Abstract

Objective

Children with amplified musculoskeletal pain (AMPS) experience significant functional disability, with impairment in their ability to participate in age-appropriate activities of daily living. Parental factors play an important role in a child’s pain symptoms and treatment outcomes, with parental pain catastrophizing and protective behaviors linked to several maladaptive outcomes for children. Aims of the current study were to examine how parental pain catastrophizing, child pain catastrophizing, and parental protective behaviors longitudinally impacted functional disability for children with AMPS.

Methods

Archival data were examined from parent-child dyads presenting to a tertiary pain clinic for treatment of AMPS. Over 1 year, parents completed measures assessing the level of pain catastrophizing, common behavioral responses to child pain, and child functional disability. Children completed measures of pain catastrophizing and functional disability. Measures were collected at initial evaluation, 6-months, and 12-months. Latent growth models (LGM) were conducted to examine how to study variables longitudinally impacted the rate of change in child functional disability.

Results

Examining a comprehensive LGM of study variables, parental catastrophizing emerged as the sole contributing factor to slower improvement in functional disability.

Conclusions

The strong influence of parental pain catastrophizing on functional disability may relate to parents limiting behaviors that promote adaptive coping in children with pain. As such, parents who catastrophize may benefit from specific interventions to increase their use of adaptive behavioral responses, such as redirecting children to complete functional activities and encouraging the use of positive coping skills for pain-related distress.

中文翻译：

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父母灾难性对小儿放大疼痛中儿童功能障碍的纵向影响

摘要

客观的

患有肌肉骨骼疼痛（AMPS）的儿童会经历严重的功能障碍，并参与适合年龄的日常生活活动的能力受到损害。父母因素在儿童的疼痛症状和治疗结果中起着重要作用，父母的疼痛灾难性和保护性行为与儿童的几种不良适应症有关。本研究的目的是研究父母痛苦的灾难性后果，儿童痛苦的灾难性后果以及父母的保护行为如何纵向影响AMPS儿童的功能障碍。

方法

从提交给第三级疼痛诊所治疗AMPS的亲子二倍体检查档案数据。在1年多的时间里，父母完成了评估疼痛灾难性程度，对儿童疼痛的常见行为反应以及儿童功能障碍程度的措施。孩子们完成了减轻灾难性疼痛和功能障碍的措施。在初始评估，6个月和12个月时收集了度量。进行了潜在生长模型（LGM），以研究如何纵向研究影响儿童功能障碍变化率的变量。

结果

通过对研究变量的综合LGM进行检查，父母灾难性的出现成为导致功能障碍改善缓慢的唯一因素。

结论

父母痛苦的灾难性后果对功能障碍的强大影响可能与父母限制行为有关，这些行为促进了痛苦儿童的适应性应对。因此，灾难性的父母可能会受益于特定的干预措施，以增加他们对适应性行为反应的使用，例如使孩子重新完成功能性活动，并鼓励使用积极的应对技巧来解决与疼痛有关的困扰。