Salari Saghar, Shaygan Maryam, Setoodeh Giti
Student Research Committee, Department of Psychiatric Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, P.O. Box 713451359, Shiraz, Iran.
Child Adolesc Psychiatry Ment Health. 2022 Jul 25;16(1):60. doi: 10.1186/s13034-022-00496-5.
Although there is a growing body of evidence linking parenting styles to health outcomes, little emphasis has been dedicated to how parenting styles affect chronic pain in adolescents. Given the high prevalence of chronic pain in adolescents and taking into consideration the complexity of chronic pain and the factors affecting it, further research is needed to better understand the processes through which parenting styles affect adolescents' pain. The purpose of the present study was to explore the mediating role of maladaptive schemas in the association between different parenting styles and chronic pain.
1302 adolescents aged 12 to 21 in Shiraz, Iran, were randomly selected to participate in this study. To identify adolescents with chronic pain, screening questions based on the 11th revision of the International Classification of Diseases were used. Buri's Parental Authority Questionnaire (PAQ), and Young's Schema Questionnaire-Short Form (YSQ-SF) were used to assess the parenting styles and maladaptive cognitive schemas, respectively. The structural equation modeling approach was carried out to evaluate the direct, indirect, and total effects of different parenting styles on chronic pain.
The results in the SEM models revealed that disconnection/ rejection (β = - 0.043, 95%CI = - 0.07 to - 0.02), impaired autonomy/ performance (β = - 0.01, 95%CI = - 0.02 to -0.003), over-vigilance/inhibition (β = - 0.007, 95%CI = - 0.01 to - 0.008), and impaired limits schemas (β = - 0.004, 95%CI = - 0.006 to - 0.002) significantly mediated the protective effects of the authoritative parenting style on chronic pain. It was also found that the mediating effects of disconnection/ rejection (β = 0.01, 95%CI = 0.01 to 0.02), and over-vigilance/ inhibition (β = 0.002, 95%CI = 0.001 to 0.02) existed in the relationship between the authoritarian style and chronic pain. The permissive style may also affect chronic pain through disconnection/ rejection (β = 0.004, 95%CI = 0.001 to 0.01), other-directedness (β = 0.01, 95%CI = 0.005 to 0.015), and impaired limits schemas (β = 0.05, 95%CI = 0.04 to 0.06).
The findings of the present study showed that maladaptive cognitive schemas play a mediating role in the relationship between parenting styles and chronic pain in adolescents. It seems that the interventions that target the effective communication between the parents and the adolescents can be considered as an important part in the chronic pain management in adolescents.
尽管越来越多的证据将养育方式与健康结果联系起来，但很少有研究关注养育方式如何影响青少年的慢性疼痛。鉴于青少年慢性疼痛的高患病率，以及考虑到慢性疼痛的复杂性及其影响因素，需要进一步研究以更好地理解养育方式影响青少年疼痛的过程。本研究的目的是探讨适应不良图式在不同养育方式与慢性疼痛之间关联中的中介作用。
随机选取伊朗设拉子1302名12至21岁的青少年参与本研究。使用基于《国际疾病分类》第11版的筛查问题来识别患有慢性疼痛的青少年。分别使用伯里的父母权威问卷（PAQ）和杨的图式问卷简表（YSQ-SF）来评估养育方式和适应不良认知图式。采用结构方程模型方法评估不同养育方式对慢性疼痛的直接、间接和总效应。
结构方程模型的结果显示，疏离/拒绝（β = -0.043，95%CI = -0.07至-0.02）、自主性/表现受损（β = -0.01，95%CI = -0.02至-0.003）、过度警惕/抑制（β = -0.007，95%CI = -0.01至-0.008）和界限图式受损（β = -0.004，95%CI = -0.006至-0.002）显著介导了权威型养育方式对慢性疼痛的保护作用。还发现疏离/拒绝（β = 0.01，95%CI = 0.01至0.02）和过度警惕/抑制（β = 0.002，95%CI = 0.001至0.02）在专制型养育方式与慢性疼痛的关系中存在中介效应。放任型养育方式也可能通过疏离/拒绝（β = 0.004，95%CI = 0.001至0.01）、他人导向（β = 0.01，95%CI = 0.005至0.015）和界限图式受损（β = 0.05，95%CI = 0.04至0.06）影响慢性疼痛。
本研究结果表明，适应不良认知图式在青少年养育方式与慢性疼痛之间的关系中起中介作用。似乎针对父母与青少年之间有效沟通的干预措施可被视为青少年慢性疼痛管理的重要组成部分。
