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Psychiatric Considerations in Pediatric Chronic Pain

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Handbook of Pediatric Chronic Pain

Abstract

The International Association for the Study of Pain defines pain as “an unpleasant sensory and emotional experience,” which recognizes both the physiological and psychological aspects of pain. According to the Biobehavioral Model of Pediatric Pain (Varni 1989), biological factors (e.g., temperament, age, gender, cognitive development), family factors, cognitive perceptions, coping styles, and perception of social support work together to influence the experience of pain. Each of these cognitive, emotional, and physiological variables can have an exacerbating or ameliorating effect on pain management; therefore, each is a potential target for intervention. The psychological aspects of chronic pain have received increased attention due to concerns about the many potentially negative consequences related to pediatric chronic pain such as missed school, restrictions in daily activities and emotional and behavioral problems (Varni 1989). In pediatric populations, the impact of chronic pain is not limited to the patient, but also affects, and is affected by, the family as well. Parents, especially, play an important role in how children and adolescents cope with pain.

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References

  • Allen, K. D., & Mathews, J. R. (1998). Management of recurrent pain in children. In T. S. Watson & F. Gresham (Eds.), Handbook of child behavior ­therapy: Ecological considerations in assessment, treatment, and evaluation (pp. 263–285). New York: Plenum.

    Google Scholar 

  • Allen, K. D., Mathews, J. R., & Shriver, M. D. (1999). Children and recurrent headaches: Assessment and treatment implications for school psychologists. School Psychology Review, 28(2), 266–279.

    Google Scholar 

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, fourth edition text revision. Washington, DC: American Psychiatric Association.

    Book  Google Scholar 

  • Boyer, M. C., Compas, B. E., Stanger, C., Colletti, R. B., Konik, B. S., Morrow, S. B., & Thomsen, A. H. (2006). Attentional biases to pain and social threat in children with recurrent abdominal pain. Journal of Pediatric Psychology, 31(2), 209–220. 6.

    Google Scholar 

  • Brazier, D. K., & Venning, H. E. (1997). Conversion ­disorders in adolescents: A practical approach to rehabilitation. British Journal of Rheumatology, 36, 594–598.

    Article  PubMed  CAS  Google Scholar 

  • Campo, J. V., & Negrini, B. J. (2000). Case study: Negative reinforcement and behavioral management of conversion disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 39(6), 787–790.

    Article  PubMed  CAS  Google Scholar 

  • Campo, J. V., Di Lorenzo, C., Bridge, J., Chiappetta, L., Colborn, D. K., Gartner, J. C., Gaffney, P., Kocoshis, S., & Brent, D. (1999). Adult outcomes of recurrent abdominal pain: Preliminary results. Orlando: American Gastroenterological Association.

    Google Scholar 

  • Campo, J. V., Bridge, J., Ehmann, M., Altman, S., Lucas, A., Birmaher, B., Di Lorenzo, C., Iyengar, S., & Brent, D. A. (2004). Recurrent abdominal pain, anxiety, and depression in primary care. Pediatrics, 113, 817–824.

    Article  PubMed  Google Scholar 

  • Carlsson, J., Larsson, B., & Mark, A. (1996). Psychosocial functioning in schoolchildren with recurrent headaches. Headache, 36, 77–82.

    Article  PubMed  CAS  Google Scholar 

  • Chambers, C. T., Craig, K. D., & Bennett, S. M. (2002). The impact of maternal behavior on children’s pain experiences: An experimental analysis. Journal of Pediatric Psychology, 27, 293–301.

    Article  PubMed  Google Scholar 

  • Compas, B. E., & Boyer, M. C. (2001). Coping and attention: Implications for child health and pediatric conditions. Developmental and Behavioral Pediatrics, 22(5), 323–333.

    Article  CAS  Google Scholar 

  • Crombez, G., Bijttebier, P., Eccleston, C., Mascagni, T., Mertens, G., Goubert, L., & Verstraeten, K. (2003). The child version of the pain catastrophizing scale (PCS-C): A preliminary validation. Pain, 104(3), 639–646.

    Article  PubMed  Google Scholar 

  • Degotardi, P. J., Klass, E. S., Rosenberg, B. S., Fox, D. G., Gallelli, K. A., & Gottlieb, B. S. (2006). Development and evaluation of a cognitive-behavioral intervention for juvenile fibromyalgia. Journal of Pediatric Psychology, 31(7), 714–723.

    Article  PubMed  Google Scholar 

  • Dorn, L., Campo, J., Thato, S., Dahl, R., Lewin, D., Chandra, R., & Di Lorenzo, C. (2003). Psychological comorbidity and stress reactivity in children and ­adolescents with recurrent abdominal pain and anxiety disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 42(1), 66–75.

    Article  PubMed  Google Scholar 

  • Eccleston, C., Crombez, G., Scotford, A., Clinch, J., & Connell, H. (2004). Adolescent chronic pain: Patterns and predictors of emotional distress in adolescents with chronic pain and their parents. Pain, 108(3), 221–229.

    Article  PubMed  Google Scholar 

  • Egger, H., Costello, E., Erkanli, A., & Angold, A. (1999). Somatic complaints and psychopathology in children and adolescents: Stomach aches, musculoskeletal pains, and headaches. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 852–860.

    Article  PubMed  CAS  Google Scholar 

  • Fordyce, W. E. (1989). The cognitive/behavioral perspective on clinical pain. In J. D. Loeser & K. J. Egan (Eds.), Managing the chronic pain patient (pp. 51–64). New York: Raven.

    Google Scholar 

  • Garber, J., Zeman, J., Walker, L. (1990). Recurent abdominal pain in children: Psychiatric diagnoses and parental Psychopathology. Journal of the American Academy of Child and Adolescent Psychiatry, 29(4), 648–656.

    Article  PubMed  CAS  Google Scholar 

  • Gauthier, J. G., Ivers, H., & Carrier, S. (1996). Nonpharmacological approaches in the management of recurrent headache disorders and their comparison and combination with pharmacotherapy. Clinical Psychology Review, 16, 543–517.

    Article  Google Scholar 

  • Gidron, Y., McGrath, P. J., & Goodday, R. (1995). The physical and psychosocial predictors of adolescents’ recovery from oral surgery. Journal of Behavioral Medicine, 18, 385–399.

    Article  PubMed  CAS  Google Scholar 

  • Gil, K. M., Williams, D. A., Thompson, R. J., & Kinney, T. R. (1991). Sickle cell disease in children and adolescents: The relation of child and parent coping strategies to adjustment. Journal of Pediatric Psychology, 16, 643–663.

    Article  PubMed  CAS  Google Scholar 

  • Gil, K. M., Wilson, J. J., Edens, J. L., Workman, E., Ready, J., et al. (1997). Cognitive coping skills training in children with sickle cell disease pain. International Journal of Behavioral Medicine, 4, 364–377.

    Article  PubMed  CAS  Google Scholar 

  • Gil, K. M., Anthony, K. K., Carson, J. W., Redding-Lallinger, R., Daeschner, C. W., & Ware, R. E. (2001). Daily coping practice predicts treatment effects in children with sickle cell disease. Journal of Pediatric Psychology, 26, 163–173.

    Article  PubMed  CAS  Google Scholar 

  • Gooch, J. L., Wolcott, R., Speed, J., et al. (1997). Behavioral management of conversion disorder in children. Archives of Physical Medical and Rehabilitation, 78, 264–268.

    Article  CAS  Google Scholar 

  • Hodges, K., Kline, J., Barbero, G., & Woodruff, C. (1985). Anxiety in children with recurrent abdominal pain and their parents. Psychosomatics, 26, 859–866.

    Article  PubMed  CAS  Google Scholar 

  • Holden, E. W., Levy, J. D., Deichmann, M. M., & Gladstein, J. (1998). Recurrent pediatric headaches: Assessment and intervention. Journal of Developmental and Behavioral Pediatrics, 19, 109–116.

    Article  PubMed  CAS  Google Scholar 

  • Hyams, J., Burke, G., Davis, P., Rzepski, B., & Andrulinos, P. (1996). Abdominal pain and irritable bowel syndrome in adolescents: A community-based study. The Journal of Pediatrics, 129, 220–226.

    Article  PubMed  CAS  Google Scholar 

  • Kashikar-Zuck, S., Goldschneider, K., Powers, S., Vaught, M., & Hershey, A. (2001). Depression and functional disability in chronic pediatric pain. The Clinical Journal of Pain, 17, 341–349.

    Article  PubMed  CAS  Google Scholar 

  • Konijnenberg, A. Y., de Graeff-Meeder, E., van der Hoeven, J., Kimpen, J., Buitelaar, J., & Uiterwaal, C. (2006). Psychiatric morbidity in children with ­medically unexplained chronic pain: Diagnosis from the pediatrician’s perspective. Pediatrics, 117, 889–897.

    Article  PubMed  Google Scholar 

  • Kozlowska, K., Nunn, K. P., Rose, D., Anne, M., Ouvrier, R. A., & Varghese, J. (2007). Conversion disorder in Australian pediatric practice. Journal of the American Academy of Child and Adolescent Psychiatry, 46(1), 68–75.

    Article  PubMed  Google Scholar 

  • Lavigne, J. V., Ross, C. K., Berry, S. L., Hayford, J. R., & Pachman, L. M. (1992). Evaluation of a psychological treatment package for treating pain in juvenile rheumatoid arthritis. Arthritis Care and Research, 5, 101–110.

    Article  PubMed  CAS  Google Scholar 

  • Lewandowski, A. S., Palermo, T. M., & Peterson, C. C. (2006). Age-dependent relationships among pain, depressive symptoms, and functional disability in youth with recurrent headaches. Headache, 46(4), 656–662.

    Article  PubMed  Google Scholar 

  • Lipsitz, J. D., Masia-Warner, C., Apfel, H., Marans, Z., Hellstern, B., Forand, N., Levenbraun, Y., & Fyer, A. J. (2004). Anxiety and depressive symptoms and anxiety sensitivity in youngsters with noncardiac chest pain and benign heart murmurs. Journal of Pediatric Psychology, 29(8), 607–612.

    Article  PubMed  Google Scholar 

  • Lock, J., & Giammona, A. (1999). Severe somatoform disorder in adolescence: A case series using a rehabilitation model for intervention. Clinical Child Psychology and Psychiatry, 4, 341–351.

    Article  Google Scholar 

  • Logan, D. E., & Curran, J. A. (2005). Adolescent chronic pain problems in the school setting: Exploring the experiences and beliefs of selected school personnel through focus group methodology. The Journal of Adolescent Health, 37(4), 281–288.

    Article  PubMed  Google Scholar 

  • Lynch, A. M., Kashikar-Zuck, S., Goldschneider, K. R., & Jones, B. A. (2006). Psychosocial risks for disability in children with chronic back pain. The Journal of Pain, 7(4), 244–251.

    Article  PubMed  Google Scholar 

  • Martin-Herz, S. P., Smith, M. S., & McMahon, R. J. (1999). Psychosocial variables associated with headache in junior high school students. Journal of Pediatric Psychology, 24, 13–23.

    Article  Google Scholar 

  • Merikangas, K. R., & Stevens, D. E. (1997). Comorbidity of migraine and psychiatric disorders. Neurologic Clinics, 15(1), 115–123.

    Article  PubMed  CAS  Google Scholar 

  • Mikkelsson, M., Salminen, J. J., & Kautiainen, H. (1997). Non-specific musculoskeletal pain in pre­adolescents. Prevalence and 1-year persistence. Pain, 73, 29–35.

    Google Scholar 

  • Mulvaney, S. A., Lambert, W., Garber, J., & Walker, L. (2006). Trajectories of symptoms and impairment in pediatric chronic pain: A 5 year longitudinal study. Journal of the American Academy of Child Psychiatry, 45(6), 737–744.

    Article  Google Scholar 

  • Newacheck, P. W., & Taylor, W. R. (1992). Childhood chronic illness: Prevalence, severity, and impact. American Journal of Public Health, 82(3), 364–371.

    Article  PubMed  CAS  Google Scholar 

  • Palermo, T. M. (2000). Impact of recurrent and chronic pain on child and family daily functioning: A critical review of the literature. Journal of Developmental and Behavioral Pediatrics, 21, 58–69.

    Article  PubMed  CAS  Google Scholar 

  • Palermo, T. M., & Scher, M. S. (2001). Treatment of functional impairment in severe somatoform pain disorder: A case example. Journal of Pediatric Psychology, 26(7), 429–434.

    Article  PubMed  CAS  Google Scholar 

  • Piira, T., Taplin, J. E., Goodenough, B., & von Baeyer, C. L. (2002). Cognitive-behavioral predictors of children’s tolerance of laboratory –induced pain: Implications for clinical assessment and future ­directions. Behaviour Research and Therapy, 40, 571–584.

    Article  PubMed  Google Scholar 

  • Power, T. J., Heathfield, L. T., Mcgoey, K. E., & Blum, N. J. (1999). Managing and preventing chronic health problems in children and youth: School psychology’s expanded mission. School Psychology Review, 28, 251–263.

    Google Scholar 

  • Sanders, M. R., Rebgetz, M., Morrison, M., Bor, W., Gordon, A., Dadds, M., & Shepherd, R. (1989). Cognitive-behavioral treatment of recurrent nonspecific abdominal pain in children: An analysis of generalization, maintenance and side effects. Journal of Consulting and Clinical Psychology, 57, 294–300.

    Article  PubMed  CAS  Google Scholar 

  • Sanders, M. R., Shepherd, R. W., Cleghorn, G., & Woolford, H. (1994). The treatment of recurrent abdominal pain in children: A controlled comparison of cognitive-behavioral family intervention and standard pediatric care. Journal of Consulting and Clinical Psychology, 62, 306–314.

    Article  PubMed  CAS  Google Scholar 

  • Schanberg, L. E., Keefe, F. J., Lefebvre, J. C., et al. (1996). Pain coping strategies in children with primary fibromyalgia syndrome: Correlation with pain, physical function, and psychological distress. Arthritis Care and Research, 9, 89–96.

    Article  PubMed  CAS  Google Scholar 

  • Stang, P. E., & Osterhaus, J. T. (1993). Impact o f migraine in the United States: Data from the National Health Interview Survey. Headache, 33, 29–35.

    Article  PubMed  CAS  Google Scholar 

  • Thomsen, A. H., Compas, B. E., Colletti, R. B., Stranger, C., Boyer, M. C., & Konik, B. S. (2002). Parent reports of coping and stress responses in children with recurrent abdominal pain. Journal of Pediatric Psychology, 27, 215–226.

    Article  PubMed  Google Scholar 

  • Vaalamo, I., Pulkkinen, L., Kinnunen, T., Kaprio, J., & Rose, R. (2002). Interactive effects of internalizing and externalizing problem behaviors on recurrent pain in children. Journal of Pediatric Psychology, 27(3), 245–257.

    Article  PubMed  Google Scholar 

  • Varni, J. W. (1989). An empirical model for the biobehavioral investigation of pediatric pain. Invited plenary address at the annual meeting of the American Pain Society, Phoenix.

    Google Scholar 

  • Varni, J. W., Rapoff, M. A., Waldron, S. A., Gragg, R. A., Bernstein, B. H., & Lindsley, C. B. (1996). Chronic pain and emotional disorder in children and adolescents. Journal of Developmental and Behavioral Pediatrics, 17(3), 154–161.

    Article  PubMed  CAS  Google Scholar 

  • Vervoort, T., Goubert, L., Eccleston, C., Bijttebier, P., & Crombez, G. (2006). Catastrophic thinking about pain is independently associated with pain severity, disability, and somatic complaints in school children and children with chronic pain. Journal of Pediatric Psychology, 31(7), 674–683.

    Article  PubMed  Google Scholar 

  • Vlaeyen, J. W. S., & Linton, S. J. (2000). Fear-avoidance and its consequences in chronic musculoskeletal pain: A state of the art. Pain, 85, 317–332.

    Article  PubMed  CAS  Google Scholar 

  • Walco, G. A., Varni, J. W., & Ilowite, N. T. (1992). Cognitive-behavioral pain management in children with juvenile rheumatoid arthritis. Pediatrics, 89, 1075–1079.

    PubMed  CAS  Google Scholar 

  • Walker, L. S. (1999). The evolution of research on recurrent abdominal pain: History, assumptions, and a conceptual model. In P. J. McGrath & G. A. Finley (Eds.), Chronic and Recurrent Pain in Children and Adolescents (pp.141–172). Seattle: International Association for the Study of Pain.

    Google Scholar 

  • Walker, L. S., & Greene, J. W. (1989). Children with recurrent abdominal pain and their parents: More somatic complaints, anxiety and depression than other patient families? Journal of Pediatric Psychology, 14, 231–243.

    Article  PubMed  CAS  Google Scholar 

  • Walker, L. S., Garber, J., Van Slyke, D. A., & Greene, J. W. (1995). Long-term health outcomes in patients with recurrent abdominal pain. Journal of Pediatric Psychology, 20, 233–245.

    Article  PubMed  CAS  Google Scholar 

  • Walker, L. S., Guite, J. W., Duke, M., Barnard, J. A., & Greene, J. W. (1998). Recurrent abdominal pain: A potential precursor of irritable bowel syndrome in adolescents and young adults. The Journal of Pediatrics, 132(6), 1010–1015.

    Article  PubMed  CAS  Google Scholar 

  • Walker, L. S., Claar, R. L., & Garber, J. (2002). Social consequences of children’s pain: When do they encourage symptoms maintenance? Journal of Pediatric Psychology, 27(8), 689–698.

    Article  PubMed  Google Scholar 

  • Walker, L. S., Smith, C. A., Garber, J., & Claar, R. L. (2007). Appraisal and coping with daily stressors by pediatric patients with chronic abdominal pain. Journal of Pediatric Psychology, 32(2), 206–216.

    Article  PubMed  Google Scholar 

  • Whitehead, W. E., Crowell, M. D., Heller, B. R., Robinson, J. C., Schuster, M. M., & Horn, S. (1994). Modeling and reinforcement of the sick role ­during childhood predicts adult illness behavior. Psychosomatic Medicine, 56, 541–550.

    PubMed  CAS  Google Scholar 

  • Zeltzer, L. Z., Bursch, B., & Walco, G. (1997). Pain responsiveness and chronic pain: A psychobiological perspective. Developmental and Behavioral Pediatrics, 18(6), 413–422.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Psychology, Northwestern University’s Feinberg School of Medicine, Chicago, IL, USA

    Mi-Young Ryee

  2. Department of Psychiatry, and Behavioral Sciences, Children’s Memorial Hospital, Chicago, IL, USA

    Mi-Young Ryee

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Correspondence to Mi-Young Ryee .

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Editors and Affiliations

  1. School of Medicine, Dept. Pathology & Pediatrics, Yale University, Cedar St. 333, New Haven, 06520, Connecticut, USA

    Brenda C. McClain

  2. Dept. Anesthesiology, Children's Memorial Hospital, Children's Plaza 2300, Chicago, 60614, Illinois, USA

    Santhanam Suresh

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Ryee, MY. (2011). Psychiatric Considerations in Pediatric Chronic Pain. In: McClain, B., Suresh, S. (eds) Handbook of Pediatric Chronic Pain. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-0350-1_6

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  • DOI: https://doi.org/10.1007/978-1-4419-0350-1_6

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