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Description
Pediatric chronic pain is surprisingly common and impactful, prospectively predicting poorer mental and physical health outcomes. Internalizing symptoms represents one such outcome. It is the most common cluster of symptoms in children, it is related to poorer child functioning, and it has been linked to future functioning/psychopathology. The psychosocial mechanisms

Pediatric chronic pain is surprisingly common and impactful, prospectively predicting poorer mental and physical health outcomes. Internalizing symptoms represents one such outcome. It is the most common cluster of symptoms in children, it is related to poorer child functioning, and it has been linked to future functioning/psychopathology. The psychosocial mechanisms through which child pain may impact internalizing have yet to be fully elaborated, but withdrawal from social engagement with peers has been proposed as one possible mechanism. Additionally, sibling relationships may play a role in enhancing or diminishing a child’s social engagement while they are in pain. The current study aimed to examine whether child social engagement at age 8 mediates the relation between child chronic pain at age 8 and internalizing symptoms at age 9. Further, the study tested whether sibling warmth and sibling conflict act as moderators between child chronic pain and child social engagement. The physical and emotional health, quality of sibling relations, and extracurricular social engagement of 491 twin children from 247 families were assessed at age 8 and age 9 via surveys completed by the children’s primary caregivers. Findings showed that child pain at age 8 did not predict lower levels of social engagement, and social engagement did not predict child internalizing at age 9. Sibling warmth, but not conflict, significantly moderated the pain—social engagement relation. Together, these findings indicate that the relation between chronic pain and internalizing functions differently in children than in adults through a variety of cognitive, environmental, and social factors. More longitudinal research in this area will help establish changes in the relation between pain and internalizing from childhood into adulthood.
ContributorsRichards, Nicole Eve (Co-author) / Richards, Nicole (Co-author) / Davis, Mary (Thesis director) / Presson, Clark (Committee member) / Lemery-Chalfant, Kathryn (Committee member) / Sanford School of Social and Family Dynamics (Contributor) / School of Art (Contributor) / Department of Psychology (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05
Description
Child chronic pain is both common and consequential and identification of malleable risk factors is a critical step towards developing effective interventions. Existing evidence points to the possibility that parent behavior may play a significant role in the development of children’s chronic pain through modeling of pain-related behaviors. An important

Child chronic pain is both common and consequential and identification of malleable risk factors is a critical step towards developing effective interventions. Existing evidence points to the possibility that parent behavior may play a significant role in the development of children’s chronic pain through modeling of pain-related behaviors. An important parental trait that predicts parent behavior in pain contexts is parental pain catastrophizing, which has been linked to child pain outcomes as well as to increased facial pain behavior in both parents and their children during pain induction. Existing research has examined facial pain behavior in aggregate, summarizing facial expressions over the course of an entire dyadic interaction, which does not allow for evaluation of the dynamic interplay between a parent and child. The current study aimed to test the hypothesis that higher parental catastrophizing would predict decreased flexibility in emotional dynamics between parent and child (reflected in facial affect during a parent-child interaction that occurs within the context of child pain-induction), which would in turn predict fewer child chronic pain symptoms. The approach used dynamic systems analysis of facial behaviors during the parent-child interaction during the child’s performance of a pain inducing cold pressor task to assess dyadic emotional flexibility. Nine-year old children from a larger sample of twins (N = 30) were video recorded during a cold-water pain task while their parents observed them. Videos of the children and their parent from these interactions were analyzed using facial action unit software (AffDex), into positive, neutral, and negative facial emotional expressions. Synchronized parent and child coded facial data were then analyzed for flexibility using GridWare (version 1.1). Parents completed the Pain Catastrophizing Scale (PCS) to assess parental trait pain catastrophizing and the Body Pain Location/Frequency scale to assess child chronic pain symptoms during the prior three months. Contrary to prediction, parental catastrophizing was related to higher levels of flexibility, and flexibility was unrelated to child chronic pain. Exploratory analyses indicated that children with higher levels of effortful control had more emotionally flexible interactions with their parent during the cold pressor, and emotionally flexible interactions predicting lower levels of children’s negative emotional responses to the acute pain task. suggesting some promising avenues for future research.
ContributorsSowards, Hayley Anne (Author) / Davis, Mary (Thesis director) / Lemery-Chalfant, Kathryn (Committee member) / Department of Psychology (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2019-05
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Description

Pediatric chronic pain is common and costly to children, their families, and society. Importantly, pediatric pain often persists into adulthood. Prior research suggests that parent chronic pain, particularly maternal pain, is a risk factor for the development of chronic pain in children. Existing evidence also suggests that parenting, including parental

Pediatric chronic pain is common and costly to children, their families, and society. Importantly, pediatric pain often persists into adulthood. Prior research suggests that parent chronic pain, particularly maternal pain, is a risk factor for the development of chronic pain in children. Existing evidence also suggests that parenting, including parental pain-related pain catastrophizing and general parenting style, are all associated with greater levels of chronic pain in children. The present study examined whether the prospective relations between parent and child pain differed between mothers and fathers, and whether parenting mediated or moderated the parent pain--child pain relations. It was hypothesized that 1a) both maternal and paternal chronic pain prospectively predicts child chronic pain, but that maternal pain would be a stronger predictor; 1b) having 0, 1, or 2 parents will increase the child’s risk of developing chronic pain; 2) maternal pain catastrophizing about their own (a) and their children’ pain (b) would mediate the relations between maternal and child pain; and 3) authoritarian parenting style (a) and negative parenting behaviors (b) would mediate the relationship between parent and child pain. Exploratory analyses tested the whether parental warmth predicted child pain, independent of mom pain. Regression models that account for twin dependency used longitudinal data collected from a sample of 895 twin children showed that maternal pain but not paternal pain predicted child pain. Maternal catastrophizing of her own pain, but not her child’s pain, significantly mediated the relation between maternal and child pain. However, maternal catastrophizing of her child’s pain predicted child pain at age 9, when controlling for child pain at age 8. All proposed relations between general parenting styles as well as warm parenting and child pain were not significant.

ContributorsLagergren, Abigail (Author) / Davis, Mary (Thesis director) / Lemery-Chalfant, Kathryn (Committee member) / Barrett, The Honors College (Contributor) / Department of Psychology (Contributor)
Created2021-12
Description
Chronic pain is common among children and can lead to future physical disability and health problems. The Biopsychosocial model of child pain suggests that biological, psychological, and social factors predict pain risk, but most research has focused on biological and psychological factors impacting child pain, and less on social factors.

Chronic pain is common among children and can lead to future physical disability and health problems. The Biopsychosocial model of child pain suggests that biological, psychological, and social factors predict pain risk, but most research has focused on biological and psychological factors impacting child pain, and less on social factors. One social factor is family stress, including parent mental and physical health problems, and parenting and marital stress. The impact of stress, however, may vary depending on the presence of positive family resources, including marital empathy, parental warmth, and interpersonal support. Thus, the current longitudinal study examined links between family stress and increases in child pain during middle childhood and tested whether positive resources acted as a buffer to protect the development of child pain and if low social status acted as an extra stressor to make pain worse. Participants were part of the Arizona Twin Project, an ongoing longitudinal project of twins. At twin age 9, primary caregivers (PCs) reported on different stress, social status, and positive resources measures, and PCs and twins reported on twin bodily pain. At twin age 11, PCs and twins again reported on twin chronic bodily pain. Neither greater family stress nor parent physical health problems predicted increases in child pain over two years, controlling for twin pain at age 9. In tests of moderation, a single significant interaction emerged in a direction opposite of prediction: the relation between family stress and child pain was moderated by social status, such that average and high levels of social status exacerbated the relation between family stress, and child pain at age 11. Although the interaction needs to be replicated, findings suggest that high social status may act as a risk factor for poor child physical health and pain when family stress is high. Future research should further explore whether and how family stress and social status, as well as peer stress and resources, alone and in combination predict health as children age into adolescence.
ContributorsRusy, Isabella (Author) / Davis, Mary (Thesis director) / Corbin, William (Committee member) / Lemery-Chalfant, Kathryn (Committee member) / Barrett, The Honors College (Contributor) / Department of Psychology (Contributor) / School of Criminology and Criminal Justice (Contributor)
Created2023-12