Parent/child catastrophizing matches and mismatches: the effect on pain, symptoms, and disability

Abstract

Catastrophizing is a cognitive coping style that significantly relates to pain in adults, children, and their parents. Greater catastrophizing by parents and children is linked to poor outcomes for pediatric chronic pain patients. However, the interaction of parent and child catastrophizing styles, i.e., the degree to which they are matched or mismatched, and the effect that has on pediatric outcomes has not been investigated. 341 parent and child dyads were recruited at their initial evaluation at a pediatric chronic pain clinic. Parents and children completed the Pain Catastrophizing Scale (PCS), a reliable and valid measure assessing parents' and children's degree of rumination, magnification, and helplessness about children's pain. Measures were summed and a median split was conducted, creating low and high catastrophizing groups for parents and children. Four parent/child groups were created: two groups of matched parent/child catastrophizing styles, low/low and high/high; and two mismatched groups of parent/child catastrophizing styles, low child/high parent, and high child/low parent. Analyses of variance were conducted for parent/child catastrophizing group by outcome: pain intensity, somatic symptoms, and disability. Outcomes were measured by child report on the Numeric Rating Scale, Child Somatization Inventory, and Functional Disability Inventory. Analyses revealed significant main effects of group by outcome for all variables; post hoc tests showed the matched high/high parent/child catastrophizing group demonstrated the worst child outcomes, with greater pain, symptoms, and disability than the mismatched groups (high child/low parent and low child/high parent), which were in turn greater than the low/low matched group, which had the best outcomes of all. In summary, shared high catastrophizing styles between children and parents may enhance the negative effect of catastrophizing on outcomes. Conversely, the effect of a high catastrophizing parent or child on outcomes may be buffered when the other member of the dyad has a low catastrophizing style.