Distinct influences of anxiety and pain catastrophizing on functional outcomes in children and adolescents with chronic pain
Open accessAbstract
OBJECTIVES: Examine whether anxiety and pain catastrophizing are distinct constructs in relation to functional outcomes in pediatric chronic pain, and whether they differentially predict functional outcomes based on age. METHODS: In all, 725 youth (191 children, 534 adolescents) with chronic pain completed measures of pain characteristics, anxiety, pain catastrophizing, functional disability, and health-related quality of life (HRQOL). Structural equation modeling was used to examine interrelationships. RESULTS: Anxiety and pain catastrophizing were distinct. For both children and adolescents, pain catastrophizing predicted pain, functional disability, and HRQOL, and was a stronger predictor of pain intensity. For children, anxiety predicted HRQOL, and pain catastrophizing was a stronger predictor of functional disability. For adolescents, anxiety predicted functional disability and HRQOL, and anxiety was a stronger predictor of HRQOL. CONCLUSIONS: There were age-related differences regarding whether anxiety or pain catastrophizing more strongly predicted specific functional outcomes. Assessment and intervention efforts should emphasize both anxiety and pain catastrophizing.
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Pain catastrophizing was evident, as per previous research, though evoking these cognitions often required more in-depth exploration, suggesting that some pain fears may not be immediately accessible by clinical interview.
“Pain catastrophizing was evident, as per previous research [11,14], though evoking these cognitions often required more in-depth exploration, suggesting that some pain fears may not be immediately accessible by clinical interview.”
From "Why Isn't It Going Away?": A Qualitative Exploration of Worry and Pain Experiences in Adolescents with Chronic Pain. (2021) · cites this paper as [11]
In pediatric chronic pain samples, higher pain catastrophizing is associated with increased pain, functional disability, and poorer quality of life.
“The role of child PC is clearer in pediatric chronic pain samples where higher PC is associated with increased pain, functional disability, and poorer quality of life. 27”
From Virtual psychoeducation for improvement of pain catastrophizing in pediatric presurgical patients and caregivers: a proof-of-concept study (2023) · cites this paper as [27]
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Cites
Hu, L., & Bentler, P. M. (1999) · Structural Equation Modeling A Multidisciplinary Journal · doi:10.1080/10705519909540118 · Cited by 108,788 · see citing works
Structural equation modeling in practice: A review and recommended two-step approach
Anderson, J. C., & Gerbing, D. W. (1988) · Psychological Bulletin · doi:10.1037/0033-2909.103.3.411 · Cited by 41,941 · see citing works
(1998) · Cited by 36,049 · see citing works
The Pain Catastrophizing Scale: Development and validation.
Sullivan, M. J. L., Bishop, S. R., & Pivik, J. (1995) · Psychological Assessment · doi:10.1037//1040-3590.7.4.524 · Cited by 8,227 · see citing works
Varni, J. W., Seid, M., & Kurtin, P. S. (2001) · Medical Care · doi:10.1097/00005650-200108000-00006 · Cited by 5,131 · see citing works
Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art.
Vlaeyen, J. W. S., & Linton, S. J. (2000) · Pain · doi:10.1016/s0304-3959(99)00242-0 · Cited by 4,931 · see citing works
The PedsQL™: Measurement Model for the Pediatric Quality of Life Inventory
Varni, J. W., Seid, M., & Rode, C. A. (1999) · Medical Care · doi:10.1097/00005650-199902000-00003 · Cited by 3,291 · see citing works
BIRMAHER, B., BRENT, D. A., CHIAPPETTA, L., BRIDGE, J., MONGA, S., & BAUGHER, M. (1999) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199910000-00011 · Cited by 2,252 · see citing works
The epidemiology of chronic pain in children and adolescents revisited: A systematic review
King, S., Chambers, C. T., Huguet, A., MacNevin, R. C., McGrath, P. J., Parker, L., & MacDonald, A. J. (2011) · Pain · doi:10.1016/j.pain.2011.07.016 · Cited by 1,688 · see citing works
The child version of the pain catastrophizing scale (PCS-C): a preliminary validation
Crombez, G., Bijttebier, P., Eccleston, C., Mascagni, T., Mertens, G., Goubert, L., & Verstraeten, K. (2003) · Pain · doi:10.1016/s0304-3959(03)00121-0 · Cited by 652 · see citing works
PALERMO, T. M. (2000) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/00004703-200002000-00011 · Cited by 494 · see citing works
Recurrent abdominal pain, anxiety, and depression in primary care
Campo, J. V., Bridge, J., Ehmann, M., Altman, S., Lucas, A., Birmaher, B., Lorenzo, C. D., Iyengar, S., & Brent, D. A. (2004) · Pediatrics · doi:10.1542/peds.113.4.817 · Cited by 467 · see citing works
Chronic pain and its impact on quality of life in adolescents and their families
Hunfeld, J. A. M. (2001) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/26.3.145 · Cited by 421 · see citing works
Parent and family factors in pediatric chronic pain and disability: An integrative approach
Palermo, T. M., & Chambers, C. T. (2005) · Pain · doi:10.1016/j.pain.2005.10.027 · Cited by 384 · see citing works
Craske, M. G., Rapee, R. M., Jackel, L., & Barlow, D. H. (1989) · Behaviour Research and Therapy · doi:10.1016/0005-7967(89)90010-7 · Cited by 256 · see citing works
The fear avoidance model of chronic pain: Examination for pediatric application
Simons, L. E., & Kaczynski, K. J. (2012) · The Journal of Pain · doi:10.1016/j.jpain.2012.05.002 · Cited by 250 · see citing works
Hoehn-Saric, R., McLeod, D. R., Funderburk, F., & Kowalski, P. (2004) · Archives of General Psychiatry · doi:10.1001/archpsyc.61.9.913 · Cited by 217 · see citing works
Vervoort, T., Goubert, L., Eccleston, C., Bijttebier, P., & Crombez, G. (2005) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsj059 · Cited by 217 · see citing works
Kashikar‐Zuck, S., Ting, T. V., Arnold, L. M., Bean, J. A., Powers, S. W., Graham, T. B., Passo, M. H., Schikler, K. N., Hashkes, P. J., Spalding, S. J., et al. (2011) · Arthritis & Rheumatism · doi:10.1002/art.30644 · Cited by 186 · see citing works
Pielech, M., Ryan, M., Logan, D., Kaczynski, K., White, M. T., & Simons, L. E. (2014) · Pain · doi:10.1016/j.pain.2014.08.035 · Cited by 185 · see citing works
Eccleston, C., Jordan, A., McCracken, L. M., Sleed, M., Connell, H., & Clinch, J. (2005) · Pain · doi:10.1016/j.pain.2005.08.025 · Cited by 172 · see citing works
Palermo, T. M., Witherspoon, D. O., Valenzuela, D., & Drotar, D. (2004) · Pain · doi:10.1016/j.pain.2004.02.023 · Cited by 166 · see citing works
Holroyd, K. A., Drew, J., Cottrell, C., Romanek, K., & Heh, V. (2007) · Cephalalgia · doi:10.1111/j.1468-2982.2007.01420.x · Cited by 163 · see citing works
Headache and Psychological Functioning in Children and Adolescents
Powers, S. W., Gilman, D. K., & Hershey, A. D. (2006) · Headache The Journal of Head and Face Pain · doi:10.1111/j.1526-4610.2006.00583.x · Cited by 126 · see citing works
The Impact of Adolescent Chronic Pain on Functioning: Disentangling the Complex Role of Anxiety
Cohen, L. L., Vowles, K. E., & Eccleston, C. (2009) · Journal of Pain · doi:10.1016/j.jpain.2009.09.009 · Cited by 105 · see citing works
Drahovzal, D. N., Stewart, S. H., & Sullivan, M. J. L. (2006) · Cognitive Behaviour Therapy · doi:10.1080/16506070600898397 · Cited by 104 · see citing works
Factors Related to the Quality of Life in Adolescents With Chronic Pain
Merlijn, V. P. B. M., Hunfeld, J. A. M., van der Wouden, J. C., Hazebroek-Kampschreur, A. A. J. M., Passchier, J., & Koes, B. W. (2006) · Clinical Journal of Pain · doi:10.1097/01.ajp.0000177509.93523.68 · Cited by 104 · see citing works
Mazzone, L., Vitiello, B., Incorpora, G., & Mazzone, D. (2005) · Cephalalgia · doi:10.1111/j.1468-2982.2005.01015.x · Cited by 102 · see citing works
Anxiety and Functional Disability in a Large Sample of Children and Adolescents with Chronic Pain
Simons, L. E., Sieberg, C. B., & Claar, R. L. (2012) · Pain Research and Management · doi:10.1155/2012/420676 · Cited by 100 · see citing works
Hermann, C., Hohmeister, J., Zohsel, K., Ebinger, F., & Flor, H. (2007) · Journal of Pain · doi:10.1016/j.jpain.2007.05.010 · Cited by 98 · see citing works
Beesdo‐Baum, K., Hoyer, J., Jacobi, F., Low, N. C. P., Höfler, M., & Wïttchen, H. (2009) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2009.02.007 · Cited by 98 · see citing works
Children’s catastrophic thinking about their pain predicts pain and disability 6 months later
Vervoort, T., Eccleston, C., Goubert, L., Buysse, A., & Crombez, G. (2010) · European Journal of Pain · doi:10.1016/j.ejpain.2009.03.001 · Cited by 95 · see citing works
Galli, F., D'Antuono, G., Tarantino, S., Viviano, F., Borrelli, O., Chirumbolo, A., Cucchiara, S., & Guidetti, V. (2007) · Cephalalgia · doi:10.1111/j.1468-2982.2006.01271.x · Cited by 90 · see citing works
Worry and catastrophizing about pain in youth: A reappraisal
Eccleston, C., Fisher, E. A., Vervoort, T., & Crombez, G. (2012) · Pain · doi:10.1016/j.pain.2012.02.039 · Cited by 79 · see citing works
Warner, C. M., Colognori, D., Kim, R. E., Reigada, L. C., Klein, R. G., Browner-Elhanan, K. J., Saborsky, A., Petkova, E., Reiss, P., Chhabra, M., et al. (2011) · Depression and Anxiety · doi:10.1002/da.20821 · Cited by 75 · see citing works
O’Sullivan, P., Beales, D. J., Jensen, L., Murray, K. J., & Myers, T. (2011) · Pediatric Rheumatology · doi:10.1186/1546-0096-9-3 · Cited by 66 · see citing works
Factorial Validity of the English-Language Version of the Pain Catastrophizing Scale–Child Version
Parkerson, H. A., Noel, M. E., Pagé, M. G., Fuss, S., Katz, J. D., & Asmundson, G. J. G. (2013) · Journal of Pain · doi:10.1016/j.jpain.2013.06.004 · Cited by 62 · see citing works
Queraltó, J. M., Kovacs, F. M., Martín, A., Plana, N., & Royuela, A. (2011) · Pain Medicine · doi:10.1111/j.1526-4637.2011.01155.x · Cited by 55 · see citing works
Mano, K. E. J., Evans, J. R., Tran, S. T., Khan, K. A., Weisman, S. J., & Hainsworth, K. R. (2012) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jss069 · Cited by 54 · see citing works
Self-citationProtective and exacerbating factors in children and adolescents with fibromyalgia
Libby, C. J., & Glenwick, D. S. (2010) · Rehabilitation Psychology · doi:10.1037/a0019518 · Cited by 53 · see citing works
Jones, D. A., Rollman, G. B., White, K. P., Hill, M. L., & Brooke, R. I. (2003) · Journal of Pain · doi:10.1016/s1526-5900(03)00630-8 · Cited by 50 · see citing works
Functional disability in paediatric patients with recurrent abdominal pain
Wendland, M., Jackson, Y., & Stokes, L. D. (2010) · Child Care Health and Development · doi:10.1111/j.1365-2214.2010.01087.x · Cited by 46 · see citing works
Hainsworth, K. R., Davies, W. H., Khan, K. A., & Weisman, S. J. (2007) · Journal of Pain · doi:10.1016/j.jpain.2007.05.005 · Cited by 44 · see citing works
Self-citationThe Influence of Anxiety Reduction on Clinical Response to Pediatric Chronic Pain Rehabilitation
Benore, E. R., D’Auria, A., Banez, G. A., Worley, S. E., & Tang, A. (2014) · Clinical Journal of Pain · doi:10.1097/ajp.0000000000000127 · Cited by 42 · see citing works
MacDonald, S., Linton, S. J., & Jansson‐Fröjmark, M. (2008) · International Journal of Behavioral Medicine · doi:10.1080/10705500802222675 · Cited by 42 · see citing works
Salamon, K. S., Davies, W. H., Fuentes, M. R., Weisman, S. J., & Hainsworth, K. R. (2014) · Pain Research and Treatment · doi:10.1155/2014/653592 · Cited by 40 · see citing works
Self-citationCunningham, N. R., Lynch‐Jordan, A., Mezoff, A. G., Farrell, M. K., Cohen, M. B., & Kashikar‐Zuck, S. (2013) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/mpg.0b013e31828b3681 · Cited by 39 · see citing works
Introduction to the Special Issue on Pain: From Pain to Pain-Associated Disability Syndrome
Zeltzer, L. K., Tsao, J. C. I., Bursch, B., & Myers, C. D. (2005) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsj053 · Cited by 22 · see citing works
Catastrophizing As a Predictor of Depressive and Anxious Symptoms in Children
Noel, V. A., Francis, S. E. B., Williams-Outerbridge, K., & Fung, S. L. (2011) · Cognitive Therapy and Research · doi:10.1007/s10608-011-9370-2 · Cited by 11 · see citing works
Measuring Treatment Response in an Outpatient Pediatric Pain Program
Lynch-Jordan, A. M., Sil, S., Cunningham, N. R., Joffe, N. E., Slater, S. K., Tran, S. T., & Crosby, L. E. (2014) · Clinical Practice in Pediatric Psychology · doi:10.1037/cpp0000081 · Cited by 9 · see citing works
Self-citation
Flagged first, then by citations
Research works printed but not linked: 3
- [1]1. American Pain Society. (2001). Pediatric chronic pain: A po- sition statement from the American Pain Society. American Pain Society Bulletin, (Jan/Feb), 10-12.
- [3]3. Asmundson, G. J. G. (1999). Anxiety sensitivity and chronic pain: Empirical findings, clinical implications, and future directions. In S. Taylor (Ed.), Anxiety sensitivity: Theory, research, and treatment of the fear of anxiety (pp. 269-285). Mahwah, NJ: Lawrence Erlbaum Associates Publishers.
- [16]16. Guite, J. W., & Kazak, A. E. (2010). Anxiety symptoms and disorders. In: R. J., Shaw & D. R., Demaso (Eds.), Textbook of pediatric psychosomatic medicine (pp. 101-119). Washington, DC: American Psychiatric Publishing, Inc.
Cited by
Sorted by citations
Feinstein, A. B., Sturgeon, J. A., Darnall, B. D., Dunn, A. L., Rico, T., Kao, M. C., & Bhandari, R. P. (2017) · The Journal of Pain · doi:10.1016/j.jpain.2016.10.009 · Cited by 101 · see citing works
Andias, R., Neto, M., & Silva, A. G. (2018) · Physiotherapy Theory and Practice · doi:10.1080/09593985.2018.1423590 · Cited by 99 · see citing works
Ruskin, D. A., Gagnon, M. M., Kohut, S. A., Stinson, J. N., & Walker, K. S. (2017) · The Clinical Journal of Pain · doi:10.1097/ajp.0000000000000490 · Cited by 45 · see citing works
Heffernan, M., Wilson, C., Keating, K., & McCarthy, K. (2021) · Pain Medicine · doi:10.1093/pm/pnaa245 · Cited by 21 · see citing works
Waldron, S. M., Gauntlett-Gilbert, J., Marks, E., Loades, M. E., & Jacobs, K. (2018) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsy036 · Cited by 18 · see citing works
Collins, A. B. (2023) · Pediatric Clinics of North America · doi:10.1016/j.pcl.2023.01.010 · Cited by 17 · see citing works
Zachariades, F., Maras, D., Mervitz, D., Martelli, B., Prayal-Brown, A., Hayawi, L., Barrowman, N., & Lamontagne, C. (2023) · Canadian Journal of Anesthesia/Journal canadien d anesthésie · doi:10.1007/s12630-023-02583-3 · Cited by 3 · see citing works
- Authors
- Tran, S. T., Jastrowski Mano, K. E., Hainsworth, K. R., Medrano, G. R., Anderson Khan, K., Weisman, S. J., & Davies, W. H.
- Affiliations
- Cincinnati Children's Hospital Medical Center (US)
- Children's Hospital of Wisconsin (US)
- Northwestern University (US)
- University of Wisconsin–Milwaukee (US)
- Venue
- Journal of Pediatric Psychology
- Publisher
- Oxford University Press (OUP)
- Published
- 2015-04-02
- Volume
- 40
- Issue
- 8
- Pages
- 744-755
- ISSN
- 0146-8693 (ISSN-L)
- 1465-735X
- OpenAlex
- W2133727800
- Semantic Scholar
- 2e713d78a4280efab2f90c00ca0c7c5a5d8bf145
- Cited by
- 119
- References
- 50
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 7 · 2023: 42 · 2022: 10 · 2021: 8 · 2020: 9 · 2019: 8 · 2018: 11 · 2017: 11 · 2016: 7
- FWCI
- 9.63
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- public-domain
- Locations
- Journal of Pediatric Psychology (publishedVersion, public-domain)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Keywords
- chronic pain, pediatric chronic pain, anxiety, pain catastrophizing, functional disability, health-related quality of life, age differences, children, adolescents, pain intensity
- MeSH terms
- Adolescent, Anxiety Disorders, Child, Female, Persons with Disabilities, Humans, Male, Pain Measurement, Quality of Life, Catastrophization, Chronic Pain
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