Pain and Mental Health in Youth (PATH) Study

Chronic pain in children and adolescents is a rising epidemic, affecting approximately 1 in 5 Canadian youth, and costing society $19 billion USD/year. 

What we studied:

Many youth with chronic pain and their parents have mental health issues, such as anxiety, depression, and PTSD and insomnia. 

What we need to know:

We need to know the neurobiological, psychological, social, and societal reasons why chronic pain and mental health often go hand in hand.

What's next:

We need to increase public awareness of these commonly co-occurring issues in children and their parents and use what we're learning to target underlying mechanisms and tailor pain care to the individual needs of families.

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We are uncovering why many children with chronic pain and their parents experience mental health issues and how to foster resilience.

Streams of Research

Uncertainty in Pediatric Chronic Pain.

In the absence of a positive test or underlying pathology, many youth will receive a diagnosis of “chronic pain”. For many families, a diagnosis of chronic pain does not provide answer or treatment, so youth and their parents may experience uncertainty regarding the diagnosis, prognosis, and treatment.

 

Diagnostic uncertainty is the perception that a label or explanation for a patient's health problem is missing or inaccurate.

 

We have found that nearly 1/3 of youth with chronic pain and their parents experience diagnostic uncertainty, which is linked to worse youth pain and functioning. 

Uncertainty is tied to family interactions with healthcare providers. We can change these conversations to reduce uncertainty

Cognitive Biases

Pain demands attention. When we feel pain, we are drawn to think about it in order to make it stop.

 

But what about when it doesn’t go away?

 

Pain can become all-consuming and occupy our attention, and influence our interpretations and memories, which can contribute to the development and maintenance of chronic pain.

 

Findings from our research shows that youth with chronic pain show attentional, interpretation and memory biases towards pain information. 

Our attention, interpretations and memories about pain are very pliable, meaning they can be changed to improve pain experiences.

The Intergenerational Transmission of Chronic Pain from Parents to Children.

Parent-child narratives about their journey with pain

To understand chronic pain in children, we have to understand chronic pain in their parents. Pain runs in families.

 

Up to 50% of youth with chronic pain have a parent with chronic pain. We are fascinated by how and why there is this intergenerational transmission of pain from parents to children.

 

Understanding the neurobiological (epigenetic) and behavioural (parenting) reasons for this transmission can help us answer a compelling and pressing question: How can chronic pain be prevented before it even begins?

People tell stories to convey meaning, interpretation, and expectancies, and narratives are constructed and shaped as a result of the cumulative interactions and experiences a person has.

 

Pediatric chronic pain is complex, with each journey and story being unique to the child experiencing pain.

 

Not only this, but parents are integral to an understanding of the experience of chronic pain in children and adolescents. The stories of youth with chronic pain and their parents are told to clinicians, family members, peers, teachers and many more.

 

Understanding how parents and children construct and develop their pain journey narrative can offer valuable insights to seek adequate support, develop shared treatment goals, and guide clinical decision-making. 

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Pain is real. Change the conversation.