The Social Context of Pain in Youth With Cerebral Palsy: The Role of Caregiver Mental Health, Parenting Style and Protective Responses to Pain

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Abstract
Background: Cerebral palsy (CP) is a neurodevelopmental disability in which 75% of youth with CP report experiencing pain. Caregiver mental health, parenting style (e.g., authoritarian) and protective responses to pain (i.e., responses that reinforce pain behaviours and avoidance) have been linked to child pain outcomes. Although caregivers of children with neurodevelopmental disabilities experience heightened stress, little is known about the influence of caregiver mental health and parenting style on pain outcomes in youth with CP. Objectives: The present study investigated if caregiver mental health symptoms (i.e., depression and anxiety) and general parenting style (i.e., authoritarian, authoritative and permissive) were associated with child‐reported pain (i.e., pain intensity and pain interference), and whether protective responses to pain mediated these proposed associations. Methods: Forty‐three pairs of youth with CP and their caregiver were recruited from Canadian agencies, organizations and social media advertisements. Participants completed cross‐sectional measures of child‐reported pain and caregiver‐reported mental health, parenting style and protective responses to pain. Results: Caregiver mental health and authoritarian parenting style were significant predictors of youth pain interference ( p 's ≤ 0.05); however, unexpectedly, protective responses to pain did not mediate these associations (confidence intervals containing 0). Conclusions: These findings highlight the need for future investigations of family‐based interventions targeting general parenting style and caregiver mental health and their potential to reduce symptoms associated with secondary conditions, such as pain, that youth with CP experience.

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