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Pain Beliefs and Readiness to Change Among Adolescents With Chronic Musculoskeletal Pain and Their Parents Before an Initial Pain Clinic Evaluation

Guite, Jessica W. PhD*,†; Kim, Sohee BS*; Chen, Chia-Pei MS; Sherker, Jennifer L. PsyD§; Sherry, David D. MD†,§; Rose, John B. MD*,†; Hwang, Wei-Ting PhD†,∥

doi: 10.1097/AJP.0b013e31828518e9
Original Articles

Objectives: To understand relationships between pain-related beliefs and readiness to change among treatment-seeking adolescents with chronic musculoskeletal pain and their parents.

Methods: A total of 102 adolescent-parent dyads were recruited at the time of initial evaluation at a multidisciplinary pain management clinic. Dyads completed self-report measures to assess pain, catastrophizing, endorsement of a biopsychosocial perspective of pain, and readiness to change/motivation to adopt a self-management approach to pain coping.

Results: Agreement between adolescent-parent dyad reports of pain catastrophizing and readiness to change was found; however, adolescents were less likely to view pain as “affected by feelings and emotions” than parents. The hypothesis that greater pain catastrophizing would be correlated with less readiness to change was partially supported. Adolescent and parents who reported lower levels of endorsement of a biopsychosocial perspective were less willing to adopt a self-management approach to pain coping. Endorsement of a biopsychosocial perspective of pain aligned with readiness to change stages more consistently for parents.

Discussion: This study documents initial relationships among pain catastrophizing, biopsychosocial perspectives of pain, and readiness to engage in a self-management approach to pain coping for adolescents with chronic pain and their parents. Although agreement exists between dyads regarding catastrophizing and readiness to change, differences were noted in biopsychosocial perspective and dominant readiness to change stage before an initial pain clinic encounter. Findings are considered in terms of future research to advance knowledge regarding the role these factors may play in treatment adherence and outcomes.

Departments of *Anesthesiology and Critical Care Medicine

§Pediatrics, Division of Rheumatology, The Children’s Hospital of Philadelphia

Departments of Biostatistics and Epidemiology

Biotechnology, School of Engineering and Applied Science

Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA

The content is solely the responsibility of the authors and does not necessarily represent the official views of the Eunice Kennedy Shriver National Institute of Child Health & Human Development or the National Institutes of Health.

The authors declare no conflict of interest. Supported in part by Grant Number R03HD054596 from the Eunice Kennedy Shriver National Institute of Child Health & Human Development, Bethesda, MD 20892-2425.

Reprints: Jessica W. Guite, PhD, Division of Pain and Palliative Medicine, Connecticut Children’s Medical Center, Hartford Hospital/The Institute of Living, University of Connecticut School of Medicine, 282 Washington Street, Hartford, CT 06106 (e-mail:

Received January 24, 2012

Accepted December 27, 2012

© 2014 by Lippincott Williams & Wilkins