Maladaptive Coping and Depressive Symptoms Partially Explain the Association Between Family Stress and Pain-Related Distress in Youth With IBD

Reed-Knight, Bonney; Tilburg, Miranda A.L. van; Levy, Rona L.; Langer, Shelby L.; Romano, Joan M.; Murphy, Tasha; DuPen, Melissa M.; Feld, Andrew D.

doi:10.1093/jpepsy/jsx082

Cited by 27 publications

(23 citation statements)

References 47 publications

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“…This distribution is reflective and representative of the population distributions of pediatric IBD 10 and comparable with other study samples. 28,35 The mean time since diagnosis was 37.42 months (SD = 33.69, range = 2–153). Most of the children had an inactive disease status at the time of study participation (n = 49, 81.7%) for those with an active disease status (n = 11, 18.3%).…”

Section: Resultsmentioning

confidence: 99%

“…Importantly, these findings are largely in line with and extend previous evidence stressing the relevance of caregiver context in understanding HRQOL. 14,15,27,28 Furthermore, the differences found between youth and parent perspectives on family functioning and the subsequent diverse influence on youth's outcomes highlights the importance of soliciting multiple perspectives of family functioning and underscores how the family system is more than the sum of its parts. 1,21 In particular, the underlying mechanisms explaining youth HRQOL seem more complex from a parental perspectives with their view on family cohesion being associated with youth's HRQOL, through their contribution in explaining pain symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…27 With respect to IBD-related pain experiences, especially during remission, a strongly influence of family stress has been observed. 28 Furthermore, youth with IBD, living in families with clinical-relevant difficulties with general family functioning report lower levels of general well-being and social functioning. 14,15 Shifting the focus from general family functioning to an exploration of the relative contribution of specific family dimensions in explaining pain experiences and HRQOL has the potential to further clarify the underlying mechanisms.…”

Section: Introductionmentioning

confidence: 99%

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Pain and quality of life in youth with inflammatory bowel disease: the role of parent and youth perspectives on family functioning

Caes

Chambers

Otley³

et al. 2019

PR9

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Introduction: Daily pain experiences are a common feature of pediatric inflammatory bowel disease (IBD), which can negatively influence their health-related quality of life (HRQOL). A holistic, family systems approach is needed to further our understanding of daily pain experiences in youth with IBD and their influence on youth's HRQOL. Objectives: The study's objectives were to (1) provide a detailed description of daily pain experiences in youth with IBD, (2) investigate the relative contribution of family functioning and pain in explaining youth's HRQOL, and (3) explore differences in parental and youth perspectives. Methods: Sixty youth with IBD (8–17 years) and a parent completed questionnaires to assess family functioning, HRQOL, and pain experiences within the past week. A subsample of 16 youth completed an online diary (7 days) about their pain experiences. Results: When including any pain experiences, higher youth-reported family satisfaction and lower pain intensity were related to better HRQOL, whereas higher parent-reported family cohesion and satisfaction indirectly related to youth HRQOL through lower pain intensity. When only accounting for abdominal pain, pain intensity related negatively with HRQOL, and only parent-reported cohesion showed an indirect relation with HRQOL through pain intensity. Diary data revealed large heterogeneity: abdominal pain, described as cramping, sharp, and/or stinging was most frequent, but other pain symptoms (eg, back pain and headache) often co-occurred. Conclusion: The findings provide a rich picture of the daily pain experiences of youth with IBD and underscore the importance of a family systems approach to understand how family functioning and pain symptoms influence HRQOL.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pain and quality of life in youth with inflammatory bowel disease: the role of parent and youth perspectives on family functioning

Caes

Chambers

Otley³

et al. 2019

PR9

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“…However, when examining specific domains of family functioning, worse family affective involvement (i.e., degree of family interest and involvement with one another) was positively correlated with parent-reported adolescent depressive symptoms, while better family problem-solving was negatively correlated with self-reported adolescent depressive symptoms [ 41 ]. Additionally, family stress has demonstrated significant, positive associations with youth self-reported depressive symptoms [ 44 ]. Although a direct comparison cannot be made, these results suggest that relationships between family functioning and adolescent depressive symptoms likely depend on specific domains of functioning as opposed to more global measures.…”

Section: Family Functioningmentioning

confidence: 99%

“…With regards to disease activity, higher family HRQOL was significantly associated with decreased youth disease activity [ 39 ], and general family dysfunction demonstrated a positive, significant relationship to pain/fatigue and the frequency of bowel movements [ 36 ]. Reed–Knight and colleagues [ 44 ] examined IBD pain-specific factors in relation to family stress and found that greater family stress was positively related to youths’ pain-related expressions of distress and passive pain coping. Across studies, results demonstrate a consistent relationship between aspects of family functioning and a variety of IBD outcomes, characterized by better family functioning and improved disease functioning.…”

Section: Family Functioningmentioning

confidence: 99%

Parent and Family Functioning in Pediatric Inflammatory Bowel Disease

2020

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Although the impact of pediatric inflammatory bowel disease (IBD) extends beyond the patient to their parents and families, the focus of previous literature has largely been on investigating the patient’s medical and psychosocial functioning, with less consideration of the family system. Having a comprehensive understanding of parent and family functioning within the context of pediatric IBD is important given the role parents and family members have in the successful management of the disease and caring of the child. The current review paper aggregates the empirical research regarding parent and family functioning, including comparisons to normative samples, other illness groups, and how functioning relates to child psychosocial and health outcomes. Extant literature on parents and families in pediatric IBD has largely focused on the variables of parenting stress, parent psychosocial functioning, parent quality of life, and family functioning. Summary findings elucidate the complex relationships between parents, families, and children affected by IBD and highlight the importance of assessing parent and family functioning within pediatric IBD. The current review also offers implications for clinical practice, notes the limitations of the present literature, and provides recommendations for future research.

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The contributions of clinical disease activity, functional disability, and illness intrusiveness to depressive symptoms in pediatric inflammatory bowel disease

Edwards,

Baudino,

Roberts

et al. 2023

J. pediatr. gastroenterol. nutr.

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BackgroundClinical disease activity associated with inflammatory bowel disease (IBD) can place physical limitations on youths' activities of daily living. In turn, functional limitations potentially contribute to youths' heightened experience of IBD‐induced intrusions on a wide range of routine and valued activities (i.e., illness intrusiveness), which can increase their risk for depressive symptoms. The present study examined the contributions of clinical disease activity, functional disability, and illness intrusiveness to depressive symptoms in youth with IBD.MethodsYouth (N = 180) completed the Functional Disability Inventory (FDI), Illness Intrusiveness Scale‐Child (IIS‐C), and Children's Depression Inventory‐2 (CDI‐2). Physicians completed the Physicians Global Assessment of disease activity (PGA).ResultsResults revealed a mediating effect for functional disability in the association between disease activity and depressive symptoms (PGA → FDI → CDI‐2); illness intrusiveness mediated the association between functional disability and depressive symptoms (i.e., FDI → IIS‐C → CDI‐2). Serial mediation revealed that clinical disease activity conferred an indirect effect on youth depressive symptoms through the sequential effects of functional disability and illness intrusiveness (i.e., PGA → FDI → IIS‐C → CDI‐2).ConclusionsTaken together, these findings indicate that youth who encounter more physical limitations as a function of clinical disease activity are more likely to experience an amplified sense of IBD‐related intrusions on their ability to participate in meaningful activities. In turn, heightened illness intrusiveness increases the likelihood of depressive symptoms. Clinical interventions that help youth maintain adequate functional ability in the face of IBD disease activity and encourage involvement in positively valued activities could decrease the negative impact of IBD on youths' emotional adjustment.

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Maladaptive Coping and Depressive Symptoms Partially Explain the Association Between Family Stress and Pain-Related Distress in Youth With IBD

Abstract: Results suggest that family stress can place children at risk for greater expressed pain-related distress through effects on coping and depressive symptoms. Addressing psychosocial difficulties is important for closing the gap between disability and health in youth with IBD.

Cited by 27 publications

References 47 publications

Pain and quality of life in youth with inflammatory bowel disease: the role of parent and youth perspectives on family functioning

Pain and quality of life in youth with inflammatory bowel disease: the role of parent and youth perspectives on family functioning

Parent and Family Functioning in Pediatric Inflammatory Bowel Disease

The contributions of clinical disease activity, functional disability, and illness intrusiveness to depressive symptoms in pediatric inflammatory bowel disease

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