Young people making sense of pain: cognitive appraisal, function, and pain in 8-16 year old children.

Recurrent pain is a common childhood problem which for some becomes chronic and is associated with severely impaired functioning. Relationships of psychological variables with impaired functioning have rarely been investigated in samples of children reporting pain in non-clinical settings. The aim of this study was to examine the role of cognitive appraisal in the relationship between chronic pain and level of functioning in a normal school-attending population of children who report pain as a common experience. Five hundred and sixty one schoolchildren aged between 8 and 16 years and their parents participated in a cross-sectional interview and questionnaire study. Child functioning was measured in two ways: self-reported quality of life, and self-reported functional disability associated with pain. Results showed a consistent pattern across both specific measures of functioning used. Catastrophic appraisals of pain can explain partially the functional impairment found in a sample of normal schoolchildren with chronic pain. Positive expectations about ability, the responsibility to exert control over the pain, and the belief that medication and doctors will help to control the pain, were found to be protective of normal functioning in chronic pain. Cognitive factors were found to mediate but not moderate the relationship between pain and disability, and quality of life.