scholarly journals Anxiety and Functional Disability in a Large Sample of Children and Adolescents with Chronic Pain

2012 ◽  
Vol 17 (2) ◽  
pp. 93-97 ◽  
Author(s):  
Laura E Simons ◽  
Christine B Sieberg ◽  
Robyn Lewis Claar
Keyword(s):  
Chronic Pain ◽  
Children And Adolescents ◽  
Functional Disability ◽  
Retrospective Chart Review ◽  
Anxiety Symptoms ◽  
Pain Clinic ◽  
Recurrent Pain ◽  
Pain Anxiety ◽  
Low Levels ◽  
Complex Relationships

BACKGROUND: Anxiety is the most common psychiatric condition in children and adolescents, and is linked to significant disruptions across domains of function. Due to the avoidant nature of anxiety and pain-related disability, studying anxiety symptoms in children with chronic and recurrent pain conditions is important.OBJECTIVES: To examine anxiety symptoms in a large cohort of children and adolescents evaluated for complex chronic and recurrent pain conditions.METHODS: Through retrospective chart review, data on anxiety, pain and functional disability were collected from 655 children evaluated at a multidisciplinary pain clinic over a three-year period.RESULTS: Approximately 11% of children and adolescents reported clinically elevated anxiety symptoms, with elevated levels across dimensions of anxiety ranging from 14% (social anxiety, worry) to 27% (physiological). In addition, a notable 31% of the sample potentially minimized their anxiety by responding in a socially desirable manner. Anxiety was linearly associated with greater pain-related functional disability, but was not directly correlated with pain. Moderation analyses revealed that at low levels of worry, higher levels of pain were associated with greater functional disability, whereas at high levels of worry, pain no longer predicted the level of functional disability.CONCLUSIONS: These findings document the prevalence of anxiety in children and adolescents with chronic pain, and also extend recent studies examining the complex relationships among pain, anxiety and pain-related disability.

scholarly journals Anxiety Sensitivity, Fear of Pain and Pain-Related Disability in Children and Adolescents with Chronic Pain

2007 ◽  
Vol 12 (4) ◽  
pp. 267-272 ◽  
Author(s):  
Andrea L Martin ◽  
Patricia A McGrath ◽  
Stephen C Brown ◽  
Joel Katz
Keyword(s):  
Chronic Pain ◽  
Children And Adolescents ◽  
Anxiety Sensitivity ◽  
Functional Disability ◽  
Depression Scale ◽  
Childhood Anxiety ◽  
Pain Clinic ◽  
Sensitivity Index ◽  
Fear Of Pain ◽  
Pain Disability

BACKGROUND: Converging lines of evidence suggest that anxiety sensitivity and fear of pain may be important vulnerability factors in the development of avoidance behaviours and disability in adults with chronic pain. However, these factors have not been evaluated in children with chronic pain.OBJECTIVES: To examine the relationships among anxiety sensitivity, fear of pain and pain-related disability in children and adolescents with chronic pain.METHODS: An interview and five questionnaires (Childhood Anxiety Sensitivity Index, Pain Anxiety Symptoms Scale, Functional Disability Inventory, Multidimensional Anxiety Scale for Children, and Reynolds Child or Adolescent Depression Scale) were administered to 21 children and adolescents eight to 17 years of age (mean ± SD 14.24±2.21 years) who continued to experience pain an average of three years after discharge from a specialized pain clinic for children.RESULTS: Anxiety sensitivity accounted for 38.6% of the variance in fear of pain (F[1,20]=11.30; P=0.003) and fear of pain accounted for 39.9% of the variance in pain-related disability (F[1,20]=11.95; P=0.003), but anxiety sensitivity was not significantly related to pain disability (R2=0.09; P>0.05).CONCLUSIONS: These findings indicate that children with high levels of anxiety sensitivity had a higher fear of pain, which, in turn, was linked to increased pain disability. The results of this study suggest that anxiety sensitivity and fear of pain may play important and distinct roles in the processes that maintain chronic pain and pain-related disability in children.

scholarly journals Reliability and validity of the Child Pain Anxiety Symptoms Scale (CPASS) in a clinical sample of children and adolescents with acute postsurgical pain

Pain ◽  
2011 ◽  
Vol 152 (9) ◽  
pp. 1958-1965 ◽  
Author(s):  
Gabrielle M. Pagé ◽  
Fiona Campbell ◽  
Lisa Isaac ◽  
Jennifer Stinson ◽  
Andrea L. Martin-Pichora ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Clinical Sample ◽  
Reliability And Validity ◽  
Anxiety Symptoms ◽  
Pain Anxiety ◽  
Postsurgical Pain ◽  
Pain Anxiety Symptoms Scale

RANDOMISED CONTROLLED TRIALS OF CHRONIC PAIN IN CHILDREN AND ADOLESCENTS: A SYSTEMATIC REVIEW

2015 ◽  
Vol 101 (1) ◽  
pp. e1.66-e1
Author(s):  
Rym Boulkedid ◽  
Armiya Yousouf Abdou ◽  
Emilie Desselas ◽  
Marlène Monegat ◽  
Corinne Alberti ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Pain ◽  
Randomized Controlled Trials ◽  
Children And Adolescents ◽  
Methodological Quality ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Recurrent Pain ◽  
Pharmacological Agents ◽  
Randomized Controlled

BackgroundApproximately 15 to 30% of children and adolescents suffer from daily pain persistent over more than 3 months and there is evidence supporting that the prevalence of chronic pain is steadily increasing in this population. Chronic pain is known to have a negative impact on children's development and social behaviour, leading often to severe psychological distress and physical disability. We reviewed medical literature to assess the characteristics and quality of randomized controlled trials (RCTs) on pharmacological and non-pharmacological therapies in chronic and recurrent pain in the paediatric population.MethodsWe performed a systematic search of PubMed, Embase and the Cochrane Library up to March 2014. Bibliographies of relevant articles were also hand-searched. We included all RCTs that involved children and adolescents (age 0 to 18 years) and evaluated the use of a pharmacological agent or a non-pharmacological approach in the context of chronic or recurrent pain. The latter was defined as pain persisting for more than 3 months. Methodological quality was evaluated using the Cochrane Risk of Bias Tool. Two reviewers independently assessed studies for inclusion and evaluated methodological quality.ResultsA total of 52 randomized controlled trials were selected and included in the analysis. The majority were conducted in single hospital institutions, with no information on study funding. Median sample size was 45 (34–57) participants. Almost 50% of the RCTs included both adults and children with a median age at inclusion of 13 years. Non-pharmacological approaches were more commonly tested whereas evaluation of pharmacological agents concerned less than 30% of RCTs. Abdominal pain and headache were the most common types of chronic pain experienced among trial participants. Overall, the methodological quality was poor and did not parallel the number of RCTs that increased over the years. The risk of bias was high or unclear in 70% of the trials.ConclusionsThis is the first systematic review of RCTs conducted to evaluate pharmacological and non-pharmacological therapies in chronic and recurrent pain in children and adolescents. Although, management of pain in adults has significantly improved over the years due to the evaluation of numerous analgesic therapies, our results highlight the existing knowledge gap with regards to children and adolescents. Therapeutic strategies, in particular pharmacological agents, applied to relieve chronic or recurrent pain in children and adolescents are not evaluated through high quality RCTs. The need to improve analgesic therapy in children and adolescents with chronic pain is still unmet. We discuss possible research constraints and challenges related to this fact as well as adequate methodologies to circumvent them.

Parental Perceptions of Pediatric Pain and POTS-Related Disability

2016 ◽  
Vol 56 (13) ◽  
pp. 1185-1192 ◽  
Author(s):  
Elizabeth M. Keating ◽  
Ryan M. Antiel ◽  
Karen E. Weiss ◽  
Dustin Wallace ◽  
Seth J. Antiel ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Functional Impairment ◽  
Functional Disability ◽  
Clinical Symptoms ◽  
Health Condition ◽  
Pain Clinic ◽  
Postural Orthostatic Tachycardia Syndrome ◽  
Parental Attributions ◽  
Attribution Questionnaire ◽  
Chronic Pain Clinic

Adolescents with postural orthostatic tachycardia syndrome (POTS) often have pain and functional impairment. This study evaluated how parental attributions of children’s symptoms relate to child functional impairment. Adolescents with chronic pain and clinical symptoms suggestive of autonomic dysfunction (fatigue, dizziness, nausea) that attended a multidisciplinary chronic pain clinic completed measures of depression, anxiety, and functioning (n = 141). Parents of 114 of these patients completed the Parent Pain Attribution Questionnaire (PPAQ), a measure indicating the extent they believe physical and psychosocial factors account for their child’s health condition. Patients were retrospectively grouped as to whether or not they had significant POTS on tilt table testing (n = 37). Greater parental attribution to physical causes was associated with increased levels of functional disability whether patients had POTS ( r = 0.45, P = .006) or not ( r = 0.25, P = .03). These results suggest that providers should advocate a more comprehensive family-oriented rehabilitative approach to treatment.

scholarly journals Psychological Distress in Out-Patients Assessed for Chronic Pain Compared to Those with Rheumatoid Arthritis

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
D. Rice ◽  
S. Mehta ◽  
A. Shapiro ◽  
J. Pope ◽  
M. Harth ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Chronic Pain ◽  
Psychological Distress ◽  
Cross Sectional Study ◽  
Anxiety Symptoms ◽  
Analysis Of Covariance ◽  
Pain Clinic ◽  
Cross Sectional ◽  
Rheumatology Clinic ◽  
Two Samples

Background. Patients diagnosed with chronic pain (CP) and rheumatoid arthritis (RA) represent two samples with overlapping symptoms, such as experiencing significant pain.Objectives. To compare the level of psychological distress among patients diagnosed CP attending a specialist pain clinic with those attending a specialist RA clinic.Measures. A cross-sectional study was conducted at an academic specialist chronic pain and rheumatology clinic.Participants. 330 participants included a CP group (n=167) and a RA group (n=163) completed a booklet of questionnaires regarding demographic characteristics, duration, and severity of their pain. Psychological and personality variables were compared between the CP and RA participants using a Multivariate Analysis of Covariance (MANCOVA).Results. Level of psychological distress based on the subscales of the DASS (depression, anxiety, and stress), PASS (escape avoidance, cognitive anxiety, fear of pain, and physiological anxiety), and PCS (rumination, magnification, and helplessness) was significantly higher in the CP group compared to the RA group. Categorization of individuals based on DASS severity resulted in significant differences in rates of depression and anxiety symptoms between groups, with a greater number of CP participants displaying more severe depressive and anxiety symptoms.Discussion and Conclusions. This study found greater levels of psychological distress among CP individuals referred to an academic pain clinic when compared to RA patients referred to an academic rheumatology clinic.

scholarly journals Disordered eating among adolescents with chronic pain: the experience of a pediatric rheumatology subspecialty pain clinic

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Lauren Pianucci ◽  
Maitry Sonagra ◽  
Brooke A. Greenberg ◽  
Diana R. Priestley ◽  
Sabrina Gmuca
Keyword(s):  
Chronic Pain ◽  
Logistic Regression ◽  
Disordered Eating ◽  
Pediatric Rheumatology ◽  
Functional Disability ◽  
Patient Characteristics ◽  
Regression Modeling ◽  
Pain Clinic ◽  
Logistic Regression Modeling ◽  
Appropriate Treatment

Abstract Background Disordered eating and chronic pain often co-occur in adolescents, but the relationship between these conditions is not well understood. We aimed to determine the prevalence of and to identify the clinical characteristics associated with the presence of disordered eating among adolescents with chronic musculoskeletal pain (CMP) presenting to a pediatric rheumatology subspecialty pain clinic. Methods This was a retrospective cohort study of pediatric patients presenting to a pediatric rheumatology subspecialty pain clinic for an initial consultation from March 2018 to March 2019. We complemented data from an existing patient registry with secondary chart review for patients identified with disordered eating. We compared patient characteristics based on the presence or absence of disordered eating among adolescents with CMP. Logistic regression modeling was used to determine factors associated with disordered eating. Results Of the 228 patients who were seen for an initial consultation in the pain clinic in 1 year, 51 (22.4%) had disordered eating. Only eight (15.7%) of the 51 patients identified with disordered eating had a previously documented formal eating disorder diagnosis. Through multivariate logistic regression modeling, we found that disordered eating was associated with older age, higher functional disability, presence of abdominal pain, presence of gastrointestinal comorbidities, and presence of anxiety (all p < 0.05). Conclusions Adolescents with chronic pain, especially those who experience gastrointestinal issues, anxiety, and greater functional disability, should be evaluated for disordered eating by the treating clinician in order to ensure timely and appropriate treatment.

Children and Adolescents with Chronic Pain and Functional Disability: Use of a Behavioral Rehabilitation Approach

2014 ◽  
Vol 2 (2) ◽  
pp. 86-92 ◽  
Author(s):  
Ximena Celedon ◽  
Adrianna Amari ◽  
Cynthia M. Ward ◽  
Suzanne Prestwich ◽  
Keith J. Slifer
Keyword(s):  
Chronic Pain ◽  
Children And Adolescents ◽  
Functional Disability

scholarly journals A Short Version of the Pain Anxiety Symptoms Scale (PASS-20): Preliminary Development and Validity

2002 ◽  
Vol 7 (1) ◽  
pp. 45-50 ◽  
Author(s):  
Lance M McCracken ◽  
Lara Dhingra
Keyword(s):  
Chronic Pain ◽  
Short Form ◽  
Internal Consistency Reliability ◽  
Anxiety Symptoms ◽  
Short Version ◽  
Initial Development ◽  
Pain Anxiety ◽  
Fear And Anxiety ◽  
Pain Anxiety Symptoms Scale ◽  
Development And Validation

BACKGROUND:Research has shown significant relations between fear and avoidance of pain and the suffering and disability of chronic pain. Effective measurement tools have formed the foundation for studying these relations.METHODS:The present article describes the initial development and validation of the PASS-20, a short form version of the Pain Anxiety Symptoms Scale (PASS). Like the original inventory, the PASS-20 measures fear and anxiety responses specific to pain. Items were selected for the short version based on item variance, item intercorrelation and reliability analyses.RESULTS:The PASS-20 shows strong internal consistency, reliability, and good predictive and construct validity. Item reduction appears to result in minimal shrinkage of validity correlations.CONCLUSIONS:Overall, the results suggest that the short form retains adequate psychometric properties. Possible research and clinical implications for the PASS-20 include more efficient screening during evaluations of patients with chronic pain, and use when the time or effort needed for the full version is prohibitive.

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