title: Family factors, emotional functioning, and functional impairment in juvenile fibromyalgia syndrome.
abstract: OBJECTIVE
  Family factors and emotional functioning can play an important role in the ability of adolescents with juvenile primary fibromyalgia syndrome (JPFS) to cope with their condition and function in their everyday lives. The primary objectives of this study were to determine 1) whether adolescents with JPFS and their caregivers differed from healthy age-matched comparison peers and their caregivers in terms of emotional distress and functional impairment; 2) whether there were any differences in the family environment of adolescents with JPFS compared with healthy comparison peers; and 3) which individual-, caregiver-, and family-level variables were associated with functional impairment in adolescents with JPFS.
  
  
  METHODS
  Participants were 47 adolescents with JPFS recruited from a pediatric rheumatology clinic and 46 comparison peers without chronic illness matched for age, sex, and race. Participants and their caregivers (all mothers) completed a battery of standardized measures administered in their homes.
  
  
  RESULTS
  Adolescents with JPFS had greater internalizing and externalizing symptoms than healthy comparison peers. Mothers of adolescents with JPFS reported twice as many pain conditions and significantly greater depressive symptoms than mothers of comparison peers. The JPFS group also had poorer overall family functioning and more conflicted family relationships. In adolescents with JPFS, maternal pain history was associated with significantly higher functional impairment.
  
  
  CONCLUSIONS
  Increased distress and chronic pain are evident in families of adolescents with JPFS, and family relationships are also impacted. Implications for child functional impairment and the need for inclusion of caregivers in treatment are discussed.
authors.affiliation: Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA. Susmita.Kashikar-Zuck@cchmc.org
authors.forename: Susmita
authors.initials: S
authors.lastname: Kashikar-Zuck
authors.forename: Anne M
authors.initials: AM
authors.lastname: Lynch
authors.forename: Shalonda
authors.initials: S
authors.lastname: Slater
authors.forename: T Brent
authors.initials: TB
authors.lastname: Graham
authors.forename: Nicole F
authors.initials: NF
authors.lastname: Swain
authors.forename: Robert B
authors.initials: RB
authors.lastname: Noll
mesh_terms: D000293:Adolescent; D000328:Adult; D000342:Affective Symptoms; D017028:Caregivers / Q000523:psychology; D015331:Cohort Studies; D003863:Depression / Q000523:psychology; D004644:Emotions; D005192:Family Health; D005260:Female; D005356:Fibromyalgia / Q000523:psychology*; D006801:Humans; D008297:Male; D009035:Mothers / Q000523:psychology; D000297:Psychology, Adolescent; D012649:Self Concept; D011795:Surveys and Questionnaires