• Christine B Sieberg, Sara Williams, and Laura E Simons.
• Pediatric Pain Rehabiliation Center, Children's Hospital Boston at Waltham, Waltham, MA 02453, USA. christine.sieberg@childrens.harvard.edu
• J Pediatr Psychol. 2011 Oct 1;36(9):1043-51.

ObjectivesTo examine whether protective parent responses mediate the relation between parent distress and child functioning.MethodsAt a pain clinic evaluation, 157 families participated. Parents completed measures of global distress (BSI-18), distress in the context of their child's pain (BAP-PIQ), and protective responses to their child's pain. Children completed measures of functional disability and pain.ResultsBAP-PIQ subscales were significantly associated with child functional disability, whereas BSI subscales were unrelated. Protective parent responses partially mediated the relation between parent distress and child functional disability for depression, anxiety, and catastrophizing. However, parent protective behavior fully mediated the relationship between parent helplessness and child functional disability, indicating that feelings of parent helplessness did not uniquely contribute to child functional disability. Discussion Results suggest that when treating youth with chronic pain, parental distress in the context of children's pain needs to be addressed.

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