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Beveridge JK, Walker A, Orr SL, Wilson AC, Birnie KA, Noel M. Parent Anxiety, Depression, Protective Responses, and Parenting Stress in the Context of Parent and Child Chronic Pain: A Daily Diary Study of Parent Variability. THE JOURNAL OF PAIN 2024; 25:104512. [PMID: 38492710 DOI: 10.1016/j.jpain.2024.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 03/02/2024] [Accepted: 03/10/2024] [Indexed: 03/18/2024]
Abstract
Parents with (vs without) chronic pain report poorer psychosocial functioning (eg, worse mental health, parenting difficulties), which has been linked to poorer child outcomes (eg, child pain). However, emerging research suggests that individuals vary in their functioning from day-to-day, particularly those with chronic pain. This study used daily diaries to compare parents with (versus without) chronic pain on variability in their anxiety, mood, protective responses, and parenting stress. We also examined parent chronic pain status as a moderator of the associations between parent variability and youth daily pain and interference. Participants were 76 youth with chronic pain (Mage = 14.26; 71.1% female) and one of their parents (89.5% mothers; n = 38 or 50.0% endorsing chronic pain). Parents and youth completed self-report questionnaires and 7 days of diaries. Parent variability was calculated to reflect the frequency and size of day-to-day changes. Multilevel models revealed that parents with (vs without) chronic pain were significantly more variable in their parenting stress, but not in their anxiety, mood, or protective responses. Contrary to hypotheses, parent variability was not significantly related to youth daily pain intensity or interference and parent chronic pain did not moderate any associations. Instead, mean levels of parent anxiety, protective responses, and parenting stress across the week significantly predicted youth daily pain interference. Findings suggest that while variability was observed among parents (with and without chronic pain) of youth with chronic pain, it did not significantly predict youth's daily pain-related functioning. Further research is needed to confirm these initial findings. PERSPECTIVE: Parents with chronic pain have expressed concerns that the variable nature of their pain negatively impacts their children. Our results found that parents (with and without chronic pain) were variable in their anxiety, mood, protective responses, and parenting stress, but this variability did not significantly predict youth's chronic pain-related functioning.
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Affiliation(s)
| | - Andrew Walker
- Department of Anesthesiology, Perioperative, and Pain Medicine, University of Calgary, Alberta, Canada
| | - Serena L Orr
- Department of Psychology, University of Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Alberta, Canada; Departments of Pediatrics and Clinical Neurosciences, University of Calgary, Alberta, Canada
| | - Anna C Wilson
- Department of Pediatrics, Institute on Development and Disability, Oregon Health & Science University, Oregon
| | - Kathryn A Birnie
- Department of Psychology, University of Calgary, Alberta, Canada; Department of Anesthesiology, Perioperative, and Pain Medicine, University of Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Alberta, Canada
| | - Melanie Noel
- Department of Psychology, University of Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, Alberta, Canada
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Beveridge JK, Noel M, Soltani S, Neville A, Orr SL, Madigan S, Birnie KA. The association between parent mental health and pediatric chronic pain: a systematic review and meta-analysis. Pain 2024; 165:997-1012. [PMID: 38112571 DOI: 10.1097/j.pain.0000000000003125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 10/10/2023] [Indexed: 12/21/2023]
Abstract
ABSTRACT Mental health problems are common among parents of children with chronic pain and associated with worse outcomes for the child with chronic pain. However, the effect sizes of these associations between parent mental health and pediatric chronic pain vary widely across studies. The aim of this systematic review and meta-analysis was to generate pooled estimates of the (1) prevalence of mental health problems among parents of children with chronic pain and (2) associations between parent mental health and the (2a) presence of child chronic pain and (2b) functioning of children with chronic pain. Embase, MEDLINE, PsycINFO, Web of Science, and CINAHL were searched up to November 2022. Observational studies that examined symptoms or diagnoses of parent anxiety, depression, or general distress and the presence of child chronic pain and/or related functioning were included. From 32,848 records, 2 coders identified 49 studies to include in random-effects meta-analyses. The results revealed that mental health problems among parents of children with chronic pain were common (anxiety: 28.8% [95% CI 20.3-39.1]; depression: 20.0% [15.7-25.2]; general distress: 32.4% [22.7-44.0]). Poorer parent mental health was significantly associated with the presence of chronic pain (anxiety: OR = 1.91 [1.51-2.41]; depression: OR = 1.90 [1.51-2.38]; general distress: OR = 1.74 [1.47-2.05]) and worse related functioning (ie, pain intensity, physical functioning, anxiety and depression symptoms; r s = 0.10-0.25, all P s < 0.05) in children. Moderator analyses were generally nonsignificant or could not be conducted because of insufficient data. Findings support the importance of addressing parent mental health in the prevention and treatment of pediatric chronic pain.
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Affiliation(s)
- Jaimie K Beveridge
- Department of Psychology, University of Calgary, Calgary, AB, Canada. Neville is now with the Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Melanie Noel
- Department of Psychology, University of Calgary, Calgary, AB, Canada. Neville is now with the Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Sabine Soltani
- Department of Psychology, University of Calgary, Calgary, AB, Canada. Neville is now with the Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Alexandra Neville
- Department of Psychology, University of Calgary, Calgary, AB, Canada. Neville is now with the Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Serena L Orr
- Department of Psychology, University of Calgary, Calgary, AB, Canada. Neville is now with the Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
- Departments of Community Health Sciences
- Pediatrics and Clinical Neurosciences, and
| | - Sheri Madigan
- Department of Psychology, University of Calgary, Calgary, AB, Canada. Neville is now with the Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Kathryn A Birnie
- Department of Psychology, University of Calgary, Calgary, AB, Canada. Neville is now with the Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
- Departments of Community Health Sciences
- Anesthesiology, Perioperative, and Pain Medicine, University of Calgary, Calgary, AB, Canada
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