Anxiety sensitivity, fear of pain and pain-related disability in children and adolescents with chronic pain.
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.


OBJECTIVE
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.
Martin
Andrea L
AL
Department of Anesthesia, Divisional Centre for Pain Management and Research, The Hospital for Sick Children, Toronto, Canada. amartin@yorku.ca
McGrath
Patricia A
PA
Brown
Stephen C
SC
Katz
Joel
J
D000293:Adolescent; D001007:Anxiety / Q000523:psychology*; D002648:Child; D002908:Chronic Disease; D004185:Disability Evaluation; D019988:Children with Disabilities / Q000523:psychology*; D005239:Fear / Q000523:psychology*; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D010146:Pain / Q000523:psychology*; D011569:Psychiatric Status Rating Scales / Q000592:standards; D000297:Psychology, Adolescent; D002666:Psychology, Child; D015203:Reproducibility of Results