4.4 Article

Examining Parent Adverse Childhood Experiences as a Distal Risk Factor in Pediatric Chronic Pain

Journal

CLINICAL JOURNAL OF PAIN
Volume 38, Issue 2, Pages 95-107

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/AJP.0000000000001002

Keywords

maltreatment; trauma; chronic pain; mental health; children

Funding

  1. Vi Riddell Pediatric Pain Initiative, (Calgary, AB) Alberta Children's Hospital Foundation
  2. Alberta Children's Hospital Research Institute, (Calgary, AB)
  3. Canadian Institutes of Health Research Strategy for Patient-Oriented Research Chronic Pain Network (Hamilton, ON)
  4. Alberta Innovates
  5. Canadian Institutes of Health Research
  6. Canada Research Chairs program
  7. Alberta Children's Hospital Foundation
  8. National Institutes of Health [T32 GM 108554]

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This longitudinal study aimed to examine the associations among parent adverse childhood experiences (ACEs), parent health, and child pain in a clinical sample of youth with chronic pain. The results indicated that parent ACEs significantly predicted parent chronic pain status and depressive symptoms, but were not significantly related to youth pain.
Objectives: Adverse childhood experiences (ACEs; ie, exposure to abuse, neglect, household dysfunction in childhood) are associated with poor mental and physical health outcomes across the lifespan. Emerging research suggests parent ACEs also confer risk for poor child outcomes. The relation between parent ACEs and child pain in youth with chronic pain has not yet been examined. The aim of the current longitudinal study was to examine the associations among parent ACEs, parent health, and child pain, in a clinical sample of youth with chronic pain. Methods: In total, 192 youth (75.5% female, 10 to 18 y old) and one of their parents (92.2% female) were recruited from tertiary pediatric chronic pain clinics in Canada. At baseline, parents completed self-report measures of ACEs, chronic pain status, anxiety and depressive symptoms, and posttraumatic stress disorder symptoms. At a 3-month follow-up, youth completed self-report measures of pain intensity and pain interference. Results: Regression and mediation analyses revealed that parent ACEs significantly predicted parent chronic pain status and depressive symptoms, but not parent anxiety or posttraumatic stress disorder symptoms. Moreover, parent ACEs were not significantly related to youth pain, either directly or indirectly through parent health variables. Discussion: Findings suggest that an intergenerational cascade from parent ACEs to parent health to child pain was not present in the current sample. Further research that examines the role of parent ACEs in the development of child chronic pain, as well as other risk and resiliency factors that may mediate or moderate the association between parent ACEs and child chronic pain, is needed.

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