According to the results of research published recently in the Journal of Pain, catastrophic thinking about pain in children may mediate the relationship between chronic pain and posttraumatic stress disorder (PTSD) in both children and parents.

Researchers enrolled 102 children with chronic pain (72.5% girls; mean age, 13.5 years) from a tertiary-level chronic pain program. In addition, for each child, one parent participated in the study. In parents, PTSD symptoms and catastrophizing about their child’s pain were evaluated with self-reporting.

In children, PTSD symptoms, pain catastrophizing, pain interference, and pain intensity were all measured by self-reporting. The relationship between and mediators of child PTSD and child pain and between parent PTSD and child pain were also assessed.

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Pain catastrophizing was considered high in 49% of children, moderate in 35% of children, and low in 16% of children. PTSD scores at or above the clinical cutoff were reported by 9% of parents and 20% of children.

Parent PTSD symptoms were positively associated with child pain interference (correlation coefficient, r =0.22; P <.05) but not pain intensity (r =0.14; P =.16). In a similar manner, child PTSD symptoms were associated with pain interference (r =0.26; P <.01) but not pain intensity (r =0.08; P =.41).

Child catastrophic thinking was shown to mediate the relationship between child PTSD and child pain indirectly, and between parent PTSD and child pain. Parent catastrophic thinking, however, was not found to mediate the relationship between parent PTSD and child pain.

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The researchers concluded that the results, “provide empirical support for the recently proposed mutual maintenance model of co-occurring PTSD symptoms and pediatric chronic pain and underscore the importance of assessing both parent and child PTSD symptoms and child cognitive appraisals about pain in this context.”

They added that catastrophic thinking may be managed using “psychological interventions, thereby illuminating new avenues for tailored interventions for these youth.”

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Neville A, Soltani S, Pavlova M, Noel M. Unravelling the Relationship between parent and child PTSD and pediatric chronic pain: the mediating role of pain catastrophizing [published online October 25, 2017]. J Pain. doi: 10.1016/j.jpain.2017.10.004