Chronic Pain, PTS Symptoms Not Reduced by “Benefit Finding” in Children/Teens

A higher level of benefit finding was not associated with a reduction in pain intensity or pain interference.

Chronic pain and post-traumatic stress symptoms (PTSS) in children aged 7-17 years were not reduced via “benefit finding,” a cognitive process for coming to see the positive benefits of adverse experiences, according to a longitudinal analysis published in The Clinical Journal of Pain.

Given the high rate of co-occurring PTSS and chronic pain in children and teens, researchers in Canada sought to examine how benefit finding, which is considered to be a factor supporting resiliency, affects symptoms associated with PTSS and chronic pain over time. Researchers defined benefit finding as “a cognitive process whereby an individual assigns value or perceives positive benefits as a result of experiencing significant adversity or a potentially traumatic event.”

The researchers conducted a study of 105 children aged 7 to 17 years with a chronic pain diagnosis who were recruited through an outpatient pediatric chronic pain clinic of a hospital in Western Canada. Study participants were assessed for pain intensity (via the Numerical Rating Scale [NRS]), pain interference (via Patient-Reported Outcomes Measurement Information System [PROMIS-25]), PTSS (via the Child PTSD Symptom Scale [CPSS-V]), and benefit finding (via the Benefit Finding/Burden Scale in Children [BBSC]). Assessments were completed via questionnaires at baseline and at 3 and 6 months. The children in the study population were mostly female (78.1%), White (92/105 patients), and had parents with a combined income greater than $90,000 (63/105 patients).

Elevated PTSS was reported in 20% of participants at baseline, 11.43% at 3 months, and 12.38% at 6 months. Significant pain interference was reported in 15.24% of children at baseline, 8.57% at 3 months, and 6.67% at 6 months.

Cross-sectionally, neither benefit finding at baseline nor at six months significantly explained the variance in pain interference or pain intensity at baseline and six months, respectively.

Benefit finding did not change significantly over time and was not associated with longitudinal improvements in PTSS or chronic pain intensity and interference. According to cross-sectional analysis, variance in ratings of pain interference and intensity was only affected significantly by benefit finding at the 3-month time point. Additionally, benefit finding at 3 months was positively correlated with pain interference and intensity, meaning higher levels of benefit finding were not associated with lower levels of pain intensity and interference. Benefit finding at 3 months also did not moderate the relationship between PTSS at baseline and pain interference or intensity at 6 months.

Study limitations include lack of assessment of the specific dates of participants’ traumatic events, which potentially limited data interpretation, and the 6-month follow-up period, which may have made it difficult to capture the long-term effects of benefit finding.

“[H]igher levels of benefit finding were not associated with less pain intensity and interference,” the researchers concluded. “Cross-sectionally, neither benefit finding at baseline nor at [6] months significantly explained the variance in pain interference or pain intensity at baseline and [6] months, respectively.” It is possible that the effects of benefit finding increase over time, warranting further research with longer follow-up periods, the researchers added.


Kaufhold J, Soltani S, Birnie KA, Noel M. The role of benefit finding in the relationship between pain and posttraumatic stress symptoms in youth with chronic pain: a longitudinal analysis. Clin J Pain. Published online May 5, 2023. doi:10.1097/AJP.0000000000001127