Association of parental and adolescent emotion-related factors with adolescent chronic pain behaviors

Abstract

Chronic pain is a prevalent condition in youth, and the pain experience is strongly influenced by emotional processes. Studying emotion variability and regulation (ER) may help better understand pain behavior. As the development of emotion-related abilities predominantly takes place in the family context, examining ER within parent-adolescent dyads is important. We set out to test the association of parent and adolescent ER and adolescent emotional variability with adolescent pain behavior (ie, pain interference, activity avoidance, and activity engagement). A sample of 56 adolescents (M age 5 14.5, 85.7% women) with chronic pain and one of their parents (92.9% mothers) participated in this study. Adolescents completed baseline measures of average pain intensity, ER, and mean positive and negative affect. Furthermore, adolescents completed an electronic diary for 14 consecutive days, reporting on emotional state, activity avoidance, activity engagement, and pain interference. Parents completed measures of ER and their own history of pain. We performed a variable selection procedure, the least absolute shrinkage and selection operator method, to determine important predictors of adolescent pain behavior. Adolescent high positive affect was associated with more activity engagement, less pain interference, and less activity avoidance, indicating that positive affect might enhance the willingness to engage in activities in the presence of pain. Adolescent ER strategy emotional reappraisal and parents' own history of pain were predictors of less activity engagement. Parent ER was not related to adolescent ER. In conclusion, our results highlight the potential of enhancing positive affect as an intervention target for chronic pain.

Schmerz-Know-How für Kids und Teenager

“…Kinder sind mehr als Erwachsene in ihr familiäres Umfeld eingebunden, davon abhängig und durch dieses beeinflussbar. Elterliche Ängste, Überzeugungen, Verhaltensweisen und Erklärungsmodelle werden auf das Kind übertragen und können ungünstige Verhaltensweisen wie Rückzug, Passivität, somatische Fixierung oder fortdauernde medizinische Untersuchungen sowie die Medikamenteneinnahme fördern [4].…”

Longitudinal Resilience and Risk Factors in Pediatric Postoperative Pain (LORRIS): Protocol for a Prospective Longitudinal Swiss University Children’s Hospitals-Based Study

“… 19 In paediatric chronic pain, one study found greater positive emotion variability to be associated with less pain-related interference and more engagement in activities despite pain. 16 Emotion variability can be measured using the within-person SD of repeated assessments of current emotional state. 16 18 20 21 …”

“… 16 Emotion variability can be measured using the within-person SD of repeated assessments of current emotional state. 16 18 20 21 …”

“…Emotion regulation refers to a person’s ability to influence what emotions they have, when they have them, and how they experience and express these emotions. 27 28 A handful of previous studies has explored the role of emotion regulation in paediatric chronic pain 16 20 29 30 yielding mixed results, while some found that different types of emotion regulation, namely expressive suppression and cognitive reappraisal, were associated with more frequent hospitalisation due to pain, 29 and lower engagement in activities despite the pain, 16 others did not identify significant associations between emotion regulation and pain intensity or pain-related disability. 20 30 The habitual use of specific emotion regulation strategies is considered stable within individuals 31–33 and can be measured by means of questionnaires.…”

Identifying and Managing Suicidality in Children and Adolescents with Chronic Pain: Evidence-Based Treatment Strategies

“…24 Positive affect is associated with greater activity engagement and less pain interference and activity avoidance. 25 How a youth copes with pain appears important, though conclusions are difficult to draw. The low conceptual clarity among studies published on the topic identified in a recent a scoping review 26 highlights the importance of methodological clarity in further studies.…”