Predictors of pain catastrophizing in youth with chronic pain engaged in pain rehabilitation treatment
OA Version
Citation
Abstract
BACKGROUND: Pain catastrophizing, a psychological response to pain characterized by feelings of helplessness, excessive magnification, and rumination, is an important predictor of disability and pain levels in youth with chronic pain. However, little research has been done to examine the factors that contribute to pain catastrophizing in the context of pediatric pain treatment. The purpose of this study is to examine the psychosocial and physical factors that influence pain catastrophizing in youth while undergoing intensive interdisciplinary pain treatment.
METHODS: For this study, 317 youth (ages 8-17, M = 14.4) and their caregivers attending a multidisciplinary pain rehabilitation program for chronic pain completed validated self-report measures at the start and the end of treatment (~3-6 weeks later). These measures included assessment of youth functioning (pain catastrophizing, anxiety symptoms, depressive symptoms, functional disability & health-related quality of life (PEDsQL emotional, physical, school, and social functioning)) and parent functioning (parental pain catastrophizing & parental responses to child pain). Correlation analysis was performed between all assessed variables and youth pain catastrophizing at the start of treatment (at baseline) and at the end of treatment (at follow-up). Based on the results, a series of linear regressions were run to determine if any of the significant variables at baseline were able to explain any of the variance in youth pain catastrophizing at follow-up. Hierarchical regressions were also run to investigate the same relationships between youth variables at baseline and youth pain catastrophizing at follow-up while controlling the parental factors (parental pain catastrophizing & parental responses to child pain). These tests were performed to determine whether removing parental variables from the model had any effect on the youth pain catastrophizing relationships during treatment. Following the linear regression analyses, a series of repeated measures ANOVAs were used to compare the pre-treatment scores of all examined variables to their post-treatment scores.
RESULTS: Linear regression analysis indicated that anxiety symptoms (F (1,267) = 15.5, β = 0.234, p < 0.001), depressive symptoms (F (1,211) = 6.009, β = 0.166, p = 0.015), and emotional functioning (F (1,264) = 19.9, β = -0.265, p < 0.001) at baseline explained a significant amount of the variance in youth pain catastrophizing at follow-up. Functional disability, physical functioning, school functioning and social functioning displayed no statistically significant (p > 0.05) ability to predict pain catastrophizing levels following treatment. In terms of caregivers, none of the parental variables at baseline were able to predict youth pain catastrophizing levels at follow-up. Further, controlling the parental variables through hierarchical regression had no influence on how youth variables at baseline contributed to pain catastrophizing at follow-up (emotional functioning, anxiety symptoms and depressive symptoms were still significant (p < 0.05), while functional disability, physical functioning, school functioning and social functioning were not (p > 0.05)).
CONCLUSIONS: These findings suggest that the parental factors measured in the current study (i.e., parental pain catastrophizing & parental responses to child pain) do not contribute to youth pain catastrophizing, nor do they influence how youth baseline factors affect pain catastrophizing after treatment. As such, encouragingly, results indicate that youth seem to respond to interdisciplinary pain treatment regardless of their parent/caregiver’s thoughts and behaviors to their child’s pain. In addition, results indicate that youth psychological factors (anxiety symptoms, depressive symptoms, & emotional functioning) contribute to pain catastrophizing, while physical factors (functional disability, physical functioning, school functioning) do not. Future research should further explore whether more targeted treatment of psychological factors results in better broad-based outcomes for youth with chronic pain engaged in pain rehabilitation.
Description
2024
License
Attribution 4.0 International