Psychosocial Functioning of Parents of Youth Receiving Intensive Interdisciplinary Pain Treatment

May combine two claims.

Parents' past trauma as well as their own physical and emotional health struggles can impact their children's pain and functioning.

“Additionally, parents' past trauma as well as their own physical and emotional health struggles can impact their children's pain and functioning (Dennis et al., 2019).”

• cites Dennis et al., 2019 sourcePartly supported

  The Discussion reports an association between maternal adverse childhood experiences and children’s depressive symptoms, and discusses possible intergenerational effects of maternal chronic pain. But it found no significant association between maternal adverse childhood experiences and children’s pain frequency or functional impairment; the study examined mothers, not parents generally. The claim therefore extends beyond the study’s findings on children’s pain and functioning. (LLM, conf=0.87)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

IIPT programs are often considered the treatment of choice for children who are experiencing significant functional disability due to chronic pain.

“IIPT programs are often considered the treatment of choice for children who are experiencing significant functional disability due to chronic pain (Claus et al., 2022;Hechler et al., 2014).”

• cites Claus et al., 2022 sourceNot checked — no full text of the source
• cites Hechler et al., 2014 sourceSupported

May combine two claims.

Studies that have targeted parents' psychosocial functioning report positive outcomes, including reductions in anxiety, depression, pain catastrophizing, perceived caregiver burden, and increased psychological flexibility.

“Studies that have targeted parents' psychosocial functioning report positive outcomes, including reductions in anxiety, depression, pain catastrophizing, perceived caregiver burden, and increased psychological flexibility (Guite et al., 2018;Palermo et al., 2016;Wallace et al., 2015).”

• cites Guite et al., 2018 sourceNot checked — no full text of the source
• cites Palermo et al., 2016 sourcePartly supported

  The Results (Parent Mental Health Outcomes; page not provided) report reduced pain catastrophizing and some reductions in depression and anxiety, although the latter effects were limited or approached significance. This paper does not report a reduction in perceived caregiver burden. The Discussion describes increased psychological flexibility only as a possible effect for future study, not an observed outcome; the other citations in the sentence are not assessed here. (LLM, conf=0.88)

  Experimental — accuracy not yet measured
• cites Wallace et al., 2015 sourceNot checked — no full text of the source

May combine two claims.

Parents of children with chronic pain experience emotional difficulties (anxiety, depression, adjustment challenges, parenting stress) and social difficulties (poorer family functioning, restrictions in social life), as well as physical symptoms, financial difficulties, and poor overall quality of life.

“Studies indicate that parents of children with chronic pain experience emotional difficulties, including anxiety, depression, adjustment challenges, and parenting stress, and social difficulties, including poorer family functioning and restrictions in social life, as well as physical symptoms, financial difficulties, and poor overall quality of life (Campo et al., 2007;Eccleston et al., 2004;Hunf”

• cites Campo et al., 2007 sourceNot checked — no full text of the source
• cites Eccleston et al., 2004 sourceNot checked — no full text of the source
• cites Hunfeld et al., 2001 sourcePartly supported

  Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

A pilot study of a group art therapy program was perceived as helpful, supportive, and validating by parents.

“In other IIPT programs, a pilot study of a group art therapy program was perceived as helpful, supportive, and validating by parents (Peng et al., 2007)”

• cites Peng et al., 2007 sourceCould not verify

  The Study procedures section describes a survey of pediatric pain-treatment centres, and the Discussion addresses multidisciplinary treatment generally. Neither reports a pilot group art therapy study or parents’ views of one; searches for “art therapy” and “parents validating supportive helpful” found no passage addressing the claim. Page numbers were unavailable in our copy. (LLM, conf=0.76)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

In caregivers of children with rare diseases, fathers experienced more stress due to economic impacts and worried more about their child's future, whereas mothers reported worries about the current impact of their child's disease, changing interpersonal relationships within the family, and feeling unable to provide sufficient support.

“Further, in caregivers of children with rare diseases, fathers experienced more stress due to economic impacts and worried more about their child's future, whereas mothers reported worries about the current impact of their child's disease, as well as changing interpersonal relationships within the family and feeling unable to provide sufficient support (Cardinali et al., 2019).”

• cites Cardinali et al., 2019 sourcePartly supported

  Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

This study used the TREND checklist to improve complete and transparent reporting.

“To improve complete and transparent reporting, this manuscript used the Transparent Reporting of Evaluations with Nonrandomized Designs (TREND) checklist (Des Jarlais et al., 2004).”

• cites Des Jarlais et al., 2004 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

Anxiety and depression are more common in females than males.

“In general, anxiety and depression are more common in females than males, which is likely due to a variety of biopsychosocial factors that contribute to more internalizing symptoms in females and more externalizing symptoms in males (Bandelow & Michaelis, 2015;Boyd et al., 2015;Eaton et al., 2012;Steel et al., 2014).”

• cites Bandelow & Michaelis, 2015 sourcePartly supported

  The Conclusions and future perspectives section (page not specified) states that anxiety disorders are more common in women. The paper does not establish that depression is more common in women or explain the sex difference through internalizing and externalizing symptoms. (LLM, conf=0.86)

  Experimental — accuracy not yet measured
• cites Boyd et al., 2015 sourceNot checked — no full text of the source
• cites Eaton et al., 2012 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

Psychological flexibility may represent an important mechanism or mediator of psychological wellbeing for parents of youth with chronic pain.

“and statements that psychological flexibility may represent an important mechanism or mediator of psychological wellbeing for parents of youth with chronic pain (Hechler et al., 2014).”

• cites Hechler et al., 2014 sourceCould not verify

  The Results describe parental interventions such as education and reinforcing children’s functional behavior, while the Method lists outcomes focused on children’s pain and functioning. Searches for parental psychological flexibility, wellbeing, and mediation found no passage addressing the claimed mechanism for parents. (LLM, conf=0.76)

  Experimental — accuracy not yet measured

May combine two claims.

Current parent interventions do not address the unique needs and challenges of parents of youth with pain, including their own emotional distress, changes in day-to-day schedule and roles, limitations in personal lives, poorer overall quality of life, and potentially their own history of chronic pain.

“Unfortunately, this does not address the unique needs and challenges of parents of youth with pain, including their own emotional distress, changes in their day-to-day schedule and roles, limitations in personal lives, poorer overall quality of life (Hunfeld et al., 2001), and potentially their own history of chronic pain.”

• cites Hunfeld et al., 2001 sourcePartly supported

  Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

In caregivers for children with Type 1 diabetes, fathers experienced lower levels of parenting stress than mothers, and fathers' stress tended to relate more to their child's anxiety and difficult behavior than disease status.

“In a study of caregivers for children with Type 1 diabetes, fathers experienced lower levels of parenting stress than mothers, and fathers' stress tended to relate more to their child's anxiety and difficult behavior than disease status (Mitchell et al., 2009).”

• cites Mitchell et al., 2009 sourcePartly supported

  The Discussion reports that fathers’ parenting stress was lower than levels previously reported among mothers, and the Results link fathers’ stress to difficult child behavior but not to child metabolic control or regimen type. The anxiety associated with stress was the fathers’ own state anxiety, not their children’s anxiety; the mother comparison also came from previous studies, not a direct comparison in this sample. (LLM, conf=0.90)

  Experimental — accuracy not yet measured

May combine two claims.

Neither change in youth-reported pain intensity nor change in parent-report of youth functioning were significantly associated with change in any of the four parent outcomes.

“Results indicated that neither change in youth-reported pain intensity nor change in parent-report of youth functioning were significantly associated with change in any of the four outcomes.”

The quote only partly states this claim.

There were no statistically significant correlations nor trends toward statistical significance between number of weeks in the program and any parent measures.

“There were no statistically significant correlations nor trends toward statistical significance.”

May combine two claims.

For parents with clinically elevated low emotional support, emotional support improved by 1.9 points per week but was not statistically significant (t=1.27, p>.10).

“Emotional support was modeled to improve by 1.9 points per week, but this was not statistically significant (t ¼ 1.27, p > .10).”

May combine two claims.

When examining the whole dataset of parents, small changes were observed in outcomes and were all in the expected direction.

“When examining the whole dataset of parents, small changes were observed in outcomes and were all in the expected direction; however, changes were statistically significant only for anxiety and depression.”

May combine two claims.

Social isolation and emotional support were associated with changes in emotional suppression and cognitive reappraisal.

“Although psychological flexibility did not predict changes in social isolation and emotional support, these outcomes were found to be associated with changes in emotional suppression and cognitive reappraisal.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Twelve parents were male, and 57 were female.

“Twelve parents were male, and 57 were female; no other demographic information was collected from parents.”

Classified as probably not a substantial claim.

Although these studies provide support for parent-focused intervention during IIPT, they have a limited focus (primarily evaluating feasibility, parenting behaviors, depressive symptoms, pain catastrophizing, and psychological flexibility).

“Although these studies provide support for parent-focused intervention during IIPT, they have a limited focus (primarily evaluating feasibility, parenting behaviors, depressive symptoms, pain catastrophizing, and psychological flexibility).”

Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

A better understanding of the psychological and social needs of parents of youth with chronic pain, as well as how their psychosocial functioning changes occur throughout the course of IIPT and in response to current treatments, can inform future parent-based interventions and may ultimately improve family outcomes.

“A better understanding of the psychological (depression and anxiety) and social (emotional support and social isolation) needs of parents of youth with chronic pain, as well as how their psychosocial functioning changes occur throughout the course of IIPT and in response to current treatments, can inform future parent-based interventions and may ultimately improve family outcomes.”

May combine two claims.

At the end of a 3-week IIPT program, parents reported significant improvements in depression, pain catastrophizing, and psychological flexibility.

“At the end of treatment, parents reported significant improvements in depression, pain catastrophizing, and psychological flexibility.”

• cites Weiss et al., 2019 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

A feasibility trial of problem-solving skills training was associated with improvements in mental health, pain catastrophizing, and problem-solving skills.

“and a feasibility trial of problem-solving skills training was associated with improvements in mental health, pain catastrophizing, and problem-solving skills (Law et al., 2017).”

• cites Law et al., 2017Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

May combine two claims.

The psychosocial needs of these parents, as well as how best to meet these needs, are a significant gap in the literature.

“The psychosocial needs of these parents, as well as how best to meet these needs, are a significant gap in the literature.”

Classified as probably not a substantial claim.

IIPT programs may be particularly well-suited for parent-based intervention.

“Of the extant treatment modalities for pediatric chronic pain, intensive interdisciplinary pain treatment (IIPT) programs may be particularly well-suited for parent-based intervention (Harbeck-Weber et al., 2022), given the significant time commitment and caregiver presence typically required in these programs and high impact of pain on these youths and their families.”

• cites Harbeck-Weber et al., 2022 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

This study did not have options for parents to complete forms on-site, which may have improved compliance with measure completion.

“This study did not have options for parents to complete forms on-site, which may have improved compliance with measure completion.”

May combine two claims.

The current results are consistent with research showing that male and female parents do not experience the same challenges and support a broad assessment approach to detect parent needs.

“In general, the current results are consistent with research showing that male and female parents do not experience the same challenges and support a broad assessment approach to detect parent needs.”

May combine two claims.

This study included participants receiving IIPT and parent groups were part of clinical care; there was no comparison or control group, which limits evaluation of potential improvement over time without specific intervention.

“Finally, this study included participants receiving IIPT and parent groups were part of clinical care; there was no comparison or control group, which limits evaluation of potential improvement over time without specific intervention.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

For eight of the children, two parents participated; for 10 children, no parent participated (5 declined or did not attend any groups, 5 agreed to participate but did not complete any measures).

“For eight of the children, two parents participated; for 10 children, no parent participated (5 declined or did not attend any groups, 5 agreed to participate but did not complete any measures).”

May combine two claims.

Parent race and ethnicity were not collected, which along with other missing demographics prohibits exploration of systemic bias in who is currently being reached and the experience of diverse populations in current interventions.

“Of particular note, parent race and ethnicity were not collected, which along with other missing demographics prohibits exploration of systemic bias in who is currently being reached and the experience of diverse populations in current interventions.”

Probably not a substantial claim: may not pass S3 (load-bearing).

All models were built with an unconstrained model followed by a model with greater complexity to ensure proper model functioning.

“all models were built with an unconstrained model followed by a model with greater complexity to ensure proper model functioning”

Probably not a substantial claim: may not pass S3 (load-bearing).

The emotional support measure had excellent internal consistency in the current sample (α=.92).

“The emotional support measure examined perceived feelings of being cared for and valued as a person and having confident relationships, and it had excellent internal consistency in the current sample (a ¼ .92).”

Probably not a substantial claim: may not pass S3 (load-bearing).

The PPFQ-17 had a Cronbach's alpha of 0.87.

“Cronbach's alpha for the PPFQ-17 was 0.87.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Measure completion rates varied across parents: 25 completed all four time points, 27 completed three, 13 completed two, and 4 completed one.

“Measure completion rates varied across parents: 25 parents completed all four time points, 27 parents completed three, 13 completed two, and 4 completed one.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The FDI has demonstrated high test-retest validity (parent report α=.64) and internal consistency with alphas ranging from 0.86 to 0.91.

“The FDI has demonstrated high test-retest validity (parent report a ¼ .64)and internal consistency with alphas ranging from 0.86 to 0.91.”

• cites Walker & Greene, 1991 sourceNot checked — no full text of the source

May combine two claims.

Using only parents who were initially elevated has the potential to capitalize on regression to the mean and may overestimate effects.

“This strategy should be viewed carefully, as using only those who were initially elevated has the potential to capitalize on regression to the mean (Kazdin, 2002), a statistical phenomenon showing that scores further from a mean tend to move toward the mean over time.”

• Also stated in: § Discussion · hedged

  “Second, analyses that used only those with elevated baseline scores may capitalize on regression to the mean (Kazdin, 2002) and may overestimate effects.”

• cites Kazdin, 2002Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing).

Gender differences have also been observed in parenting stress.

“Gender differences have also been observed in parenting stress.”

May combine two claims.

Findings identify increasing psychological flexibility and cognitive reappraisal, and decreasing emotional suppression as potential mediators of change and targets for parenting interventions.

“Additionally, findings identify increasing psychological flexibility and cognitive reappraisal, and decreasing emotional suppression as potential mediators of change and targets for parenting interventions.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

This study was approved by the hospital's Institutional Review Board, and parents provided appropriate informed consent.

“This study was approved by the hospital's Institutional Review Board, and parents were invited to participate and provided appropriate informed consent.”