Goal Pursuit in Youth with Chronic Pain

Fisher, Emma; Palermo, Tonya M.

doi:10.3390/children3040036

Cited by 14 publications

(18 citation statements)

References 56 publications

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“…The fear avoidance model of pain with an emphasis on the maladaptive behaviors that lead to activity avoidance has guided pediatric chronic pain research and clinical practice [29]. Certainly most, if not all, people seek to avoid pain.…”

Section: Children With Chronic Painmentioning

confidence: 99%

Chronic Pain in Children and Adolescents: Diagnosis and Treatment of Primary Pain Disorders in Head, Abdomen, Muscles and Joints

et al. 2016

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Primary pain disorders (formerly “functional pain syndromes”) are common, under-diagnosed and under-treated in children and teenagers. This manuscript reviews key aspects which support understanding the development of pediatric chronic pain, points to the current pediatric chronic pain terminology, addresses effective treatment strategies, and discusses the evidence-based use of pharmacology. Common symptoms of an underlying pain vulnerability present in the three most common chronic pain disorders in pediatrics: primary headaches, centrally mediated abdominal pain syndromes, and/or chronic/recurrent musculoskeletal and joint pain. A significant number of children with repeated acute nociceptive pain episodes develop chronic pain in addition to or as a result of their underlying medical condition “chronic-on-acute pain.” We provide description of the structure and process of our interdisciplinary, rehabilitative pain clinic in Minneapolis, Minnesota, USA with accompanying data in the treatment of chronic pain symptoms that persist beyond the expected time of healing. An interdisciplinary approach combining (1) rehabilitation; (2) integrative medicine/active mind-body techniques; (3) psychology; and (4) normalizing daily school attendance, sports, social life and sleep will be presented. As a result of restored function, pain improves and commonly resolves. Opioids are not indicated for primary pain disorders, and other medications, with few exceptions, are usually not first-line therapy.

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Section: Children With Chronic Painmentioning

confidence: 99%

Chronic Pain in Children and Adolescents: Diagnosis and Treatment of Primary Pain Disorders in Head, Abdomen, Muscles and Joints

et al. 2016

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“…Thus, chronic pain can significantly disrupt the development of children and adolescents and hamper the pursuit of personal goals [5–7]. Paradoxically, at the same time, many youngsters with chronic pain are able to live adaptively and pursue personal goals, in spite of experiencing chronic pain [3, 6, 8, 9]. An important question to consider, then, is why some children and adolescents are able to live adaptively and to continue pursuing their personal goals in spite of their chronic condition, while others are not.…”

Section: Introductionmentioning

confidence: 99%

Topical Review: Basic Psychological Needs in Adolescents with Chronic Pain—A Self-Determination Perspective

Riggenbach

Goubert

Petegem

et al. 2019

Pain Research and Management

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This topical review outlines the resilience pathway to adaptive functioning in pediatric pain within a developmental perspective. Self-Determination Theory proposes that the satisfaction of one's basic psychological needs (for autonomy, relatedness, and competence) is crucial for understanding human flourishing and healthy development. However, the role of the basic psychological needs received little attention in a pediatric-pain population. Yet, we propose that need satisfaction may be a resilience factor and need frustration a risk factor, for living with chronic pain. In this topical review, we first discuss two major models that have been developed to understand pain-related disability: the fear-avoidance model of pain and the ecological resilience-risk model in pediatric chronic pain. Both models have been used with children and adolescents but do not include a developmental perspective. Therefore, we introduce Self-Determination Theory and highlight the potentially moderating and mediating role of the basic needs on pain-related disability in children and adolescents. Taken together, we believe that Self-Determination Theory is compatible with the fear-avoidance model of pain and the ecological resilience-risk model in pediatric chronic pain and may deepen our understanding of why some adolescents are able to live adaptively in spite of chronic pain.

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“…In their continuous attempts to manage chronic pain, they usually change the way in which they engage in daily activities. However, the goal of pain management is just one of the goals to be pursued in a context of other concomitant goals [ 1 – 5 ]. The specific strategies that patients use to manage these different and sometimes opposing goals may determine their behaviour when dealing with daily activities (i.e., the so-called activity patterns).…”

Section: Introductionmentioning

confidence: 99%

Optimism, Positive and Negative Affect, and Goal Adjustment Strategies: Their Relationship to Activity Patterns in Patients with Chronic Musculoskeletal Pain

Esteve

López‐Martínez

Peters

et al. 2018

Pain Research and Management

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Objective Activity patterns are the product of pain and of the self-regulation of current goals in the context of pain. The aim of this study was to investigate the association between goal management strategies and activity patterns while taking into account the role of optimism/pessimism and positive/negative affect. Methods Two hundred and thirty-seven patients with chronic musculoskeletal pain filled out questionnaires on optimism, positive and negative affect, pain intensity, and the activity patterns they employed in dealing with their pain. Questionnaires were also administered to assess their general goal management strategies: goal persistence, flexible goal adjustment, and disengagement and reengagement with goals. Results Structural equation modelling showed that higher levels of optimism were related to persistence, flexible goal management, and commitment to new goals. These strategies were associated with higher positive affect, persistence in finishing tasks despite pain, and infrequent avoidance behaviour in the presence or anticipation of pain. Conclusions The strategies used by the patients with chronic musculoskeletal pain to manage their life goals are related to their activity patterns.

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Goal Pursuit in Youth with Chronic Pain

Cited by 14 publications

References 56 publications

Chronic Pain in Children and Adolescents: Diagnosis and Treatment of Primary Pain Disorders in Head, Abdomen, Muscles and Joints

Chronic Pain in Children and Adolescents: Diagnosis and Treatment of Primary Pain Disorders in Head, Abdomen, Muscles and Joints

Topical Review: Basic Psychological Needs in Adolescents with Chronic Pain—A Self-Determination Perspective

Optimism, Positive and Negative Affect, and Goal Adjustment Strategies: Their Relationship to Activity Patterns in Patients with Chronic Musculoskeletal Pain

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