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Longitudinal change in parent and child functioning after internet-delivered cognitive-behavioral therapy for chronic pain
Open accessAbstract
Theoretical models of pediatric chronic pain propose longitudinal associations between children's pain experiences and parent and family factors. A large body of cross-sectional research supports these models, demonstrating that greater parent distress and maladaptive parenting behaviors are associated with greater child disability. Family-based cognitive-behavioral therapy interventions have been developed for youth with chronic pain which aim to improve child disability and reduce maladaptive parenting behaviors. However, little is known about temporal, longitudinal associations between parent and child functioning in this population. In the present study, we conducted a secondary analysis of data from 138 families of youth with chronic pain aged 11 to 17 years old who received family-based cognitive-behavioral therapy delivered through the Internet as part of a randomized controlled trial. Measures of child disability, parent protective behavior, and parent distress were obtained at pretreatment, immediate posttreatment, 6-month follow-up, and 12-month follow-up. Latent growth modeling indicated that child disability, parent protective behavior, and parent distress improved with treatment over the 12-month study period. Latent growth modeling for parallel processes indicated that higher parent distress at pretreatment predicted less improvement in child disability over 12 months. No other predictive paths between parent and child functioning were significant. These findings indicate that parent distress may increase the risk of poor response to psychological pain treatment among youth with chronic pain. At present, parent distress is not routinely targeted in psychological interventions for pediatric chronic pain. Research is needed to determine optimal strategies for targeting parent and family factors in the treatment of pediatric chronic pain.
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“CBT and ACT have been shown effective in improving psychological outcomes such as stress- and health-related quality of life of children with a CI and their families (Kemani et al., 2018; Law et al., 2017; Palermo et al., 2016; Wynne et al., 2019).”
From Online psychosocial group intervention for parents: Positive effects on anxiety and depression. (2021) · cites this paper as Law et al., 2017
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Metadata
- Authors
- Law, E. F., Fisher, E., Howard, W. J., Levy, R., Ritterband, L., & Palermo, T. M.
- Affiliations
- University of Washington (US)
- Seattle Children's Research Institute (US)
- University of Virginia Health System (US)
- Corresponding author
- Law, Emily F.
- Venue
- Pain
- Published
- 2017-07-03
- Volume
- 158
- Issue
- 10
- Pages
- 1992-2000
- ISSN
- 0304-3959 (ISSN-L)
- 1872-6623
- PMC
- PMC5608643
- OpenAlex
- W2732936456
- Cited by
- 61
- References
- 40
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 4 · 2023: 7 · 2022: 3 · 2021: 10 · 2020: 12 · 2019: 10 · 2018: 8 · 2017: 3
- FWCI
- 9.86
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Pain (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Neurological Disorders and Stroke (K23NS089966)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD062538)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- pediatric chronic pain, online therapy, parental distress, child disability, maladaptive parenting, treatment response, longitudinal change
- MeSH terms
- Adaptation, Psychological, Adolescent, Child, Cross-Sectional Studies, Female, Humans, Longitudinal Studies, Male, Pain Measurement, Parent-Child Relations, Parents, Surveys and Questionnaires, Cognitive Behavioral Therapy, Children with Disabilities, Disabled Children, Internet, Chronic Pain
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