Testing a model of pain appraisal and coping in children with chronic abdominal pain

Abstract

This prospective study of children with recurrent abdominal pain (N=133; ages 8--15 years) used path analysis to examine relations among dispositional pain beliefs and coping styles, cognitions and behavior related to a specific pain episode, and short- and long-term outcomes. Children believing they could not reduce or accept pain appraised their episode-specific coping ability as low and reported passive coping behavior. Dispositional passive coping had direct effects on both episode-specific passive coping and long-term symptoms and disability. Accommodative coping (acceptance and self-encouragement) was associated with reduced episode-specific distress, which itself predicted reduced depressive symptoms 3 months later. Results suggest that coping-skill interventions for children with chronic pain should target reductions in passive coping and consider the potential benefits of accommodative coping strategies.

Figure 1

Conceptual model. The dashed lines indicate that the observed relations between short- and long-term outcomes were expected to be weak.

Figure 2

Specific model of hypothesized relations among variables. The dashed lines indicate that the depicted relations between short- and long-term outcomes were expected to be weak.

Figure 3

Final model of observed relations among variables, χ²(75, N = 133) = 142.5, p < .01, comparative fit index = .91, root-mean-square error of approximation = .08. The numerical values represent standardized beta weights. The dashed lines indicate that the depicted paths between short- and long-term outcomes were expected to be weak.