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Cognitive styles and processes in paediatric pain 

Cognitive styles and processes in paediatric pain
Cognitive styles and processes in paediatric pain

Liesbet Goubert

and Laura E. Simons

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date: 29 July 2021

Chronic pain is prevalent in children and adolescents. The current chapter outlines an interpersonal perspective on child pain, demonstrating the central role of child and parent pain-related cognitions in the development and maintenance of chronic pain in childhood. Pain takes place within a social context: children’s expressions of pain (e.g. facial pain displays) are observed and decoded by others (parents), eliciting emotional and behavioural responses. Parents’ responses may impact child outcomes in two ways, directly by imposing activity limitations/encouraging activity engagement or indirectly through observational learning. Although personality and temperamental factors may predispose children and parents to perceive pain as more or less threatening to deal with, the model presented in this chapter focuses on proximal pain-related cognitive processes and associated behaviours that contribute to pain-related disability in children. Recent evidence suggests that perceptions of pain as highly threatening (i.e. catastrophizing) may lead to fearful reactions to pain, activity avoidant behaviours, and more disability. In parents, catastrophizing thoughts about child pain are associated with higher levels of child disability, with recent evidence implicating parent protective behaviours as a mediating mechanism.

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