Parental Catastrophizing Partially Mediates the Association between Parent-Reported Child Pain Behavior and Parental Protective Responses

Abstract

This study sought to model and test the role of parental catastrophizing in relationship to parent-reported child pain behavior and parental protective (solicitous) responses to child pain in a sample of children with Inflammatory Bowel Disease and their parents (n = 184 dyads). Parents completed measures designed to assess cognitions about and responses to their child's abdominal pain. They also rated their child's pain behavior. Mediation analyses were performed using regression-based techniques and bootstrapping. Results supported a model treating parent-reported child pain behavior as the predictor, parental catastrophizing as the mediator, and parental protective responses as the outcome. Parent-reported child pain behavior predicted parental protective responses and this association was mediated by parental catastrophizing about child pain: indirect effect (SE) = 2.08 (0.56); 95% CI = 1.09, 3.30. The proportion of the total effect mediated was 68%. Findings suggest that interventions designed to modify maladaptive parental responses to children's pain behaviors should assess, as well as target, parental catastrophizing cognitions about their child's pain.

Remembering pain after surgery

“…This is consistent with previous research showing that parent as opposed to child factors are most influential to long-term trajectories of pediatric post-surgical pain [27]. Upon observing their child in pain, parents who catastrophize tend to exhibit avoidance and distress [16; 6], engage in protective [19] and pain attending behaviors [7; 4] and show attentional biases related to their child’s pain [35]. The current findings extend this research by showing that parent catastrophizing about child pain also influences children’s and parents’ memories for pain several months following a major painful event.…”

Child Pain Catastrophizing Mediates the Relation Between Parent Responses to Pain and Disability in Youth With Functional Abdominal Pain

“…Parental responses (specifically protective parental responses) and pain catastrophizing have previously been examined in relation to impairment in mixed samples of youth with chronic pain conditions (10, 11, 15), school-based samples (21) and in youth with organic causes of abdominal pain, such as Inflammatory Bowel Diseases (12). However, examining the role of pain catastrophizing in relation to multiple parent responses (including protection, minimizing and encouragement/ monitoring) in youth with FAP has not previously been investigated.…”

“…Some research suggests that parental overprotectiveness (i.e., limiting the child’s normal activities and/or giving the child special attention secondary to pain) and/or minimizing (i.e., criticism) uniquely influence FAP-related disability (16, 18) whereas other research did not find evidence of such relationships (20). Given the tendency for pain conditions to occur in families, it is conceivable that parents’ catastrophizing may be related to the expression of disability in youth with FAP, though this research has generally focused on the role of parent catastrophizing about their own pain versus their child’s pain (17), though there are several recent exceptions (12, 21). In youth with Inflammatory Bowel Disease, parent catastrophizing about their child pain partially explained the relationship between child pain behavior and parental protective responses; however, the relationship between these factors and child impairment was not examined (12).…”

“…Given the tendency for pain conditions to occur in families, it is conceivable that parents’ catastrophizing may be related to the expression of disability in youth with FAP, though this research has generally focused on the role of parent catastrophizing about their own pain versus their child’s pain (17), though there are several recent exceptions (12, 21). In youth with Inflammatory Bowel Disease, parent catastrophizing about their child pain partially explained the relationship between child pain behavior and parental protective responses; however, the relationship between these factors and child impairment was not examined (12). Yet another recent investigation has found support for the role of child pain catastrophizing underlying the association between parent catastrophizing about their child’s pain and pain related disability in a school-based sample of adolescents (21).…”

Longitudinal change in parent and child functioning after internet-delivered cognitive-behavioral therapy for chronic pain

“…Theoretical models have been proposed which emphasize longitudinal relationships between children’s pain experiences and parent’s emotional and behavioral functioning [25, 31]. Many cross-sectional studies support these models by demonstrating positive correlations between children’s pain-related disability and parental distress and behavior [e.g., 7, 9, 17, 22, 38], where higher disability is associated with greater parental distress and more frequent maladaptive parenting behaviors.…”