Functional Area Medical Psychology, Functional Unit Behavioral Medicine, Karolinska University Hospital.
Department of Clinical Neuroscience, Karolinska Institutet.
J Pediatr Psychol. 2018 Oct 1;43(9):981-994. doi: 10.1093/jpepsy/jsy031.
Parental factors are central in the development and maintenance of chronic pain in youths. Only a handful of studies have investigated the impact of psychological treatments for pediatric chronic pain on parental factors, and the relationships between changes in parental and adolescent factors. In the current study, we evaluated the effects of an intensive interdisciplinary pain treatment (IIPT) program based on Acceptance and Commitment Therapy (ACT) for adolescents with chronic pain, on adolescent and parental variables, and the relationship between parental psychological flexibility and adolescent pain acceptance.
Adolescents (N = 164) with chronic pain were included, with a mean age of 15.5 years, and completed the 3-week treatment with an accompanying parent (N = 164). Linear mixed-effects models were used to analyze change over time (from pretreatment to 3-month follow-up) on parent (depression, health-related quality of life and parent psychological flexibility) and adolescent (physical, social and emotional functioning, and adolescent pain acceptance) variables. Additionally, linear mixed-effects models were used to analyze the relationship between parent psychological flexibility and adolescent pain acceptance.
Results illustrated significant improvements over time in depressive symptoms and levels of psychological flexibility in parents. Excluding social development, adolescents improved significantly in all assessed aspects of functioning and pain acceptance. Additionally, changes in parent psychological flexibility were significantly associated with changes in adolescent pain acceptance.
Results indicated that treatment had positive effects for parents and adolescents, and a significant positive relationship between changes in parent psychological flexibility and adolescent pain acceptance was found.
父母因素是青少年慢性疼痛发展和维持的核心。只有少数研究调查了针对儿童慢性疼痛的心理治疗对父母因素的影响，以及父母和青少年因素变化之间的关系。在当前的研究中，我们评估了基于接受与承诺疗法（ACT）的密集跨学科疼痛治疗（IIPT）方案对青少年慢性疼痛的青少年和父母变量的影响，以及父母心理灵活性与青少年疼痛接受之间的关系。
纳入了患有慢性疼痛的青少年（N=164），平均年龄为 15.5 岁，并由一名陪同父母（N=164）完成了为期 3 周的治疗。线性混合效应模型用于分析随时间的变化（从治疗前到 3 个月随访）对父母（抑郁、与健康相关的生活质量和父母心理灵活性）和青少年（身体、社会和情感功能以及青少年疼痛接受）变量的影响。此外，线性混合效应模型还用于分析父母心理灵活性与青少年疼痛接受之间的关系。
结果表明，父母的抑郁症状和心理灵活性水平随着时间的推移显著改善。除了社交发展，青少年在所有评估的功能和疼痛接受方面都有显著的改善。此外，父母心理灵活性的变化与青少年疼痛接受的变化显著相关。
结果表明，治疗对父母和青少年都有积极的影响，并且发现父母心理灵活性的变化与青少年疼痛接受之间存在显著的正相关关系。
