Longitudinal change in parent and child functioning after internet-delivered cognitive-behavioral therapy for chronic pain.
Longitudinal change in parent and child functioning after internet-delivered cognitive-behavioral therapy for chronic pain.
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DOI：
10.1097/j.pain.0000000000000999
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发表时间：
2017-10
期刊：
影响因子：
7.4
通讯作者：
Palermo TM
中科院分区：
文献类型：
--
作者：
Law EF;Fisher E;Howard WJ;Levy R;Ritterband L;Palermo TM
儿童慢性疼痛的理论模型提出了儿童疼痛经历与父母和家庭因素之间的纵向关联。大量的横断面研究支持这些模型，表明父母更大的痛苦和不适应的养育行为与更大的儿童残疾有关。以家庭为基础的认知行为治疗干预措施已经发展为青少年慢性疼痛，其目的是改善儿童残疾和减少不良的养育行为。然而，在这一人群中，父母和儿童功能之间的时间和纵向关联知之甚少。在本研究中，我们对138个11至17岁的慢性疼痛青少年家庭的数据进行了二次分析，这些家庭通过互联网接受了基于家庭的认知行为治疗，作为随机对照试验的一部分。在治疗前、治疗后立即、6个月随访和12个月随访时获得儿童残疾、父母保护行为和父母困扰的测量。潜在生长模型显示，在12个月的研究期间，治疗改善了儿童残疾、父母保护行为和父母痛苦。平行过程的潜在增长模型表明，预处理时父母焦虑程度越高，12个月后儿童残疾的改善程度越低。父母和子女功能之间没有其他显著的预测路径。这些发现表明，父母的困扰可能会增加慢性疼痛青少年心理疼痛治疗反应不良的风险。目前，在儿童慢性疼痛的心理干预中，父母的困扰并不是常规的目标。需要研究确定针对儿童慢性疼痛治疗中父母和家庭因素的最佳策略。
Theoretical models of pediatric chronic pain propose longitudinal associations between children’s pain experiences and parent and family factors. A large body of cross-sectional research supports these models, demonstrating that greater parent distress and maladaptive parenting behaviors are associated with greater child disability. Family-based cognitive-behavioral therapy interventions have been developed for youth with chronic pain which aim to improve child disability and reduce maladaptive parenting behaviors. However, little is known about temporal, longitudinal associations between parent and child functioning in this population. In the present study, we conducted a secondary analysis of data from 138 families of youth with chronic pain aged 11 to 17 years old who received family-based cognitive-behavioral therapy delivered through the Internet as part of a randomized controlled trial. Measures of child disability, parent protective behavior, and parent distress were obtained at pretreatment, immediate posttreatment, 6-month follow-up, and 12-month follow-up. Latent growth modeling indicated that child disability, parent protective behavior, and parent distress improved with treatment over the 12-month study period. Latent growth modeling for parallel processes indicated that higher parent distress at pretreatment predicted less improvement in child disability over 12 months. No other predictive paths between parent and child functioning were significant. These findings indicate that parent distress may increase the risk of poor response to psychological pain treatment among youth with chronic pain. At present, parent distress is not routinely targeted in psychological interventions for pediatric chronic pain. Research is needed to determine optimal strategies for targeting parent and family factors in the treatment of pediatric chronic pain.
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DOI：
10.1080/10705519909540118
发表时间：
1999-01-01
影响因子：
6
作者：
Hu, Li-tze;Bentler, Peter M.
通讯作者：
Bentler, Peter M.
影响因子：
4
作者：
Chow, Erika T.;Otis, John D.;Simons, Laura E.
通讯作者：
Simons, Laura E.
影响因子：
16.4
作者：
Palermo, Tonya M.;Valrie, Cecelia R.;Karlson, Cynthia W.
通讯作者：
Karlson, Cynthia W.
影响因子：
7.4
作者：
Palermo, Tonya M.;Law, Emily F.;Tai, Gabrielle
通讯作者：
Tai, Gabrielle
DOI：
10.1080/10705510701301834
发表时间：
2005-01-01
影响因子：
6
作者：
Chen, FF;Sousa, KH;West, SG
通讯作者：
West, SG