Personal and Contextual Factors Affecting the Functional Ability of Children and Adolescents with Chronic Pain: A Systematic Review
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OBJECTIVE: Chronic pain can significantly impair functioning of children and adolescents; however, evidence suggests that current psychological approaches have limited effect on functioning post treatment. The objective of this review is to present the current evidence for the personal and contextual factors that affect functioning and disability of children and adolescents with chronic pain, to support the evolution of new treatments. METHOD: Key word searches were conducted in PsycINFO, MEDLINE via Ovid, CINAHL, and PubMed from 1995 to October 2014. Studies were included if they (1) were written in English, (2) included children or adolescents with chronic pain (>3 mo), (3) had at least 1 personal attribute or 1 contextual factor, (4) had 1 measure of functional ability, and (5) had reported correlations between personal or contextual factors and functional measure. RESULTS: Thirty-three studies were identified which met all inclusion criteria. Several personal factors (depression, anxiety, pain intensity, and catastrophizing) and contextual/environmental factors (parenting characteristics) were consistently associated with higher levels of disability, whereas evidence for other factors was less consistent. Complex interactions between personal and contextual factors were reported. Child physical/cognitive capacities, teacher/peer behaviors, and broader cultural and environmental social systems, received little attention. CONCLUSION: Several parent and child factors were consistently linked with functional disability, whereas better family functioning was associated with functional ability. Applying an ecological framework, assisted identification of areas for further research, and provides direction for treatments that may be more effective in optimizing long-term functional outcomes, extending current psychological approaches.
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Pediatric chronic pain is not only a matter of the child, but also a family concern.
“serve as yet another indication of pediatric chronic pain not only being a matter of the child, but also a family concern [42]”
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Cáceres‐Matos, R., Gil‐García, E., Barrientos‐Trigo, S., Molina, E., & Pórcel‐Gálvez, A. M. (2018) · Gaceta Sanitaria · doi:10.1016/j.gaceta.2017.11.007 · Cited by 11 · see citing works
Chronic non-cancer pain in adolescents: a narrative review
Silva, C., de Oliveira, D. A. C., Pestana‐Santos, M., Portugal, F., & Capelo, P. (2021) · Brazilian Journal of Anesthesiology (English Edition) · doi:10.1016/j.bjane.2021.04.033 · Cited by 10 · see citing works
Clinical relevance of attentional biases in pediatric chronic pain: an eye-tracking study
Soltani, S., Ryckeghem, D. M. L. V., Vervoort, T., Heathcote, L. C., Yeates, K. O., Sears, C. R., & Noel, M. E. (2020) · Pain · doi:10.1097/j.pain.0000000000002346 · Cited by 12 · see citing works
A systematic review of social functioning and peer relationships in adolescents with chronic pain
Wolock, E. R., Sinisterra, M., Fedele, D. A., Bishop, M. D., Boissoneault, J., & Janicke, D. M. (2025) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsaf014 · Cited by 9 · see citing works
Zhang, K., Sun, J., Zhang, Q., Zhang, J., He, L., Wang, Z., & Hu, L. (2023) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2824 · Cited by 9 · see citing works
Predictors and Consequences of Pediatric Pain Symptom Trajectories: A 14-Year Longitudinal Study
Mun, C. J., Lemery‐Chalfant, K., Wilson, M. N., & Shaw, D. S. (2021) · Pain Medicine · doi:10.1093/pm/pnab173 · Cited by 8 · see citing works
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Esin, O. R., Esin, R. G., Gorobets, E. A., Хайруллин, И. Х., Makaricheva, E. V., Gamirova, R., & Shamsutdinova, R. F. (2021) · S S Korsakov Journal of Neurology and Psychiatry · doi:10.17116/jnevro202112111272 · Cited by 7 · see citing works
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Ceniza-Bordallo, G., Simons, L. E., Martín‐Casas, P., & Sieberg, C. B. (2026) · Journal of Pain · doi:10.1016/j.jpain.2026.106221 · Cited by 4 · see citing works
An Ecological and Life Span Approach of Social Influences on Childhood Pain Experiences
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Kerley, L., Meredith, P. J., Harnett, P. H., Sinclair, C., & Strong, J. (2021) · Journal of Child and Family Studies · doi:10.1007/s10826-021-01966-8 · Cited by 3 · see citing works
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Pain Management in Curative and Palliative Clinical Settings for Pediatric Cancer Patients
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Pain Management in Curative and Palliative Clinical Settings for Pediatric Cancer Patients
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The impact of pain in children and adolescents with cerebral palsy: A daily diary study
Nania, C. G., Clark, C. A., Noel, M. E., Brunton, L. K., Condliffe, E. G., Kopala‐Sibley, D. C., Mish, S. J., Harris, A. D., & McMorris, C. A. (2026) · Acta Psychologica · doi:10.1016/j.actpsy.2026.107342
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- Authors
- Sinclair, C. M., Meredith, P., Strong, J., & Feeney, R.
- Affiliations
- Royal Children's Hospital (AU)
- Venue
- Journal of Developmental & Behavioral Pediatrics
- Published
- 2016-05
- Volume
- 37
- Issue
- 4
- Pages
- 327-342
- ISSN
- 0196-206X (ISSN-L)
- OpenAlex
- W2339588776
- Cited by
- 49
- References
- 74
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 2 · 2023: 3 · 2022: 5 · 2021: 8 · 2020: 4 · 2019: 7 · 2018: 6 · 2017: 5 · 2016: 1
- FWCI
- 0.97
- Type
- journal article
- Language
- en
- Open access
- green
- eprints.qut.edu.au
- Locations
- Journal of Developmental & Behavioral Pediatrics (publishedVersion)
- PubMed (publishedVersion)
- QUT ePrints (Queensland University of Technology) (submittedVersion)
- Acquire (CQUniversity) (submittedVersion)
- Figshare (submittedVersion)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
- Keywords
- chronic pain, children, adolescents, functional capacity, disability, depression, anxiety, pain intensity, pain catastrophizing, parenting, family functioning, ecological model, contextual factors, psychotherapy outcome
- MeSH terms
- Adolescent, Child, Humans, Severity of Illness Index, Chronic Pain
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