Differential Utility of Pain Catastrophizing by Reporter for Predicting Later Functioning in Chronic Pain

Susan T. Tran1, Gustavo R. Medrano1, Kim Anderson Khan2, Renee J. Ladwig3,

Steven J. Weisman2, W. Hobart Davies1, & Keri R. Hainsworth2

1University of Wisconsin-Milwaukee, 2Medical College of Wisconsin, 3Children’s Hospital of Wisconsin

Mothers’ Pain Catastrophizing• Mothers’ increased PC at intake, and at 1 month predicted their

decreased HRQOL at 1 and 3 months, respectively, above pain characteristics (ΔR2 = .19 and ΔR2 = .45, both p < .01).

• Mothers’ PC did not predict children’s HRQOL at either time point (ΔR2 = .04 and ΔR2 = .07, both p = ns).

Youths’ Pain Catastrophizing• Youths’ increased PC at intake and at 1 month predicted their

decreased HRQOL at 1 and 3 months, respectively, above pain characteristics (ΔR2 = .14, p < .01 and ΔR2 = .24, p < .05).

• Youths’ PC did not predict mothers’ HRQOL at either time point (ΔR2 = .04 and ΔR2 = .03, both p = ns).

• Mothers’ and youths’ PC significantly predict their own later HRQOL, but not each others’.

• This is contrary to past research which has shown an interaction between child and parent functioning, including the longitudinal relationship between parent HRQOL and child HRQOL.

• Future research should clarify how family variables and context influence treatment outcomes for both patients and parents.

• Given the importance of PC, results highlight the need for family involvement in treatment to reduce maladaptive perceptions of pain in order to improve parents’ and children’s HRQOL.

• Participants• Eighty-two mother-youth dyads

• 76% female youth, 84% Caucasian• 8-18 years (M = 14.45, SD = 2.58)

• Procedure• Youth and their parents completed questionnaires

while receiving care at an interdisciplinary chronic pain clinic.• Timepoints: Intake, 1, and 3 months

• Measures• Pain Catastrophizing Scale – child and parent• PedsQL – child HRQOL• Family Impact Module – parent HRQOL

• Data analysis• Stepwise regression analyses:

• Pain characteristics entered in first step (duration, usual intensity, and frequency)• Pain catastrophizing entered in second step

• Pain Characteristics• Duration of pain M = 21.72 months, SD = 23.05• Usual pain M = 6.30, SD = 2.00• Pain frequency M = 11.54 days out of last 14 days,

SD = 3.65For more information, please contact Susan Tran at stheinze@uwm.edu.

Presented at the 2013 National Conference for Pediatric Psychology

• Pain catastrophizing (PC) is an important predictor of decreased health related quality of life (HRQOL) in youth with chronic pain (Libby & Glenwick, 2010).

• Parental beliefs regarding children's chronic pain affect children's ability to cope (Simons et al., 2008; Crushell et al., 2003; Logan & Scharff, 2005).

• However, parent variables have frequently been excluded from studies (Palermo & Eccleston, 2009).

• There are few longitudinal studies including parent variables.

STUDY AIMS

* p < .05, ** p < .01

Variable F (df) B SE(B) β ΔR2

PREDICTING YOUTHS’ HRQOL 1 MONTH POST INTAKE

Youth PC Intake 4.42(4,66)** -0.61 .18 -.38 .14**

Mother PC Intake 2.22(4, 67) -0.37 .20 -.21 .04

PREDICTING YOUTHS‘ HRQOL 3 MONTHS POST INTAKE

Youth PC 1 Month Post Intake 3.59 (4,25)* -0.60 .19 -.53 .24*

Mother PC 1 Month Post Intake 1.52(4, 25) -0.46 .31 -.31 .07

• This study examines how youths’ and parents' PC about children's chronic pain is longitudinally associated with youths’ and parents’ HRQOL.

CONCLUSIONS

RESULTSPURPOSE/BACKGROUND

TABLE 3. PAIN CATASTROPHIZING PREDICTING MOTHERS’ HRQOL

METHODS

Crushell, E., Rowland, M., Doherty, M., Gormally, S., Harty, S., Bourke, B., et al. (2003). Importance of parental conceptual model of illness in severe recurrent abdominal pain. Pediatrics, 112(6, Pt. 1), 1368–1372.Libby, C. J., & Glenwick, D. S. (2010). Protective and exacerbating factors in

children and adolescents with fibromyalgia. Rehabilitation Psychology, 55 (2), 151-158.

Logan, D.E. & Scharff, L. (2005). Relationships between family and parent characteristics and functional abilities in children with recurrent pain syndromes: an investigation of moderating effects on the pathway from pain to disability. Journal of Pediatric Psychology, 30(8), 698-707.Palermo, T.M. & Eccleston, C. (2009). Parents of children and adolescents with chronic pain. Pain, 146(1-2), 15-17.Simons, L. , Claar, R. , & Logan, D. (2008). Chronic pain in adolescence: Parental responses, adolescent coping, and their impact on adolescent's pain behaviors. Journal of Pediatric Psychology, 33(8), 894- 904.

TABLE 1. MEASURE DESCRIPTIVES

Variable F (df) B SE(B) β ΔR2

PREDICTING MOTHERS’ HRQOL 1 MONTH POST INTAKE

Youth PC Intake 1.46(4,67) -.42 .23 -.22 .04

Mother PC Intake 4.34(4, 68)** -0.94 .24 -.44 .19**

PREDICTING MOTHERS’ HRQOL 3 MONTHS POST INTAKE

Youth PC 1 Month Post Intake .48(4,26) -0.30 .35 -.18 .03

Mother PC 1 Month Post Intake 6.19(4,26)** -1.73 .363 -.77 .45**

* p < .05, ** p < .01

REFERENCES

TABLE 2. PAIN CATASTROPHIZING PREDICTING YOUTHS’ HRQOL

Timepoint Youth PC Mother PC Youth HRQOL Mother HRQOL

Intake

M (SD)

n = 80

24.71 (12.83)

n = 82

17.71 (11.22)

n = 81

58.39 (15.93)

n = 80

70.85 (18.53)

1 month

M (SD)

n = 77

22.56 (14.40)

n = 82

17.13 (11.09)

n = 78

61.85 (19.42)

n = 80

69.94(23.95)

3 month

M (SD)

n = 30

23.40 (14.32)

n = 33

15.91(11.04)

n = 31

68.09 (15.54)

n = 32

77.85 (23.18)