Category: Health Psychology / Behavioral Medicine - Child
Keywords: Pain | Child | Parenting
Presentation Type: Symposium
While it has been well established that both parent distress and responses to children’s pain exert significant influences on children’s pain and functional outcomes, few studies have specifically addressed how parental variables may work together and impact treatment outcomes. Longitudinal studies are needed to explore potential causal relations between parent and child behaviors. Additionally, the vast majority of the research examining parent factors in the context of pediatric chronic pain and its treatment has focused almost exclusively on mothers, a limitation that reflects a larger issue within pediatric research (Macfadyen et al, 2011). This prospective study compared paternal versus maternal functioning and their impact on child outcomes on 104 youth with chronic pain and their parents enrolled in an intensive interdisciplinary pediatric pain rehabilitation program. Patients participated in daily individual and group CBT, daily physical and occupational therapy, and family CBT twice/week and parents participated in a weekly psychoeducation/ support group. Measures of pain, functional disability, and parent pain-related attitudes (e.g., catastrophizing), perceptions of child pain (e.g., pain-related fear) and behaviors (e.g. protective parent responses) were completed at admission and discharge by all patients, mothers, and fathers. Linear mixed models were used. While all mothers enrolled during this time period were involved daily in the program, only 41% of fathers participated in daily treatment, 21% were partially involved, and 38% had no involvement. Controlling for significant demographic and clinical characteristics, mothers and fathers who were present for the program typically demonstrated better improvement from admission to discharge compared to non-present fathers. Mothers made the most significant gains in protective parent responses toward their child in pain. Children reported significant decreases in pain and improvements in functioning over time. Results indicate the efficacy of this treatment model for both children with chronic pain and their parents, and highlight the importance of parental presence in treatment.
Attending Psychologist/Assistant Professor
Boston Children's Hospital/Harvard Medical School
Saturday, November 18
1:45 PM – 3:15 PM
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