Wallrath Maren K, Geremek Adam, Rubel Julian, Lindner Clemens, Hechler Tanja
Abteilung für Klinische Psychologie und Psychotherapie des Kindes- und Jugendalters, Universität Trier, Universitätsring 15, 54286, Trier, Deutschland.
Klinik für Kinder- und Jugendpsychiatrie, Helios Klinikum, Schleswig, Deutschland.
Schmerz. 2022 Feb;36(1):39-48. doi: 10.1007/s00482-021-00551-8. Epub 2021 Apr 30.
Parental cognitive-affective and behavioural responses impact on the chronification of the child's pain. Whether mothers and fathers differ in their responses and whether top-down variables (parental somatization, anxiety symptoms) and bottom-up variables (child's pain-related disability, anxiety symptoms) impact on parental responses remains unresolved.
(1) A comparison of maternal and paternal somatization, anxiety, symptoms and their responses (parental catastrophizing, solicitousness) to children with chronic pain; (2) an analysis of the impact of top-down variables (parental somatization, anxiety symptoms) and bottom-up variables (child's pain-related disability, anxiety symptoms) on parental maladaptive responses.
Pediatric chronic pain and anxiety symptoms, parental somatization and anxiety symptoms, as well as parental responses in N =21 parent-child triads (child, mother, father; N = 21 each, total-N = 63; children: 50% female, 11-19 years, ∅15.14 years) were assessed via validated questionnaires during child and adolescent psychiatric treatment for child chronic pain.
Mothers and fathers did not differ in somatization, anxiety symptoms and responses. Parental catastrophizing was higher if the child suffered from anxiety symptoms and from pain-related disability. Parental solicitousness was higher if parents reported more own anxiety symptoms. Younger children and girls received more solicitous responses.
As shown by previous studies, parental and child anxiety symptoms, but not parental gender, play a pivotal role in modulating parental maladaptive pain-related responses. This should be taken into account in prevention as well as in the treatment of children with chronic pain and their caregivers.
父母的认知情感和行为反应会影响孩子疼痛的慢性化。母亲和父亲的反应是否存在差异,以及自上而下的变量(父母躯体化、焦虑症状)和自下而上的变量(孩子与疼痛相关的残疾、焦虑症状)是否会影响父母的反应,这些问题仍未得到解决。
(1)比较患有慢性疼痛儿童的母亲和父亲的躯体化、焦虑症状及其反应(父母灾难化、关怀);(2)分析自上而下的变量(父母躯体化、焦虑症状)和自下而上的变量(孩子与疼痛相关的残疾、焦虑症状)对父母适应不良反应的影响。
在儿童和青少年因慢性疼痛接受精神治疗期间,通过经过验证的问卷对N = 21个亲子三元组(孩子、母亲、父亲;每组N = 21,总计N = 63;孩子:50%为女性,11 - 19岁,平均年龄15.14岁)中的儿科慢性疼痛和焦虑症状、父母躯体化和焦虑症状以及父母反应进行评估。
母亲和父亲在躯体化、焦虑症状和反应方面没有差异。如果孩子患有焦虑症状和与疼痛相关的残疾,父母的灾难化程度会更高。如果父母报告自己有更多的焦虑症状,父母的关怀程度会更高。年龄较小的孩子和女孩得到的关怀反应更多。
如先前研究所示,父母和孩子的焦虑症状而非父母性别,在调节父母与疼痛相关的适应不良反应中起关键作用。在预防以及治疗慢性疼痛儿童及其照顾者时应考虑到这一点。