title: Pain Interference Mediates the Relationship between Pain and Functioning in Pediatric Chronic Pain.
abstract: Pediatric chronic pain is a major health problem commonly associated with impaired functioning. There is a great need for more knowledge regarding the complex interplay between demographic variables such as age and gender, pain, and functioning in pediatric chronic pain.Objective:The objective of the study was to investigate if; (1) pediatric chronic pain patients with high and low levels of functioning differ in demographic variables, pain, and pain interference; (2) explore the mediating function of pain interference in the relationship between pain and functioning (i.e., depression and functional disability).Method:The study includes a consecutive sample of children and adolescents referred to a tertiary pain clinic due to chronic pain (n= 163). Cross-sectional data was analyzed to investigate the interrelationships between variables. Analyses of indirect effects were used to assess the impact of pain interference on the relation between pain and depression.Results:Findings illustrate high levels of depression, school absence and pain interference in this sample. Furthermore, pain interference mediated the relationship between pain and depression.Conclusion:Thus, this study adds to the growing support of findings suggesting that functioning and pain interference should be routinely assessed in pediatric chronic pain and a central target in treatment. Particularly, these findings imply a need for interventions specifically aimed at improved functioning for patients with chronic debilitating pain.
authors.affiliation: Behavior Medicine Pain Treatment Service, Karolinska University HospitalStockholm, Sweden; Department of Clinical Neuroscience, Karolinska InstitutetStockholm, Sweden.
authors.forename: Rikard K
authors.initials: RK
authors.lastname: Wicksell
authors.affiliation: Behavior Medicine Pain Treatment Service, Karolinska University HospitalStockholm, Sweden; Department of Clinical Neuroscience, Karolinska InstitutetStockholm, Sweden.
authors.forename: Marie
authors.initials: M
authors.lastname: Kanstrup
authors.affiliation: Behavior Medicine Pain Treatment Service, Karolinska University HospitalStockholm, Sweden; Department of Clinical Neuroscience, Karolinska InstitutetStockholm, Sweden.
authors.forename: Mike K
authors.initials: MK
authors.lastname: Kemani
authors.affiliation: Behavior Medicine Pain Treatment Service, Karolinska University HospitalStockholm, Sweden; Neuropediatric Research Unit, Department of Women's and Children's Health, Karolinska InstitutetStockholm, Sweden.
authors.forename: Linda
authors.initials: L
authors.lastname: Holmström
keywords: chronic; depression; functioning; interference; pain; pediatric