S Cappucci1, L E Simons. 1. Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, USA.
Abstract
BACKGROUND: Recent research suggests that anxiety sensitivity (AS) may be a critical factor in the maintenance of chronic pain. Converging lines of evidence also propose a relationship between AS and fear of pain (FOP) that may result from interoceptive fear conditioning in interoceptively biased individuals. While some AS and FOP research has been carried out in adults, literature exploring this relationship is sparse in clinical paediatric populations. METHODS: This study investigated the hypotheses that FOP mediates the relationships between AS and disability as well as AS and somatization in children and adolescents with chronic headache pain. Mediation models were investigated using bootstrap regression analyses. RESULTS: Results indicate that the AS-disability relationship is mediated by FOP, whereas AS seems to contribute both directly and indirectly to somatization. CONCLUSION: These results provide evidence for the pivotal role of AS in the paediatric chronic pain model. The findings of this study further emphasize the application of the fear-avoidance model in children and provide new evidence for the critical role of AS in a paediatric headache population.
BACKGROUND: Recent research suggests that anxiety sensitivity (AS) may be a critical factor in the maintenance of chronic pain. Converging lines of evidence also propose a relationship between AS and fear of pain (FOP) that may result from interoceptive fear conditioning in interoceptively biased individuals. While some AS and FOP research has been carried out in adults, literature exploring this relationship is sparse in clinical paediatric populations. METHODS: This study investigated the hypotheses that FOP mediates the relationships between AS and disabilityas well asAS and somatization in children and adolescents with chronic headache pain. Mediation models were investigated using bootstrap regression analyses. RESULTS: Results indicate that the AS-disability relationship is mediated by FOP, whereas AS seems to contribute both directly and indirectly to somatization. CONCLUSION: These results provide evidence for the pivotal role of AS in the paediatric chronic pain model. The findings of this study further emphasize the application of the fear-avoidance model in children and provide new evidence for the critical role of AS in a paediatric headache population.
Authors: Susmita Kashikar-Zuck; Stacy R Flowers; Robyn Lewis Claar; Jessica W Guite; Deirdre E Logan; Anne M Lynch-Jordan; Tonya M Palermo; Anna C Wilson Journal: Pain Date: 2011-03-31 Impact factor: 6.961