番茄社区

ANAHEIM, Calif. -- Parents' emotions are tied to the trajectory of their child's chronic pain, researchers reported here.

In an analysis of an interdisciplinary pain management program for children with various types of chronic pain, a parent with feelings of self-blame for their child's pain as well as the child's own emotions were the two biggest predictors of long-term functionality (AUC=0.84) and pain outcomes (AUC=0.86), according to Gadi Revivo, DO, of Northwestern University in Chicago, and colleagues. In particular, less parental-self-blame and healthier emotions in children were associated with better outcomes.

The observational study, presented at the , included 144 children from ages 8 to 18 with one of the following types of chronic pain: complex regional pain syndrome, abdominal pain, back pain, hypermobility, headaches, or fibromyalgia.

"It's interesting because I think that the parent and how much anxiety they have can definitely play a role in how much the child thinks they're experiencing pain, because pain is very psychological," explained co-author Cara Vernacchia, DO candidate, to 番茄社区. "If the parent is blaming themselves and maybe babying the child a little bit and coddling them, then that can lead to more pain for the child."

All patients underwent an interdisciplinary program to manage chronic pain that was comprised of patient education, medical management of symptoms, biofeedback, pain psychology, physical therapy and occupational therapy. Outcomes were measured using the Bath Adolescent Pain Questionnaire and Pain-Parental Impact Questionnaire.

Among the various types of chronic pain, all the patients showed similar levels of both pain and functional levels at baseline, which wasn't expected according to the researchers, who wrote that they had expected to see more differences between these groups.

Although few differences were reported among child-reported pain, those with complex regional pain syndrome and hypermobility had significantly higher scores than children with headaches. Parental anxiety scores were also higher among those with children who had abdominal pain versus fibromyalgia.

Although everyone improved from the interdisciplinary program for pain management, Vernacchia explained that it was a clinically relevant finding to pinpoint that parental involvement is so closely tied to improved outcomes.

"At this point, the standard of care does not involve the parent in the child's psychological treatment of the chronic pain experience, and so the child goes through all these psychological treatment programs but the parent does not," she said. "Our study is implying that the parent should be involved in the child's psychological treatment, and instead of just giving the child these techniques to implement when their pain is really bad, we can also give the parent some sort of techniques to implement, or even just making the parent aware that their anxiety -- their self-blame -- is really contributing to their [child's pain]."

In regards to future research, Vernacchia noted hopes for her group to look at functional MRIs and "see if these chronic pain groups have certain brain areas that might light up more than others or if there's differences in white matter or gray matter for the different pain groups, because we did not detect using our questionnaires any sort of differences in their baseline emotional functioning."

Comment