Resilience factors in children with juvenile idiopathic arthritis and their parents : the role of child and parent psychological flexibility

in Pain Medicine (2019), 20(6), 1120--1131

Objective. Chronic pain is central to juvenile idiopathic arthritis (JIA) and is predictive of impaired functioning. Whereas most work has focused on identifying psychosocial risk factors for maladaptive ... [more ▼]

Objective. Chronic pain is central to juvenile idiopathic arthritis (JIA) and is predictive of impaired functioning. Whereas most work has focused on identifying psychosocial risk factors for maladaptive outcomes, we explored the idea that child and parental psychological flexibility (PF) represent resilience factors for adaptive functioning of the child. We also explored differences between general vs pain-specific PF in contributing to child outcomes. Methods. Children with JIA (age eight to 18 years) and (one of) their parents were recruited at the Department of Pediatric Rheumatology at the Ghent University Hospital in Belgium. They completed questionnaires assessing child and parent general and pain-specific PF and child psychosocial and emotional functioning and disability. Results. The final sample consisted of 59 children and 48 parents. Multiple regression analyses revealed that child PF contributed to better psychosocial functioning and less negative affect. Child pain acceptance contributed to better psychosocial functioning, lower levels of disability, and lower negative affect, and also buffered the negative influence of pain intensity on disability. Bootstrap mediation analyses demonstrated that parental (general) PF indirectly contributed to child psychosocial functioning and affect via the child's (general) PF. Parent pain-specific PF was indirectly linked to child psychosocial functioning, disability, and negative affect via child pain acceptance. Conclusions. Our findings indicate that child and parental PF are resilience factors and that pain acceptance buffers the negative impact of pain intensity. Implications for psychosocial interventions that target (pain-specific) PF in children and parents are discussed. [less ▲]

Resilience factors in children with Juvenile Idiopathic Arthritis and their parents: the role of child and parent psychological flexibility.

in Pain Medicine (2018)

Objective: Chronic pain is central to Juvenile Idiopathic Arthritis (JIA) and is predictive of impaired functioning. Whereas most work has focused on identifying psychosocial risk factors for maladaptive ... [more ▼]

Objective: Chronic pain is central to Juvenile Idiopathic Arthritis (JIA) and is predictive of impaired functioning. Whereas most work has focused on identifying psychosocial risk factors for maladaptive outcomes, we explored the idea that child and parental psychological flexibility (PF) represent resilience factors for adaptive functioning of the child. We also explored differences between general versus pain-specific PF in contributing to child outcomes. Methods: Children with JIA (8-18 years) and (one of) their parents were recruited at the department of pediatric rheumatology at the Ghent University Hospital in Belgium. They completed questionnaires assessing child and parent general and pain-specific PF and child psychosocial and emotional functioning, and disability. Results: The final sample consisted of fifty-nine children and forty-eight parents. Multiple regression analyses revealed that child PF contributed to better psychosocial functioning and less negative affect. Child pain acceptance contributed to better psychosocial functioning, lower levels of disability and lower negative affect, and also buffered against the negative influence of pain intensity on disability. Bootstrap mediation analyses demonstrated that parental (general) PF indirectly contributed to child psychosocial functioning and affect via the child’s (general) PF. Parent pain-specific PF was indirectly linked to child psychosocial functioning, disability, and negative affect via child pain acceptance. Conclusion: Our findings indicate that child and parental PF are resilience factors and show that pain acceptance buffers against the negative impact of pain intensity. Implications for psychosocial interventions that target (pain-specific) PF in children as well as in parents are discussed. [less ▲]

The predictive value of attentional bias towards pain-related information in chronic pain patients: a diary study.

in Pain (2013), 154(3), 468-75

Theoretical accounts of chronic pain hypothesize that attentional bias towards pain-related information is a maintaining or exacerbating factor, fuelling further pain, disability, and distress. However ... [more ▼]

Theoretical accounts of chronic pain hypothesize that attentional bias towards pain-related information is a maintaining or exacerbating factor, fuelling further pain, disability, and distress. However, empirical research testing this idea is currently lacking. In the present study, we investigated whether attentional bias towards pain-related information predicts daily pain-related outcomes in a sample of chronic pain patients (n=69; M(age)=49.64 years; 46 females). During an initial laboratory session, attentional bias to pain-related information was assessed using a modified spatial cueing task. In advance, patients completed a number of self-report measures assessing current pain intensity, current disability, and pain duration. Subsequently, daily pain outcomes (self-reported pain severity, disability, avoidance behaviour, and distractibility) were measured for 2 weeks by means of an electronic diary. Results indicated that, although an attentional bias towards pain-related information was associated with the current level of disability and pain severity, it had no additional value above control variables in predicting daily pain severity, avoidance, distractibility, and disability. Attentional bias towards pain-related information did, however, moderate the relationship between daily pain severity and both daily disability and distractibility, indicating that, particularly in those patients with a strong attentional bias, increases in pain were associated with increased disability and distractibility. The use of interventions that diminish attentional bias may therefore be helpful to reduce daily disability and the level of distraction from current tasks despite the presence of pain in chronic pain patients. [less ▲]