The Interpersonal Context of Co-occurring Posttraumatic Stress Disorder Symptoms and Pediatric Chronic Pain: The Role of Parent Responses
Date
2018-09-18
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Abstract
Introduction: Posttraumatic stress disorder (PTSD) symptoms occur at elevated rates among youth with chronic pain and their parents and are associated with worse youth pain outcomes. Interpersonal factors, such as parent distress and protective behaviours, have been posited as key mechanisms likely to influence the persistence of pain and PTSD symptoms in youth. Parent responses to youth pain have been shown to be dynamic over time, pointing to the importance of examining the interpersonal context of pediatric chronic pain using an ecological momentary assessment (EMA) approach. Method: The current study adopted a multi-method approach to examine the role of parent protective responses in the relationship between parent and youth PTSD symptoms and youth chronic pain outcomes, among a sample of youth with chronic pain and their parents. Eighty-four youth with chronic pain (70% female, Mage = 14.2 years), recruited from a tertiary level pediatric chronic pain program, and one of their parents, participated. At baseline, youth and one of their parents participated in a diagnostic clinical interview of internalizing mental health symptoms. Youth also completed self-report measures assessing pain intensity, pain interference, pain unpleasantness, and PTSD symptoms. Parents completed self-report measures of their own PTSD symptoms and protective responses to youth pain. Following baseline assessment, youth and parents completed daily electronic assessments of pain and parent protective responses for 7 days. Finally, youth and parents participated in a lab-visit, where parents and youth engaged in a discussion task following youth completion of the cold pressor task. Results: Findings revealed that higher parent PTSD symptoms predicted a stronger daily association between parent protective behaviours and youth pain unpleasantness, but not youth pain intensity or interference. However, parent protective responses measured with a static questionnaire, parents’ stop tendency following an experimental pain task, and pain attending talk during a discussion task following the experimental pain task, were not associated with youth or parent PTSD symptoms or youth pain outcomes. Conclusion: These findings suggest that parent protective responses to youth pain may be an interpersonal mechanism through which parent PTSD impacts children’s chronic pain symptoms. Additionally, EMA methodology may be a more ecologically valid approach to studying pediatric chronic pain.
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Keywords
pain, posttraumatic stress disorder, Children, adolescents, parents
Citation
Neville, A. (2018). The interpersonal context of co-occurring posttraumatic stress disorder symptoms and pediatric chronic pain: The role of parent responses (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca. doi:10.11575/PRISM/32965