Parental Protectiveness Mediates the Association between Parent-Perceived Child Self-Efficacy and Health Outcomes in Pediatric Functional Abdominal Pain Disorder

Abstract

Previous studies have shown that parental protectiveness is associated with increased pain and disability in Functional Abdominal Pain Disorder (FAPD) but the role that perceived child self-efficacy may play remains unclear. One reason why parents may react protectively towards their child's pain is that they perceive their child to be unable to cope or function normally while in pain (perceived low self-efficacy). This study sought to examine (a) the association between parent-perceived child pain self-efficacy and child health outcomes (symptom severity and disability); and (b) the role of parental protectiveness as a mediator of this association. Participants were 316 parents of children aged 7-12 years with FAPD. Parents completed measures of perceived child self-efficacy when in pain, their own protective responses to their child's pain, child gastrointestinal (GI) symptom severity, and child functional disability. Parent-perceived child self-efficacy was inversely associated with parent-reported child GI symptom severity and disability, and parental protectiveness mediated these associations. These results suggest that parents who perceive their child to have low self-efficacy to cope with pain respond more protectively when they believe he/she is in pain, and this, in turn, is associated with higher levels of GI symptoms and disability in their child. This finding suggests that directly addressing parent beliefs about their child's ability to manage pain should be included as a component of FAPD, and potentially other child treatment interventions.

Keywords: Functional Abdominal Pain Disorder; children; coping; disability; pain; parenting; protectiveness; self-efficacy; somatic symptoms.

Figure 1

Mediation model 1—Parent-perceived child pain self-efficacy, parental protectiveness, and parent-reported child gastrointestinal (GI) symptom severity. ^a CSES: Child Self-Efficacy Scale; ^b ARCS: Adult Responses to Children’s Symptoms—Protectiveness subscale; ^c CSI: Children’s Somatization Inventory—GI subscale.

Figure 2

Mediation model 2—Parent-perceived child pain self-efficacy, parental protectiveness, and parent-reported child disability. ^a CSES: Child Self-Efficacy Scale; ^b ARCS: Adult Responses to Children’s Symptoms—Protectiveness subscale; ^d FDI: Functional Disability Inventory.