Transmission of risk from parents with chronic pain to offspring: an integrative conceptual model.
Transmission of risk from parents with chronic pain to offspring: an integrative conceptual model.
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DOI：
10.1097/j.pain.0000000000000637
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发表时间：
2016-12
期刊：
影响因子：
7.4
通讯作者：
Wilson AC
中科院分区：
文献类型：
--
作者：
Stone AL;Wilson AC
患有慢性疼痛的父母的子女患疼痛和不良身心健康结果的风险增加(Higgins等人，2015年)。尽管父母和子女之间的慢性疼痛之间的联系已经确定，但很少有研究探讨这种联系发生的原因或方式。确定导致子代发生慢性疼痛的风险传递机制，对于制定旨在降低慢性疼痛风险和相关后果(如残疾和内在化症状)的预防性干预措施非常重要。这篇综述为慢性疼痛从父母到后代的代际传递提供了一个概念模型，目的是为未来的研究和预防干预的发展制定议程。我们提出的模型强调了父母慢性疼痛和儿科慢性疼痛及其相关不良后果之间关系的5种潜在机制：(1)遗传，(2)早期神经生物学发育的改变，(3)疼痛特有的社会学习，(4)一般的父母养育和家庭健康，以及(5)暴露在压力环境中。此外，该模型还提出了3个潜在的调节因素来影响父母和孩子之间的慢性疼痛：(1)第二个父母的慢性疼痛的存在，(2)父母慢性疼痛的时间、病程和位置，以及(3)子女的特征(即性别、发育阶段、种族或民族和气质)。这样的框架突出了慢性疼痛的内在家族性和跨代性，为新的干预和预防模式开辟了道路，这些模式可以以家庭为中心，并包括高危儿童。
Offspring of parents with chronic pain are at increased risk for pain and adverse mental and physical health outcomes (Higgins et al, 2015). Although the association between chronic pain in parents and offspring has been established, few studies have addressed why or how this relation occurs. Identifying mechanisms for the transmission of risk that leads to the development of chronic pain in offspring is important for developing preventive interventions targeted to decrease risk for chronic pain and related outcomes (eg, disability and internalizing symptoms). This review presents a conceptual model for the intergenerational transmission of chronic pain from parents to offspring with the goal of setting an agenda for future research and the development of preventive interventions. Our proposed model highlights 5 potential mechanisms for the relation between parental chronic pain and pediatric chronic pain and related adverse outcomes: (1) genetics, (2) alterations in early neurobiological development, (3) pain-specific social learning, (4), general parenting and family health, and (5) exposure to stressful environment. In addition, the model presents 3 potential moderators for the relation between parent and child chronic pain: (1) the presence of chronic pain in a second parent, (2) timing, course, and location of parental chronic pain, and (3) offspring’s characteristics (ie, sex, developmental stage, race or ethnicity, and temperament). Such a framework highlights chronic pain as inherently familial and intergenerational, opening up avenues for new models of intervention and prevention that can be family centered and include at-risk children.
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