The Impact of the COVID-19 Pandemic on Youth with Chronic Pain and Their Parents: A Longitudinal Examination of Who Are Most at Risk

Abstract

Objectives: Chronic pain and mental illness in youth and parents are poised to reach new heights amidst the societal and healthcare impacts of the COVID-19 pandemic. Evidence from natural disasters (i.e., hurricanes) suggests that a degree of personal impact and individual personality may moderate the effects of high stress events, such as the COVID-19 pandemic, on mental health. Methods: In a pre-existing cohort of 84 youth with chronic pain (Mage = 14.39; 12–18 years; 67.8% female) and 90 parents (86.7% female), we examined changes in youth pain interference and youth and parent mental health (depression, anxiety) from before to during the first wave of the COVID-19 pandemic, and the influence of personal impact of the pandemic (i.e., financial, familial, health, social, occupational, and educational domains) and individual personality (neuroticism, conscientiousness, extroversion). Results: Overall, youth reported significantly lower pain interference and anxiety as compared to pre-pandemic; however, those more personally impacted by the pandemic reported worsening pain interference and anxiety symptoms. Overall, parents reported greater depressive symptoms as compared to pre-pandemic; however, those more personally impacted by the pandemic reported increased anxiety symptoms. Personality traits (high neuroticism, and low conscientiousness and extroversion) predicted worsened pain and mental health, and exacerbated effects of COVID-19-related personal impact on youth and parent anxiety symptoms. Discussion: Identifying risk and resilience profiles in youth and parents at high risk for worsening pain and mental health may better inform matching interventions to individual need.

“We survived the pandemic together”: The impact of the COVID-19 pandemic on Canadian families living with chronic pain

“…Youth expressed changes in pain symptoms and mental health challenges, which subsequently impacted their caregivers and siblings, resulting in changes to family dynamics. Some quantitative studies among youth with chronic pain reported no change 29 or reductions in pain symptoms during the pandemic 21 ; however, many studies found increases in mental health challenges. 21 , 29 , 48 Our research team completed a large survey-based study with over 600 youth, siblings, and parents and found significant increases in mental health symptoms such as anxiety, depression, and PTSD; however, significant changes in pain intensity were not found.…”

“…Some quantitative studies among youth with chronic pain reported no change 29 or reductions in pain symptoms during the pandemic 21 ; however, many studies found increases in mental health challenges. 21 , 29 , 48 Our research team completed a large survey-based study with over 600 youth, siblings, and parents and found significant increases in mental health symptoms such as anxiety, depression, and PTSD; however, significant changes in pain intensity were not found. 37 In contrast, most qualitative studies among youth and adults with chronic pain recounted a deterioration of their pain condition during the pandemic.…”

“… 30 Early longitudinal studies with youth with chronic pain and their families suggest that pain interference and well-being have improved when compared to before the pandemic. 21 , 29 However, youth and their families who experienced greater personal impact (e.g., economic stress, job instability, housing insecurity) during the pandemic have been shown to develop worsened anxiety, 21 pain, and parent insomnia. 21 , 29 Overall, research has varied widely regarding the impact of the pandemic on youth living with chronic pain; however, few studies have examined this phenomenon at the family system level with both caregivers and siblings of youth living with pain.…”

“… 21 , 29 However, youth and their families who experienced greater personal impact (e.g., economic stress, job instability, housing insecurity) during the pandemic have been shown to develop worsened anxiety, 21 pain, and parent insomnia. 21 , 29 Overall, research has varied widely regarding the impact of the pandemic on youth living with chronic pain; however, few studies have examined this phenomenon at the family system level with both caregivers and siblings of youth living with pain. There are relatively few studies that have examined the experience of siblings of young people with chronic pain, and the majority of research on siblings that does exist has used quantitative methods to explore the biological or physical components of pain.…”

Pain and insomnia as risk factors for first lifetime onsets of anxiety, depression, and suicidality in adolescence

“…Although this study did not focus on the impact of the pandemic on mental health in youth specifically, it is possible that this contextual factor might in part explain the higher rates of mental health symptoms in this sample, consistent with previous research noting high rates of mental health concerns in youth during this period. 7…”