• Jessica W Guite, Deirdre E Logan, Rebecca McCue, David D Sherry, and John B Rose.
• Department of Anesthesiology & Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA 19104-4399, USA. guite@email.chop.edu
• Clin J Pain. 2009 Mar 1;25(3):223-32.

ObjectivesTo explore relationships between beliefs and worries held by parents of adolescents with chronic, nondisease specific, musculoskeletal pain and (1) parental pain promoting behaviors, (2) the adolescent's pain-related disability, (3) family functioning, and (4) parenting stress.MethodsA retrospective chart review was conducted for 138 adolescents with chronic musculoskeletal pain syndromes presenting at an outpatient pediatric multidisciplinary pain management clinic. Adolescents reported on pain, disability, and parental pain promoting behaviors. Parents reported on their beliefs about the cause of and their responsibility for the adolescent's pain, worry about the adolescent's physical and emotional/behavioral health, parental pain promoting behaviors, family functioning, and parenting stress.ResultsParental beliefs that the cause of the adolescent's pain was "medical only" significantly moderated the relationship between adolescent pain and disability. Adolescent disability was positively correlated with parental worry about the adolescent's physical, but not emotional/behavioral, health. Parental worries about both physical and emotional/behavioral health were positively correlated with parents' use of pain promoting behaviors. A positive relationship between poorer family functioning and parenting stress was found to be partially mediated by parent beliefs that the adolescent's pain was "medical only."DiscussionThese findings provide insight into the complex interrelationships that exist among parents' beliefs and worries about adolescent pain, parental pain promoting behavior, adolescent disability, family functioning, and parenting stress that may have implications for treatment decisions made on the adolescent's behalf.

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