Family and parent influences on pediatric chronic pain: a developmental perspective

Palermo, Tonya M.; Valrie, Cecelia R.; Karlson, Cynthia W.

doi:10.1037/a0035216

Cited by 426Pediatric Pain Management TechniquesFamily Support in IllnessChild and Adolescent Psychosocial and Emotional Development

Family and parent influences on pediatric chronic pain: a developmental perspective

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Palermo, Tonya M., Valrie, Cecelia R., Karlson, Cynthia W.·2014·American Psychologist

DOI 10.1037/a0035216PMC PMC4056332

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Abstract

Pain that recurs or persists is unfortunately a common experience for children. One of the unique considerations in pediatric chronic pain management is the bidirectional influences of children's pain experiences and parental and family factors. In this review we present a developmental perspective on understanding pediatric chronic pain and disability, highlighting factors relevant from infancy to adolescence, and family and parent influences. Preliminary evidence indicates that developmental processes are influenced and may also shape the pediatric pain experience. Parent emotions, behaviors, and health also play a role in children's pain experiences, where overly protective parent behaviors, increased distress, and history of chronic pain are important parent-level influences. Research on family-level influences has revealed that families of children with chronic pain have poorer family functioning (e.g., more conflict, less cohesion) than families of healthy children. Several important gaps exist in this research, such as in understanding basic developmental processes in children with chronic pain and how they influence children's perception of and responses to pain. Also, there is a lack of longitudinal data on family relationships and individual adjustment to allow for understanding of whether changes occur in parenting over the course of the child's chronic pain experience. Although parent interventions have been successfully incorporated into many cognitive-behavioral treatments for children with chronic pain conditions, little guidance exists for adapting intervention strategies to be developmentally appropriate. Additional research is needed to examine whether parent interventions are effective at different developmental stages and the best way to incorporate developmental goals into treatment.

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Parental overprotective behaviour can increase distress and disability in young people with FSS.
“parental overprotective behaviour can increase distress and disability in the young [18–21]”
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 [19]
In “Parent Emotions and Behaviors” (page unavailable), the paper says protective parental responses are related to increased disability in children with recurrent or chronic pain. It does not establish that those responses increase the young people’s distress, and the reported relationship does not establish causation. The passage is not specific to young people with functional somatic symptoms (FSS). (LLM, conf=0.86)
Experimental — accuracy not yet measured
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 [19]
The Conceptual Framework section (page not provided) says parental attention may inadvertently reinforce maladaptive pain and coping behaviors, including activity restriction and catastrophizing. The Parent Emotions and Behaviors section reports several studies linking solicitous parental responses to disability. The paper focuses on pediatric chronic pain, however, and does not establish the claim for children and adolescents with FSS generally or explicitly describe reinforcement of illness beliefs. (LLM, conf=0.84)
Experimental — accuracy not yet measured
Parents play an essential role in their children's experience of pain, their treatment, and potential treatment outcomes.
“Parents play an essential role in their children's experience of pain, their treatment, and potential treatment outcomes (Donnelly et al., 2020;Harbeck-Weber et al., 2022;Palermo et al., 2014;Simons et al., 2016).”
From Psychosocial Functioning of Parents of Youth Receiving Intensive Interdisciplinary Pain Treatment (2024) · cites this paper as Palermo et al., 2014
Reinterpreting pain sensations shows weak correlations with functional variables such as pain interference and physical disability.
“it shows weak correlations with functional variables such as pain interference and physical disability 281, 284–287.”
From Evaluating psychosocial contributions to chronic pain outcomes (2018) · cites this paper as [286]

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“Despite our understanding that other psychosocial systems such as family environments [51,52,81,82] and schools [55,83–85] can influence a child’s pain and recovery, there remain few interventions designed to address these broader systems.”
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Pain in long‐term survivors of childhood cancer: A systematic review of the current state of knowledge and a call to action from the Children's Oncology Group
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Dyadic analysis of child and parent trait and state pain catastrophizing in the process of children's pain communication
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Opioid-prescribing patterns for pediatric patients in the United States.
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A Broad Consideration of Risk Factors in Pediatric Chronic Pain: Where to Go from Here?
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Unravelling the Relationship Between Parent and Child PTSD and Pediatric Chronic Pain: the Mediating Role of Pain Catastrophizing
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The Experience of Pain Dismissal in Adolescence
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Intergenerational examination of pain and posttraumatic stress disorder symptoms among youth with chronic pain and their parents
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Sociodevelopmental Challenges Faced by Young People with Chronic Pain: A Scoping Review
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Long COVID symptoms in exposed and infected children, adolescents and their parents one year after SARS-CoV-2 infection: A prospective observational cohort study
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Development and Usability Evaluation of an Art and Narrative-Based Knowledge Translation Tool for Parents With a Child With Pediatric Chronic Pain: Multi-Method Study
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Promoting Psychological Flexibility in Parents of Adolescents With Chronic Pain: Pilot Study of an 8-Week Group Intervention
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Efficacy of the Buzzy System for pain relief during venipuncture in children: a randomized controlled trial.
Susam, V., Friedel, M., Basile, P. C., Ferri, P., & Bonetti, L. (2018) · Acta bio-medica dell'Ateneo parmense/Acta biomedica · doi:10.23750/abm.v89i6-s.7378 · Cited by 44 · see citing works
Moving on: transition experiences of young adults with chronic pain
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Pain and health-related quality of life in adolescents and the mediating role of self-esteem and self-efficacy: a cross-sectional study including adolescents and parents
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Models of Care for addressing chronic musculoskeletal pain and health in children and adolescents
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Review of the Management of Pediatric Post-Concussion Syndrome—a Multi-Disciplinary, Individualized Approach
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Family history of pain and risk of musculoskeletal pain in children and adolescents: a systematic review and meta-analysis
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Factors Related to Agreement Between Child and Caregiver Report of Child Functioning With Chronic Pain: PROMIS Pediatric and Parent Proxy Report
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The Co-occurrence of Pediatric Chronic Pain and Anxiety
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Parent physical and mental health contributions to interpersonal fear avoidance processes in pediatric chronic pain
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Internet-Delivered Cognitive Behavioral Therapy for Children With Pain-Related Functional Gastrointestinal Disorders: Feasibility Study
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Parents’ experiences with pediatric chronic pain
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Why Unidimensional Pain Measurement Prevails in the Pediatric Acute Pain Context and What Multidimensional Self-Report Methods Can Offer
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A Single-Arm Feasibility Trial of Problem-Solving Skills Training for Parents of Children with Idiopathic Chronic Pain Conditions Receiving Intensive Pain Rehabilitation
Law, E. F., Fales, J. L., Beals-Erickson, S. E., Failo, A., Logan, D., Randall, E., Weiss, K., Durkin, L., & Palermo, T. M. (2016) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsw087 · Cited by 33 · see citing works
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Parent Factors are Associated With Pain and Activity Limitations in Youth With Acute Musculoskeletal Pain
Clementi, M. A., Faraji, P., Cordts, K. M. P., MacDougall, K., Wilson, A. C., Palermo, T. M., & Holley, A. L. (2018) · Clinical Journal of Pain · doi:10.1097/ajp.0000000000000668 · Cited by 33 · see citing works
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“A journey to learn about pain”: the development and validation of a comic book about pain neuroscience education for children
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Becoming flexible: Increase in parent psychological flexibility uniquely predicts better well-being following participation in a pediatric interdisciplinary pain rehabilitation program
Benjamin, J. Z., Harbeck-Weber, C., Ale, C., & Sim, L. (2020) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2020.01.003 · Cited by 31 · see citing works
The Cyclical Relation Between Chronic Pain, Executive Functioning, Emotional Regulation, and Self-Management
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Pain Management in Pediatric Burns: A Review of the Science behind It
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Feeling the Pressure to Be Perfect: Effect on Pain-Related Distress and Dysfunction in Youth With Chronic Pain
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Topical Review: Basic Psychological Needs in Adolescents with Chronic Pain—A Self-Determination Perspective
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Economic Impact of Headache and Psychiatric Comorbidities on Healthcare Expenditures Among Children in the United States: A Retrospective Cross‐Sectional Study
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State of The Art in Biobehavioral Approaches to the Management of Chronic Pain in Childhood
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Similarities and Differences Between Migraine in Children and Adults: Presentation, Disability, and Response to Treatment
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Predictors of Depression, Anxiety and Stress Indicators in a Cohort of Women with Chronic Pelvic Pain
Brooks, T., Sharp, R., Evans, S., Baranoff, J. A., & Esterman, A. (2020) · Journal of Pain Research · doi:10.2147/jpr.s223177 · Cited by 29 · see citing works
Chronic non-cancer pain in children: we have a problem, but also solutions
Vega, E., Beaulieu, Y., Gauvin, R., Ferland, C. E., Stabile, S., Pitt, R., Cárdenas, V. H. G., & Ingelmo, P. M. (2018) · Minerva Anestesiologica · doi:10.23736/s0375-9393.18.12367-4 · Cited by 28 · see citing works
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Parent-Child Dyadic Coping and Quality of Life in Chronically Diseased Children
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Use of smartphones to prospectively evaluate predictors and outcomes of caregiver responses to pain in youth with chronic disease
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Feasibility of group-based acceptance and commitment therapy for adolescents (AHEAD) with multiple functional somatic syndromes: A pilot study
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ASPECTOS CONTEXTUAIS SOBRE O GERENCIAMENTO DO CUIDADO DE ENFERMAGEM À CRIANÇA COM DOR ONCOLÓGICA CRÔNICA
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Circles of engagement: Childhood pain and parent brain
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Systematic Review: Pain and Emotional Functioning in Pediatric Sickle Cell Disease
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Systematic Review: Psychosocial Correlates of Pain in Pediatric Inflammatory Bowel Disease
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Authors: Palermo, T. M., Valrie, C. R., & Karlson, C. W.
Affiliations: University of Washington (US)
East Carolina University (US)
University of Mississippi Medical Center (US)
ORCID: Palermo, Tonya M.
Valrie, Cecelia R.
Karlson, Cynthia W.
Venue: American Psychologist
Publisher: American Psychological Association (APA)
Published: 2014
Volume: 69
Issue: 2
Pages: 142-152
ISSN: 0003-066X (ISSN-L)
1935-990X
DOI: 10.1037/a0035216
PMC: PMC4056332
OpenAlex: W2335484472
Cited by: 426
References: 59
Citations by year: 2026: 19 · 2025: 34 · 2024: 22 · 2023: 31 · 2022: 40 · 2021: 47 · 2020: 68 · 2019: 48 · 2018: 32 · 2017: 38 · 2016: 28 · 2015: 11 · 2014: 4 · 2013: 1 · 2012: 2
FWCI: 25.41
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: American Psychologist (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Heart, Lung, and Blood Institute (K01HL103155)
National Institute of Child Health and Human Development (K24HD060068)
Topics: Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
Social Sciences › Sociology and Political Science › Family Support in Illness
Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Keywords: pediatric chronic pain, family influence, parental influence, developmental perspective, parental distress, family functioning, family conflict, family cohesion, cognitive-behavioral intervention, developmental appropriateness, children with disabilities
MeSH terms: Adaptation, Psychological, Adolescent, Child, Child Development, Child, Preschool, Family, Humans, Infant, Parent-Child Relations, Parents, Stress, Psychological, Adolescent Development, Chronic Pain

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Family and parent influences on pediatric chronic pain: a developmental perspective

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