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Transmission of risk from parents with chronic pain to offspring: an integrative conceptual model

Stone, Amanda L.; Wilson, Anna C.

doi: 10.1097/j.pain.0000000000000637
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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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aDepartment of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA

bDepartment of Pediatrics, Institute on Development & Disability, Oregon Health & Science University, Portland, OR, USA

Corresponding author. Address: Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Mailstop CDRC, Portland, OR 97239, USA. Tel.: 1-503-494-0333. E-mail address: longann@ohsu.edu (A. C. Wilson).

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.painjournalonline.com).

Received October 23, 2015

Received in revised form April 22, 2016

Accepted April 26, 2016

© 2016 International Association for the Study of Pain
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