CHILD OUTCOMES IN THE CONTEXT OF PARENTAL CHRONIC PAIN: EXAMINING SOCIAL TRANSMISSION PATHWAYS

Abstract

Parents play a crucial role in children’s pain experiences. Theory and empirical studies have highlighted the association between parental chronic pain and children’s pain and mental health. The current dissertation aimed to: synthesize the results of existing literature on outcomes in offspring of parents with chronic pain (Paper 1); examine theorized social transmission pathways in predicting child pain and internalizing symptoms in children of parents with chronic pain (Paper 2); and examine the role of a novel construct, child catastrophizing about parental chronic pain, in predicting child outcomes (Paper 3). Paper 1 describes a systematic review of 59 studies of outcomes in offspring of parents with chronic pain. Meta-analyses indicated that offspring of parents with chronic pain had poorer outcomes than other offspring in several areas (e.g., increased pain, internalizing outcomes, and adverse birth outcomes; poorer social competence and family outcomes), while meta-ethnography results identified both negative and positive (e.g., development of compassion) impacts on offspring. In Paper 2, 72 dyads comprised of adults with chronic pain and their children (ages 8-15 years) completed questionnaires (regarding pain, pain catastrophizing, child internalizing symptoms) and children completed the cold pressor task (CPT) in the presence of their parent. Verbalizations during the CPT were coded and pain outcomes (observational, child-reported, parent-reported) were recorded. Support was found for parental modeling in predicting child internalizing symptoms but not the presence of child recurrent pain, and parental reinforcement of child pain behavior predicted increased child CPT pain. Paper 3 presents a dyadic analysis of children’s catastrophizing about their parent’s chronic pain and its role in predicting child pain and internalizing outcomes in the same sample of dyads. Children’s increased catastrophizing about their parent’s pain predicted increased child- and parent-reported child internalizing symptoms and CPT pain intensity over and above the influence of parent and child catastrophizing about their own pain. The findings of the dissertation suggest that parents’ own management of their chronic pain and reinforcement of child pain behavior, as well as children’s catastrophizing about their own and their parent’s chronic pain, could be potential targets for intervention and prevention programs in this vulnerable population.