Parental responses to child pain: The role of parental and child somatic and anxiety symptoms

Abstract

Background: Parental cognitive-affective and behavioural responses impact on the chronification of the child’s pain. Whether mothers and fathers differ in their responses and whether top-down variables (parental somatization, anxiety symptoms) and bottom-up variables (child’s pain-related disability, anxiety symptoms) impact on parental responses remains unresolved. Objectives: (1) A comparison of maternal and paternal somatization, anxiety, symptoms and their responses (parental catastrophizing, solicitousness) to children with chronic pain; (2) an analysis of the impact of top-down variables (parental somatization, anxiety symptoms) and bottom-up variables (child’s pain-related disability, anxiety symptoms) on parental maladaptive responses. Methods: Pediatric chronic pain and anxiety symptoms, parental somatization and anxiety symptoms, as well as parental responses in N =21 parent–child triads (child, mother, father; N = 21 each, total-N = 63; children: 50% female, 11–19 years, ∅15.14 years) were assessed via validated questionnaires during child and adolescent psychiatric treatment for child chronic pain. Results: Mothers and fathers did not differ in somatization, anxiety symptoms and responses. Parental catastrophizing was higher if the child suffered from anxiety symptoms and from pain-related disability. Parental solicitousness was higher if parents reported more own anxiety symptoms. Younger children and girls received more solicitous responses. Conclusion: As shown by previous studies, parental and child anxiety symptoms, but not parental gender, play a pivotal role in modulating parental maladaptive pain-related responses. This should be taken into account in prevention as well as in the treatment of children with chronic pain and their caregivers.