A developmental arrest? Interruption and identity in adolescent chronic pain

Abstract

Introduction:Although the pediatric pain literature has explored the role of developmental factors in young children's acute pain, relatively less is known about specific developmental challenges in adolescents with chronic pain.Objectives:To meet this knowledge gap, this study sought to adopt an idiographic phenomenological approach to examine how adolescents make sense of their own development in the context of living with chronic pain.Methods:Semistructured interviews were conducted with ten adolescents (12–17 years; 7 females) recruited from a tertiary care pain treatment programme. Interview data were transcribed verbatim and analysed using Interpretative Phenomenological Analysis.Results:Study findings identified 2 themes: “An externally imposed lens on identity” and “Paradoxes of developmental progress.” The first theme highlighted an understanding of how adolescent identity is perceived. Some adolescents perceived identity as distinct from pain, whereas others perceived identity as part of their chronic pain condition. This theme also detailed how identity was negotiated by adolescents and others through engagement with valued activities. The second theme represented an understanding of how chronic pain disrupts and alters adolescent developmental trajectories at an individual level, suggesting possibilities of enhanced and delayed trajectories. Enhanced trajectories were associated with increased management of emotionally difficult situations and resulted in mastery of complex interpersonal skills.Conclusion:Findings provided a nuanced understanding of developmental progress in the context of adolescent chronic pain and suggested challenges with drawing normative comparisons. Future research could extend findings by adopting a longitudinal approach to studying adolescent development and eliciting accounts from broader social groups.

Adolescent and Parent Experiences of Acceptance and Commitment Therapy for Pediatric Chronic Pain: An Interpretative Phenomenological Analysis

“…Interpretative Phenomenological Analysis (IPA) was chosen a priori because of its particular focus on the personal lived experience [38]. IPA has been used extensively to examine a variety of health-related topics, and more specifically within psychology and the field of chronic pain [8,18,39,40,41,42,43]. IPA offers a structured and idiographic approach in which both the participant and the researchers strive to make sense of their experiences, positioning the role of the researcher as important within the analytical process.…”

“…In qualitative studies, young people have described that their experiences of chronic pain include difficult encounters with medical professionals, limitations in functioning due to pain, extreme experiences of pain, and altered emotional wellbeing and social impairment [4,5,6,7]. Pediatric chronic pain has also been described as having an impact on identity development [8], and development and maintenance of peer relationships [9], and is related to impaired family functioning, caregiver burden and extensive health care costs [10,11,12].…”

A usability and feasibility study of a computerized version of the Bath Adolescent Pain Questionnaire: the BAPQ-C

“…It is notable that these relatively simple functional improvements observed during BAPQ-C completion where not merely seen as increasing the accessibility and acceptability of the measure. They were also experienced in terms of fostering participants' autonomy and independence; factors which are often restricted in adolescents who experience persistent pain [5]. By providing a format through which adolescents could complete the BAPQ more independently, the BAPQ-C enhanced the potential for participants' privacy during assessment and reduced the burden of completion as a result.…”

“…For these adolescents, the impact of ongoing pain is wide-ranging and all encompassing. Adolescents who experience chronic pain report impaired functioning across numerous domains including physical, psychological, social and developmental functioning [5][6][7].…”

Introduction to special issue on innovations in pediatric pain research and care

“…Developing and refining theoretical frameworks is also of importance to advance the field of pediatric pain research. The article by Wakefield et al 21 offers a literature review and findings from focus groups to inform a pain-related stigma framework for children with chronic pain, whereas the article by Jordan et al 14 uses a qualitative approach to further the understanding of how children with chronic pain make sense of their development. These kinds of careful delineations of factors that relate to pain lay important groundwork for future research.…”