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Systematic Review of Family Functioning in Families of Children and Adolescents With Chronic Pain
Open accessAbstract
Unlabelled Disturbances in family functioning have been identified in youth with chronic pain and are associated with worse child physical and psychological functioning. Assessment measures of family functioning used in research and clinical settings vary. This systematic review summarizes studies investigating relationships among family functioning, pain, and pain-related disability in youth with chronic pain. Sixteen articles were reviewed. All studies were cross-sectional; 7 utilized between-group comparisons (chronic pain versus healthy/control) and 12 examined within-group associations among family functioning, pain, and/or pain-related disability. Studies represented youth with various pain conditions (eg, headache, abdominal pain, fibromyalgia) ages 6 to 20 years. Findings revealed group differences in family functioning between children with chronic pain and healthy control subjects in 5 of 7 studies. Significant associations emerged among family variables and pain-related disability in 6 of 9 studies with worse family functioning associated with greater child disability; relationships between family functioning and children's pain were less consistent. Different patterns of results emerged depending on family functioning measure used. Overall, findings showed that families of children with chronic pain generally have poorer family functioning than healthy populations and that pain-related disability is more consistently related to family functioning than pain intensity.Perspective This review highlights the importance of family factors in pain-related disability in youth with chronic pain. Results suggest that family-level variables may be an important target for intervention. Family functioning measures showed significant variation, and researchers should take this into account when selecting instruments for use in research and clinical settings.
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“Family functioning is so vital that it impacts disability more than pain intensity [3].”
From Multi-family pediatric pain group therapy: Capturing acceptance and cultivating change (2017) · cites this paper as [3]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Peers [2], parents, and families can cultivate adaptive outcomes or foster progressive dysfunction [3].”
From Multi-family pediatric pain group therapy: Capturing acceptance and cultivating change (2017) · cites this paper as [3]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“Scores ≥2 on the reliable and valid FAD-GF reflect greater concern regarding family dynamics [3].”
From Multi-family pediatric pain group therapy: Capturing acceptance and cultivating change (2017) · cites this paper as [3]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“The occurrence of functional changes in the absence of any significant changes in pain level in an intervention with a family component was also congruent with previous literature highlighting the impact of family dynamics on functional changes over and above pain amelioration”
From Multi-family pediatric pain group therapy: Capturing acceptance and cultivating change (2017) · cites this paper as [3]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Pediatric chronic pain is related to poorer family functioning and may lead to an economic burden for parents and society [3,4].”
From A clinical pilot study of individual and group treatment for adolescents with chronic pain and their parents: Effects of acceptance and commitment therapy on functioning (2016) · cites this paper as [3]
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“The most studied factors include family history of chronic pain, parental emotional distress, parental thoughts/behaviours related to pain (eg, parent pain catastrophizing, protective responses to pain), parent-child interactions and overall family environment and family functioning (eg, the extent of conflict, cohesion and expressiveness within the family).”
From Ecological system influences in the treatment of pediatric chronic pain (2012) · cites this paper as [3]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“Family, school and the peer network each shape the pain experience of the individual child or adolescent, and each also represents a domain of functioning that is often impaired by chronic pain.”
From Ecological system influences in the treatment of pediatric chronic pain (2012) · cites this paper as [3]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“A recent systematic review of the literature regarding family factors in pediatric chronic pain (3) yielded 16 studies that focused on associations between parent and family functioning and child pain outcomes.”
From Ecological system influences in the treatment of pediatric chronic pain (2012) · cites this paper as [3]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“Many of these factors have been examined both as predictors of chronic pain and as outcomes altered by the existence of a child's pain within the family.”
From Ecological system influences in the treatment of pediatric chronic pain (2012) · cites this paper as [3]
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“Much of the research to date has been cross-sectional, leaving open questions about whether premorbid family functioning influences painrelated disability or vice versa.”
From Ecological system influences in the treatment of pediatric chronic pain (2012) · cites this paper as [3]
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“A review by Lewandowski et al (3) published in 2008 concluded that the best evidence exists in support of an association between family functioning and pain-related disability, with better family functioning associated with lower levels of child disability in the face of chronic pain.”
From Ecological system influences in the treatment of pediatric chronic pain (2012) · cites this paper as [3]
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Metadata
- Authors
- Lewandowski, A. S., Palermo, T. M., Stinson, J., Handley, S., & Chambers, C. T.
- Affiliations
- Oregon Health & Science University (US)
- University of Toronto (CA)
- Dalhousie University (CA)
- Corresponding author
- Lewandowski, Amy S.
- Venue
- The Journal of Pain
- Publisher
- Elsevier BV
- Published
- 2010-11
- Volume
- 11
- Issue
- 11
- Pages
- 1027-1038
- ISSN
- 1526-5900 (ISSN-L)
- PMC
- PMC2993004
- OpenAlex
- W2170191452
- Cited by
- 374
- References
- 34
- Citations by year
- 2026: 20 · 2025: 31 · 2024: 39 · 2023: 37 · 2022: 38 · 2021: 37 · 2020: 28 · 2019: 19 · 2018: 21 · 2017: 16 · 2016: 25 · 2015: 12 · 2014: 17 · 2013: 18 · 2012: 12
- FWCI
- 1.60
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Pain (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Canadian Institutes of Health Research
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (K24HD060068)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Social Sciences › Psychology › Clinical Psychology › Family Support in Illness
- Keywords
- family functioning, chronic pain, children and adolescents, pain-related disability, headache, abdominal pain, fibromyalgia
- MeSH terms
- Adolescent, Child, Chronic Disease, Family Health, Female, Humans, Male, Pain, Children with Disabilities, Disabled Children, Young Adult
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