Parent Anxiety, Depression, Protective Responses, and Parenting Stress in the Context of Parent and Child Chronic Pain: A Daily Diary Study of Parent Variability

Jaimie K Beveridge; Andrew Walker; Serena L Orr; Anna C Wilson; Kathryn A Birnie; Melanie Noel

doi:10.1016/j.jpain.2024.03.008

Parent Anxiety, Depression, Protective Responses, and Parenting Stress in the Context of Parent and Child Chronic Pain: A Daily Diary Study of Parent Variability

J Pain. 2024 Mar 16:104512. doi: 10.1016/j.jpain.2024.03.008. Online ahead of print.

Authors

Jaimie K Beveridge¹, Andrew Walker², Serena L Orr³, Anna C Wilson⁴, Kathryn A Birnie⁵, Melanie Noel⁶

Affiliations

¹ Department of Psychology, University of Calgary, Alberta, Canada.
² Department of Anesthesiology, Perioperative, and Pain Medicine, University of Calgary, Alberta, Canada.
³ Department of Psychology, University of Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Alberta, Canada; Departments of Pediatrics and Clinical Neurosciences, University of Calgary, Alberta, Canada.
⁴ Department of Pediatrics, Institute on Development and Disability, Oregon Health & Science University, Oregon.
⁵ Department of Psychology, University of Calgary, Alberta, Canada; Department of Anesthesiology, Perioperative, and Pain Medicine, University of Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Alberta, Canada.
⁶ Department of Psychology, University of Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, Alberta, Canada.

PMID: 38492710
DOI: 10.1016/j.jpain.2024.03.008

Abstract

Parents with (vs without) chronic pain report poorer psychosocial functioning (eg, worse mental health, parenting difficulties), which has been linked to poorer child outcomes (eg, child pain). However, emerging research suggests that individuals vary in their functioning from day-to-day, particularly those with chronic pain. This study used daily diaries to compare parents with (versus without) chronic pain on variability in their anxiety, mood, protective responses, and parenting stress. We also examined parent chronic pain status as a moderator of the associations between parent variability and youth daily pain and interference. Participants were 76 youth with chronic pain (M_age = 14.26; 71.1% female) and one of their parents (89.5% mothers; n = 38 or 50.0% endorsing chronic pain). Parents and youth completed self-report questionnaires and 7 days of diaries. Parent variability was calculated to reflect the frequency and size of day-to-day changes. Multilevel models revealed that parents with (vs without) chronic pain were significantly more variable in their parenting stress, but not in their anxiety, mood, or protective responses. Contrary to hypotheses, parent variability was not significantly related to youth daily pain intensity or interference and parent chronic pain did not moderate any associations. Instead, mean levels of parent anxiety, protective responses, and parenting stress across the week significantly predicted youth daily pain interference. Findings suggest that while variability was observed among parents (with and without chronic pain) of youth with chronic pain, it did not significantly predict youth's daily pain-related functioning. Further research is needed to confirm these initial findings. PERSPECTIVE: Parents with chronic pain have expressed concerns that the variable nature of their pain negatively impacts their children. Our results found that parents (with and without chronic pain) were variable in their anxiety, mood, protective responses, and parenting stress, but this variability did not significantly predict youth's chronic pain-related functioning.

Keywords: Chronic pain; Distress; Intraindividual variability; Parents; Pediatric.