title: The influence of maternal vulnerability and parenting stress on chronic pain in adolescents in a general population sample: the TRAILS study.
abstract: Investigating possible psychosocial predictors of unexplained chronic pain in adolescents is crucial in understanding its development and prevention. A general population sample of adolescents (n = 2230) from the TRAILS cohort study was investigated longitudinally to assess the influence of maternal vulnerability, in terms of anxiety, depression and stress, and parenting stress at age 10-12 years, on the presence of chronic pain at age 12-15 years. Of these adolescents, 269 (12.9%) reported experiencing chronic pain, of which 77% reported severe chronic pain and 22% reported multiple chronic pain. Maternal anxiety, maternal stress and higher levels of parenting stress were related to chronic pain at a later age. Subgroup analyses showed similar results for adolescents with severe chronic pain. Mediation analyses indicated that parenting stress mediates the effect between maternal anxiety, or stress, and chronic pain. The findings suggest that interventions to diminish maternal feelings of anxiety and stress, while in turn adjusting maternal behaviour, may prevent the development of chronic pain in adolescence.
authors.affiliation: Department of Medical Psychology and Psychotherapy, Erasmus MC, Rotterdam, The Netherlands. a.darlington@soton.ac.uk
authors.forename: A-S E
authors.initials: AS
authors.lastname: Darlington
authors.forename: F C
authors.initials: FC
authors.lastname: Verhulst
authors.forename: A F
authors.initials: AF
authors.lastname: De Winter
authors.forename: J
authors.initials: J
authors.lastname: Ormel
authors.forename: J
authors.initials: J
authors.lastname: Passchier
authors.forename: J A M
authors.initials: JA
authors.lastname: Hunfeld
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000523:psychology; D002648:Child; D059350:Chronic Pain / Q000453:epidemiology* / Q000523:psychology*; D015331:Cohort Studies; D003625:Data Collection; D003863:Depression / Q000523:psychology; D005260:Female; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D009035:Mothers / Q000523:psychology*; D009483:Neuropsychological Tests; D016017:Odds Ratio; D059408:Pain Management; D010147:Pain Measurement; D016487:Parenting / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D013315:Stress, Psychological / Q000209:etiology / Q000523:psychology*; D016896:Treatment Outcome