OBJECTIVES: This study investigates the relationship between anxiety reduction and functional outcomes in children and adolescents receiving intensive interdisciplinary rehabilitation services for chronic pain (CP). Specifically, we evaluated whether: (1) anxiety changes over the course of treatment; (2) anxiety covaries with functional outcomes to rehabilitation; and (3) change in anxiety predicts change in functional outcomes from rehabilitation for CP. Using 3 separate measures assessing anxiety-related constructs, we hypothesized that anxiety would be associated with functioning, both before and following intensive rehabilitation for CP. Further, we hypothesized that a decrease in anxiety-related symptoms following rehabilitation would predict a positive change in functional outcomes. MATERIALS AND METHODS: Our sample consisted of 119 children and adolescents treated for CP in an interdisciplinary rehabilitation program between 2007 and 2012. Children completed 3 measures related to anxiety (general anxiety, pain-specific anxiety, pain catastrophizing) and 2 functional outcome measures (eg, Bath Adolescent Pain Questionnaire, PedsQL) as part of clinical care. RESULTS: Measures of anxiety-related constructs were significantly correlated with measures of impairment and functioning, both at admission and at 1-month postdischarge. Regression analyses demonstrated that, after controlling for age, sex, and pain level at admission, a decrease in anxiety significantly predicted between 14% and 40% unique variance in functional outcomes. DISCUSSION: The findings of this study support existing research on anxiety and CP, specifically the relationship between anxiety and pain-related disability. This study also supports the benefit of intensive interdisciplinary rehabilitation for both reducing anxiety and increasing functional outcomes, suggesting a possible link in children's response to intervention. Study limitations and future directions for related research are discussed.
OBJECTIVES: This study investigates the relationship between anxiety reduction and functional outcomes in children and adolescents receiving intensive interdisciplinary rehabilitation services for chronic pain (CP). Specifically, we evaluated whether: (1) anxiety changes over the course of treatment; (2) anxiety covaries with functional outcomes to rehabilitation; and (3) change in anxiety predicts change in functional outcomes from rehabilitation for CP. Using 3 separate measures assessing anxiety-related constructs, we hypothesized that anxiety would be associated with functioning, both before and following intensive rehabilitation for CP. Further, we hypothesized that a decrease in anxiety-related symptoms following rehabilitation would predict a positive change in functional outcomes. MATERIALS AND METHODS: Our sample consisted of 119 children and adolescents treated for CP in an interdisciplinary rehabilitation program between 2007 and 2012. Children completed 3 measures related to anxiety (general anxiety, pain-specific anxiety, pain catastrophizing) and 2 functional outcome measures (eg, Bath Adolescent Pain Questionnaire, PedsQL) as part of clinical care. RESULTS: Measures of anxiety-related constructs were significantly correlated with measures of impairment and functioning, both at admission and at 1-month postdischarge. Regression analyses demonstrated that, after controlling for age, sex, and pain level at admission, a decrease in anxiety significantly predicted between 14% and 40% unique variance in functional outcomes. DISCUSSION: The findings of this study support existing research on anxiety and CP, specifically the relationship between anxiety and pain-related disability. This study also supports the benefit of intensive interdisciplinary rehabilitation for both reducing anxiety and increasing functional outcomes, suggesting a possible link in children's response to intervention. Study limitations and future directions for related research are discussed.
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Authors: Natoshia R Cunningham; Anjana Jagpal; Sarah Nelson; Kristen E Jastrowski Mano; Susan T Tran; Anne M Lynch-Jordan; Keri Hainsworth; James Peugh; Constance A Mara; Susmita Kashikar-Zuck Journal: Clin J Pain Date: 2019-03 Impact factor: 3.442
Authors: Pola Heimann; Beate Herpertz-Dahlmann; Jonas Buning; Norbert Wagner; Claudia Stollbrink-Peschgens; Astrid Dempfle; Georg G von Polier Journal: Child Adolesc Psychiatry Ment Health Date: 2018-06-28 Impact factor: 3.033
Authors: Laura E Simons; Christine B Sieberg; Caitlin Conroy; Edin T Randall; Julie Shulman; David Borsook; Charles Berde; Navil F Sethna; Deirdre E Logan Journal: J Pain Date: 2017-12-06 Impact factor: 5.820