Family Variables

Children look to their parents in order to assess the dangerousness of a situation and to learn how to cope with adverse situations. Parents directly impact their children's pain experiences and behavior through modeling responses to painful stimuli (Goodman and McGrath 1999). Parental behaviors of nonprocedural talk, encouragement to use coping strategies, and humor are related to decreases in child distress (Blount et al. 1989, 1990). On the other hand, parental reassurance, empathy, apologies, giving of control, and criticism are related to increases in children's distress during painful medical procedures. Some parental behaviors (discouraging children's coping efforts, providing special attention) are related to long-term distress, difficulties coping with pain, and the likelihood of developing chronic pain (e.g., Walker and Zeman 1992; Walker et al. 1993). Parental behavior has been found to account for up to 55% of variance in child distress behavior (Frank et al. 1995). Parental substance abuse, antisocial behaviors, anxiety, depression, pain-related distress, and somatization have also been shown to correlate with child symptoms.

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