title: Child pain catastrophizing mediates the relation between parent responses to pain and disability in youth with functional abdominal pain.
abstract: OBJECTIVE
  Functional abdominal pain (FAP) in youth is associated with substantial impairment in functioning, and prior research has shown that overprotective parent responses can heighten impairment. Little is known about how a range of parental behaviors (overprotection, minimizing, and/or encouragement) in response to their child's pain interact with child coping characteristics (eg, catastrophizing) to influence functioning in youth with FAP. In this study, it was hypothesized that the relation between parenting factors and child disability would be mediated by children's levels of maladaptive coping (ie, pain catastrophizing).
  
  
  METHODS
  Seventy-five patients with FAP presenting to a pediatric pain clinic and their caregivers participated in the study. Youth completed measures of pain intensity (Numeric Rating Scale), pain catastrophizing (Pain Catastrophizing Scale), and disability (Functional Disability Inventory). Caregivers completed measures of parent pain catastrophizing (Pain Catastrophizing Scale), and parent responses to child pain behaviors (Adult Responses to Child Symptoms: Protection, Minimizing, and Encouragement/Monitoring subscales).
  
  
  RESULTS
  Increased functional disability was significantly related to higher child pain intensity, increased child and parent pain catastrophizing, and higher levels of encouragement/monitoring and protection. Parent minimization was not related to disability. Child pain catastrophizing fully mediated the relation between parent encouragement/monitoring and disability and partially mediated the relation between parent protectiveness and disability.
  
  
  CONCLUSIONS
  The impact of parenting behaviors in response to FAP on child disability is determined, in part, by the child's coping style. Findings highlight a more nuanced understanding of the parent-child interaction in determining pain-related disability levels, which should be taken into consideration in assessing and treating youth with FAP.
authors.affiliation: *Division of Behavioral Medicine and Clinical Psychology †Department of Anesthesiology, Pain Management Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors.forename: Natoshia R
authors.initials: NR
authors.lastname: Cunningham
authors.forename: Anne
authors.initials: A
authors.lastname: Lynch-Jordan
authors.forename: Kimberly
authors.initials: K
authors.lastname: Barnett
authors.forename: James
authors.initials: J
authors.lastname: Peugh
authors.forename: Soumitri
authors.initials: S
authors.lastname: Sil
authors.forename: Kenneth
authors.initials: K
authors.lastname: Goldschneider
authors.forename: Susmita
authors.initials: S
authors.lastname: Kashikar-Zuck
mesh_terms: D015746:Abdominal Pain / Q000503:physiopathology* / Q000523:psychology*; D000293:Adolescent; D058443:Catastrophization / Q000523:psychology*; D002648:Child; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D010147:Pain Measurement; D010287:Parent-Child Relations; D016487:Parenting / Q000523:psychology; D010290:Parents / Q000523:psychology*