Background and aims
Pain coping has been associated with function in children with pain. The objective of this study was to better understand the role that coping strategies play in the adjustment to pain in a non- clinical sample of school-age children with pain.
Methods
Two hundred and forty-five children (60% girls; age (SD): 11.73 (2.24) years old, range=7-15) who reported having pain in the previous three months provided demographic and pain-related information (pain location, frequency, and intensity), and completed measures assessing pain interference, anger, depression severity, and pain coping strategies (approach, problem-focused avoidance, internalizing/catastrophizing and externalizing coping strategies). Zero-order correlation analyses were used to estimate the associations between pain coping strategies and the study criterion variables. Three mediation analyses were performed to evaluate the extent to which pain coping strategies mediate the association between pain intensity and measures of function.
Results
Problem-focused avoidance coping was significantly and negatively associated with pain interference, anger and depression, whereas internalizing/catastrophizing and externalizing coping were positively and significantly associated with pain intensity, pain interference, anger and depression. Internalizing/catastrophizing was found to mediate the association between pain intensity and anger (β=0.11, CI= 0.03 to 0.22 at 95% confidence), and pain intensity and depression severity (β=0.12, CI= 0.02 to 0.24 at 95% confidence).
Conclusions
Internalizing/catastrophizing emerged as a primary pain coping strategy that mediates the association between pain intensity and emotional function. This suggests the possibility that targeting reductions in internalizing/catastrophizing may improve emotional function in children with pain; research to evaluate this possibility is warranted.

PAIN COPING AND FUNCTION IN CHILDREN WITH PAIN