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Clinical Journal of Pain:
doi: 10.1097/AJP.0000000000000127
Original Article: PDF Only

The Influence of Anxiety Reduction on Clinical Response to Pediatric Chronic Pain Rehabilitation.

Benore, Ethan PhD; D’Auria, Alexandra BS; Banez, Gerard A. PhD; Worley, Sarah; Tang, Anne

Published Ahead-of-Print
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Objectives: This study investigates the relationship between anxiety reduction and functional outcomes in children and adolescents receiving intensive interdisciplinary rehabilitation services for chronic pain. 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 chronic pain. Using three separate measures assessing anxiety-related constructs, we hypothesized that anxiety would be associated with functioning, both before and following intensive rehabilitation for chronic pain. Further, we hypothesized that a decrease in anxiety-related symptoms following rehabilitation would predict a positive change in functional outcomes.

Methods: Our sample consisted of 119 children and adolescents treated for chronic pain in an interdisciplinary rehabilitation program between 2007 and 2012. Children completed three measures related to anxiety (general anxiety, pain-specific anxiety, pain catastrophizing) and two functional outcome measures (e.g., 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 one-month post-discharge. Regression analyses demonstrated that, after controlling for age, gender, 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 chronic pain, 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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