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Family and parent influences on pediatric chronic pain: a developmental perspective
Open accessAbstract
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 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]
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“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]
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“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
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“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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Metadata
- 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)
- Venue
- American Psychologist
- Published
- 2014
- Volume
- 69
- Issue
- 2
- Pages
- 142-152
- ISSN
- 0003-066X (ISSN-L)
- 1935-990X
- 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
- 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 › Psychology › Clinical Psychology › 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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