Executive Functioning in Children with Chronic Pain

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dc.contributor.advisorNordstokke, David W.
dc.contributor.advisorWilcox, Gabrielle
dc.contributor.authorJones, Kailyn Maria
dc.contributor.committeememberNoel, Melanie
dc.contributor.committeememberSchroeder, Meadow
dc.date2020-11
dc.date.accessioned2020-07-10T15:54:23Z
dc.date.available2020-07-10T15:54:23Z
dc.date.issued2020-07-06
dc.description.abstractObjective: School serves as a crucial site for youth development and the potential consequences of poor school functioning are extensive. Limited school functioning is well documented in youth with chronic pain; however, variables that may explain poor school functioning are not adequately understood. Preliminary research suggests differences in executive functioning (EF) to possibly play a role, yet little research specifically examining EF in youth with chronic pain is available. Given the critical role of EF in learning, problem-solving, school functioning, and coping, the overall aim of this dissertation was to examine potential differences in EF between youth with and without chronic pain. A subsequent aim was to explore associations between EF and school functioning in youth with chronic pain and to investigate relationships between performance-based measures and behaviour ratings of EF in a mixed sample of youth. Method: A series of studies examining school functioning in youth with chronic pain in direct relation to one or more additional variables were synthesized and a preliminary conceptual model of school functioning in youth with chronic pain was proposed. A total of 26 youth with chronic pain (80.8% girls) and their parents were recruited from two tertiary-care pain clinics and a comparison group of 30 youth without chronic pain and their parents were recruited from the community. Participants completed ratings of pain; physical, emotional, social, and school functioning; sleep quality; medication; and a brief measure of general intelligence. Standardized neuropsychological tests were used to examine EF with a focus on working memory, divided and alternating attention, inhibition, flexibility, incidental memory, and planning. A parent- and self- report behaviour rating of EF was also administered. Results: Participants with chronic pain had significantly lower scores on performance-based tests of working memory, divided and alternating attention, inhibition, and flexibility compared to the non-chronic pain group. Poorer behaviour ratings of overall emotion and cognitive regulation as well as global EF were also found for youth with chronic pain. Several of these observed group differences remained after controlling for covariates. Performance-based measures of EF were not found to be significant predictors of school functioning. In contrast, parent- and self-report behaviour rating scales of EF showed a statistically significant result; however, subsequent analysis found only the self-report cognitive regulation scale to be a significant predictor of school functioning. Performance-based and parent- and self-report scales evaluating the same EF domains showed some weak correlations and several non-significant associations. Conclusion: This empirical work offers one of few multidimensional examinations of EF in youth with chronic pain, using a comprehensive neuropsychological test battery combined with behaviour ratings of EF. It offers several novel and pertinent findings, and demonstrates EF differences in youth with chronic pain. It also raises potential implications for the evaluation of EF in youth with chronic pain, lending evidence to the use of both performance-based measures and behaviour ratings when evaluating, remediating, and accommodating EF. This dissertation highlights the need for multidisciplinary healthcare and education teams to achieve collaborative and integrated services within individualized pain management for youth.en_US
dc.identifier.citationJones, K. M. (2020). Executive Functioning in Children with Chronic Pain (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.en_US
dc.identifier.doihttp://dx.doi.org/10.11575/PRISM/38000
dc.identifier.urihttp://hdl.handle.net/1880/112278
dc.language.isoengen_US
dc.publisher.facultyWerklund School of Educationen_US
dc.publisher.institutionUniversity of Calgaryen
dc.rightsUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.en_US
dc.subjectadolescentsen_US
dc.subjectyouthen_US
dc.subjectcognitive functionen_US
dc.subjectchronic painen_US
dc.subjectchildrenen_US
dc.subjectexecutive functioningen_US
dc.subjectschool functioningen_US
dc.subjectassessmenten_US
dc.subjectevaluationen_US
dc.subject.classificationEducational Psychologyen_US
dc.subject.classificationPsychology--Cognitiveen_US
dc.subject.classificationPsychology--Developmentalen_US
dc.titleExecutive Functioning in Children with Chronic Painen_US
dc.typedoctoral thesisen_US
thesis.degree.disciplineEducation Graduate Program – Educational Psychologyen_US
thesis.degree.grantorUniversity of Calgaryen_US
thesis.degree.nameDoctor of Philosophy (PhD)en_US
ucalgary.item.requestcopytrueen_US
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