Associations between parent and child pain and functioning in a pediatric chronic pain sample: a mixed methods approach

Abstract

This study employed a mixed-method design to test sex-specific parent-child pain associations. Subjects were 179 chronic pain patients aged 11–19 years (mean = 14.34; 72% female) presenting for treatment at a multidisciplinary, tertiary clinic. Mothers and children completed questionnaires prior to their clinic visit, including measures of children’s pain, functioning and psychological characteristics. Mothers also reported on their own pain and psychological functioning. Interviews were conducted with a sub-sample of 34 mothers and children prior to the clinic visit and analyzed using a grounded theory approach. The quantitative data suggest stronger mother-daughter than mother-son pain relationships. The qualitative data suggest that girls’ pain and pain-related disability is related to an overly enmeshed mother-daughter relationship and the presence of maternal models of pain, while boys’ pain and disability is linked to male pain models and criticism and to maternal worry and solicitousness. Boys and girls appear to have developmentally incongruous levels of autonomy and conformity to maternal expectations. The mixed-method data suggest distinct trajectories through which mother and father involvement may be linked to chronic pain in adolescent boys and girls.

Sex differences in the relationship between maternal fear of pain and children's conditioned pain modulation

“…CPM is thought to reflect central pain inhibitory processes and is relatively unstudied in children. We have also demonstrated relationships between maternal psychological factors and daughters’ pain and anxiety responses to traditional, static laboratory pain tasks 18,29,30. Both the current study and this prior research suggest alignment between mother and daughter pain-related psychological functioning.…”

Association of Parental Chronic Pain With Chronic Pain in the Adolescent and Young Adult

“…Investigations on the relationship between parental pain and adolescent pain have shown conflicting results. While some studies [22][23][24]48,49 found an association, other studies [19][20][21]50,51 did not. Several interpretations may explain this discrepancy.…”

“…Reporting has also varied; some studies 45,53 have used parental report of children's pain, one study 51 used children's report about their parents' pain, and other studies 19,20 have used pain reports both from the children and from the parents. However, other studies 22,23,49 have reported from only one parent, usually the mother. When examining the relationship between parental pain and adolescent pain, it is essential to have self-reports from all involved.…”

Transmission of risk from parents with chronic pain to offspring: an integrative conceptual model

“…38,39,125 Parent—child communication and interaction styles investigated in the context of pediatric chronic pain have found associations between high conflict and low adolescent autonomy with increased depressive symptoms 86 and lower autonomy than expected for age in youth with pain. 42 …”