Distinct Influences of Anxiety and Pain Catastrophizing on Functional Outcomes in Children and Adolescents With Chronic Pain

J Pediatr Psychol. 2015 Sep;40(8):744-55. doi: 10.1093/jpepsy/jsv029. Epub 2015 Apr 2.

Abstract

Objectives: 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.

Keywords: anxiety; functional disability; pain catastrophizing; pediatric chronic pain.

MeSH terms

  • Adolescent
  • Anxiety Disorders / complications
  • Anxiety Disorders / psychology*
  • Catastrophization / complications
  • Catastrophization / psychology*
  • Child
  • Chronic Pain / complications
  • Chronic Pain / psychology*
  • Disabled Persons / psychology*
  • Disabled Persons / statistics & numerical data
  • Female
  • Humans
  • Male
  • Pain Measurement
  • Quality of Life / psychology*