Fear of pain in the context of intensive pain rehabilitation among children and adolescents with neuropathic pain: associations with treatment response
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Unlabelled Recent research has implicated pain-related fear in relation to functional outcomes in children with chronic pain. The current study examined fear of pain, disability, and depression within the context of an intensive pain rehabilitation program. One hundred forty-five children and adolescents who participated in an intensive interdisciplinary pediatric pain rehabilitation day program were assessed in this study. Patients completed measures of pain intensity, pain-related fears, functional disability, and depressive symptoms at admission, discharge, and on average, 2 months postdischarge. After controlling for pain intensity, pain-related fear was significantly related to disability and depressive symptoms at all time points. As predicted, a decline in pain-related fear was significantly associated with a decrease in disability and depressive symptoms. Interestingly, high levels of pain-related fears at admission predicted less reduction in functional disability and depression at discharge, suggesting that high levels of pain-related fear may be a risk factor in relation to treatment outcomes. Overall, results indicate that the relationship between fear of pain and changes in disability and depressive symptoms are closely linked, with fear of pain playing an important role in treatment.Perspective This paper presents results underscoring the importance of pain-related fear in relation to treatment response for children and adolescents with chronic pain. These findings support the need to develop and implement interventions that target reductions in pain-related fear.
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Harm expectations that cause fear and avoidance have a particularly salient influence on pain-related functional outcomes and treatment responsiveness.
“GL challenges harm expectations that cause fear and avoidance, which have a particularly salient influence on pain-related functional outcomes[14; 52; 70; 71] and treatment responsiveness[54].”
From A randomized controlled trial of graded exposure treatment (GET living) for adolescents with chronic pain (2024) · cites this paper as [54]
Pain-related fear and avoidance of activities is a risk factor for less favorable response to treatment.
“Pain-related fear and avoidance of activities has been found to have a significant influence on pain outcomes in children and adolescents [[2], [3], [4]] and is a risk factor for less favorable response to treatment [3].”
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- Authors
- Simons, L. E., Kaczynski, K. J., Conroy, C., & Logan, D. E.
- Affiliations
- Boston Children's Hospital (US)
- Corresponding author
- Simons, Laura E.
- Venue
- The Journal of Pain
- Publisher
- Elsevier BV
- Published
- 2012-12
- Volume
- 13
- Issue
- 12
- Pages
- 1151-1161
- ISSN
- 1526-5900 (ISSN-L)
- PMC
- PMC3508158
- OpenAlex
- W2084841486
- Cited by
- 80
- References
- 50
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 4 · 2023: 3 · 2022: 10 · 2021: 5 · 2020: 5 · 2019: 7 · 2018: 7 · 2017: 12 · 2016: 8 · 2015: 5 · 2014: 4 · 2013: 3 · 2012: 1
- FWCI
- 3.65
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Pain (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (K23HD067202, HD067202)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- fear of pain, neuropathic pain, children and adolescents, chronic pain, functional disability, depressive symptoms, treatment response, interdisciplinary pain rehabilitation
- MeSH terms
- Adolescent, Association, Child, Exercise Therapy, Fear, Female, Follow-Up Studies, Humans, Length of Stay, Male, Neuralgia, Pain Measurement, Treatment Outcome, Pain Management
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