Conclusions

1. Family Functioning Moderates the Relationship Between Pain Catastrophizing and Social Consequences of Pain Jessica M. Joseph1, Katherine Simon1, Kathryn S. Holman1, Kimberly A. Khan2, Renee Ladwig3, Keri R. Hainsworth2, W. Hobart Davies1,3, & Steven J. Weisman2,3 University of Wisconsin-Milwaukee1, Medical College of Wisconsin2, Children’s Hospital of Wisconsin3 • Background • Raising a child with chronic pain has been associated with greater parenting stress (Eccleston et al., 2004), impaired social functioning and personal strain (Hunfeld et al., 2001). • Parents’ catastrophic thinking about their child’s pain has been shown to significantly explain parent distress and child disability beyond child pain intensity (Goubert et al., 2006). • Social consequences such as parent attention and staying home from school, have been shown to influence symptom maintenance in children with chronic pain (Walker et al., 2002). • This study examines the moderating role of family functioning on the relationship between parent pain catastrophizing and the provision of social consequences of pain. • Specifically, parent pain catastrophizing is hypothesized to be associated with social consequences of pain, dependent upon level of family functioning. • Results • Pain catastrophizing was significantly related to all four subscales on the SCP: positive attention, negative attention, activity restriction and privileges (Step 1 in Table 2). • Controlling for pain catastrophizing, family functioning significantly predicted all four social consequences of pain (positive attention, activity restriction, negative attention, and privileges (Step 2 in Table 2). • The interaction between pain catastrophizing and family functioning was significantly related to activity restriction and negative attention, but not to positive attention and privileges. (Step 3 in Table 2). • Measures • PedsQL Family Impact Module (Varni et al, 2004) is a 36-item parent-report questionnaire designed to assess the impact of having a child with a chronic health condition on parents and the family. The Total Scale Score was used in this study, with scores ranging from 0 to 100 (α = 0.97). • Pain Catastrophizing Scale (PCS; Goubert et al., 2006) is a 13-item measure developed to assess parents’ likelihood to catastrophize about their child’s pain. Total scores were calculated ranging from 0 to 52 (α = 0.94). • Social Consequences of Pain Questionnaire (SCP; Walker et al., 2002) is a 32-item measure with scores ranging from 32 to 128, and reflects the impact of social consequences on illness behavior in children. This measure yields four subscales based on consequence type: Positive Attention (α = 0.84), Activity Restriction (α = 0.89), Negative Attention (α = 0.67), and Privileges (α = 0.70). • Analyses • Hierarchical regression analyses were conducted to examine the extent to which parent pain catastrophizing moderated the relationship between family impact and social consequences of pain, using techniques described by Baron and Kenny (1986). • Conclusions • These results suggest that the relationship between mother pain catastrophizing and the provision of negative attention and activity restriction may be affected by level of family functioning. • One possible explanation for these findings is that in lower functioning families, mothers higher on pain catastrophizing are more likely to display negative attention and activity restriction in response to their child’s pain • Furthermore, mothers in higher functioning families who show similar rates of pain catastrophizing may have more resources and are less likely to show these negative social consequences. • Follow-up post-hoc analyses are needed to examine the significance and direction of these interactions. • Future Directions • Routine assessment of family functioning can help clinicians predict how mothers’ thoughts about their children’s pain may contribute to the factors that lead to symptom maintenance. • Methods • Participants • 301 Youth (4-19 years; 66% female) were referred to an outpatient pain clinic at a large Midwestern children’s hospital. See Table 1 below for additional demographic information. Table 2: Family Functioning Moderator Analyses Table 1: Demographic Information • Procedure • All measures were completed by the patients’ mothers prior to or at their intake appointment as part of standard clinic procedure. Corresponding Author: Jessica M. Joseph, B.A. University of Wisconsin-Milwaukee 2441 E. Hartford Ave. Milwaukee, WI 53211 Phone: (414)-229-2932 Email address: josephjm@uwm.edu PCS: Pain Catastrophizing; FIM: Family Functioning *p< 0.05, **p<0.01 Poster presented at the 2008 Kansas Conference in Clinical Child and Adolescent Psychology: Translating Research into Practice, Lawrence, KS