Sciences › Sociology and Political Science › Family Support in Illness
Keywords
pediatric chronic pain, family environment, family structure, adolescents, parental distress, risk factors for chronic pain, family functioning
MeSH terms
Female, Humans, Male, Parents, Chronic Pain

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