The Longitudinal Impact of Parent Distress and Behavior on Functional Outcomes Among Youth With Chronic Pain
Open accessAbstract
Unlabelled Accumulating evidence supports the concurrent association between parent distress and behavior and child functioning in the context of chronic pain, with existing longitudinal studies limited to a pediatric surgical context that identify parent catastrophizing as influential. In this study, we examined how parent factors assessed at a multidisciplinary pediatric pain clinic evaluation affect child psychological and functional outcomes over time. A cohort of 195 patients with chronic pain (ages 8-17 years) and their parents who presented for a multidisciplinary evaluation completed measures at baseline and at 4-month follow-up. Patients completed measures of pain catastrophizing, pain-related fear and avoidance, generalized anxiety, depressive symptoms, and functional disability. Parents completed measures of pain catastrophizing, pain-related fear and avoidance, and protective responses to child pain. Parent-reported child school functioning was also collected. Parent distress and behavior was concurrently associated with child distress and functioning at evaluation. After controlling for baseline child functioning, baseline parent avoidance and protective behavior emerged as significant predictors of child functioning at 4-month follow-up. Parent distress and behavior influence child distress and functioning over time and these findings identify key parent domains to target in the context of a child's pain treatment.Perspective Parent behavior, specifically avoidance and protective responses, influence child distress and functioning over time. Child pain treatment interventions should include influential parent factors to ensure successful outcomes.
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In children and adolescents with FSS, several studies support that parents inadvertently may play a role in reinforcement of maladaptive illness behaviours and beliefs.
“In children and adolescents with FSS, this is supported by the findings of several studies, where parents inadvertently may play a role in reinforcement of maladaptive illness behaviours and beliefs [19, 20, 92, 93].”
From Feasibility of group-based acceptance and commitment therapy for adolescents (AHEAD) with multiple functional somatic syndromes: A pilot study (2020) · cites this paper as [93]
The Discussion > Review of Findings (page not available) says well-intentioned parental support can inadvertently reinforce illness behavior and links parental behavior to children’s fear and avoidance. The study concerns youth with chronic pain, however, and does not establish the claim for children and adolescents with FSS generally. (LLM, conf=0.85)
Experimental — accuracy not yet measuredMaladaptive parenting behaviors negatively influence adolescent pain-related function.
“This, in turn, is known to negatively influence adolescent pain-related function [8].”
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- Authors
- Chow, E. T., Otis, J. D., & Simons, L. E.
- Affiliations
- Boston University (US)
- Boston Children's Hospital (US)
- Corresponding author
- Simons, Laura E.
- Venue
- The Journal of Pain
- Publisher
- Elsevier BV
- Published
- 2016-06
- Volume
- 17
- Issue
- 6
- Pages
- 729-738
- ISSN
- 1526-5900 (ISSN-L)
- PMC
- PMC4885759
- OpenAlex
- W2297268436
- Cited by
- 111
- References
- 53
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 5 · 2023: 3 · 2022: 6 · 2021: 14 · 2020: 23 · 2019: 18 · 2018: 14 · 2017: 9 · 2016: 5 · 2014: 1
- FWCI
- 17.83
- 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
- National Center for Advancing Translational Sciences (8ULTR000170)
- Sara Page Mayo Endowment for Pediatric Pain Research and Treatment
- 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
- chronic pain, pediatric chronic pain, parental distress, parental behavior, pain catastrophizing, protective response, child psychological distress, functional disability, school functioning, multidisciplinary pain clinic, parent-child relationship
- MeSH terms
- Adolescent, Anxiety, Child, Depression, Disability Evaluation, Fear, Female, Humans, Longitudinal Studies, Male, Parent-Child Relations, Parents, Retrospective Studies, Sex Factors, Stress, Psychological, Children with Disabilities, Young Adult, Catastrophization, Chronic Pain
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