title: Distinct Influences of Anxiety and Pain Catastrophizing on Functional Outcomes in Children and Adolescents With Chronic Pain.
abstract: OBJECTIVE
  Examine whether anxiety and pain catastrophizing are distinct constructs in relation to functional outcomes in pediatric chronic pain, and whether they differentially predict functional outcomes based on age.
  
  
  METHODS
  In all, 725 youth (191 children, 534 adolescents) with chronic pain completed measures of pain characteristics, anxiety, pain catastrophizing, functional disability, and health-related quality of life (HRQOL). Structural equation modeling was used to examine interrelationships.
  
  
  RESULTS
  Anxiety and pain catastrophizing were distinct. For both children and adolescents, pain catastrophizing predicted pain, functional disability, and HRQOL, and was a stronger predictor of pain intensity. For children, anxiety predicted HRQOL, and pain catastrophizing was a stronger predictor of functional disability. For adolescents, anxiety predicted functional disability and HRQOL, and anxiety was a stronger predictor of HRQOL.
  
  
  CONCLUSIONS
  There were age-related differences regarding whether anxiety or pain catastrophizing more strongly predicted specific functional outcomes. Assessment and intervention efforts should emphasize both anxiety and pain catastrophizing.
authors.affiliation: Cincinnati Children's Hospital Medical Center, Susan.Tran@cchmc.org.
authors.forename: Susan T
authors.initials: ST
authors.lastname: Tran
authors.affiliation: University of Cincinnati.
authors.forename: Kristen E
authors.initials: KE
authors.lastname: Jastrowski Mano
authors.affiliation: Medical College of Wisconsin, Children's Hospital of Wisconsin.
authors.forename: Keri R
authors.initials: KR
authors.lastname: Hainsworth
authors.affiliation: The Family Institute at Northwestern University, and.
authors.forename: Gustavo R
authors.initials: GR
authors.lastname: Medrano
authors.affiliation: Medical College of Wisconsin, Children's Hospital of Wisconsin.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Anderson Khan
authors.affiliation: Medical College of Wisconsin, Children's Hospital of Wisconsin.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Weisman
authors.affiliation: University of Wisconsin-Milwaukee.
authors.forename: W Hobart
authors.initials: WH
authors.lastname: Davies
mesh_terms: D000293:Adolescent; D001008:Anxiety Disorders / Q000150:complications / Q000523:psychology*; D058443:Catastrophization / Q000150:complications / Q000523:psychology*; D002648:Child; D059350:Chronic Pain / Q000150:complications / Q000523:psychology*; D006233:Persons with Disabilities / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D010147:Pain Measurement; D011788:Quality of Life / Q000523:psychology*
keywords: anxiety; functional disability; pain catastrophizing; pediatric chronic pain