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Children with a higher fear of pain linked to increased disability

Children and adolescents with high levels of anxiety sensitivity have a higher fear of pain and this, in turn, is linked to increased pain-related disability, suggests a study by a team of Toronto researchers at York University and The Hospital for Sick Children (SickKids).

Adults who are high in anxiety sensitivity fear that the symptoms of anxiety, such as a rapidly beating heart, will have harmful consequences, such as a heart attack. Studies of adults with chronic pain suggest that anxiety sensitivity may be an important factor in maintaining their pain. However, much less is known about the risk factors among children and adolescents for developing ongoing pain and disability.

"We know that chronic pain is a serious problem for children and adolescents, but there has been very little research about how children with anxiety sensitivity and fear of pain may avoid activity, and by doing so, increase their disability from pain," says Andrea Martin, a PhD candidate studying with Professor Joel Katz at York University.

Right: A child in hospital helps her teddy bear

Martin is lead author of the study "Anxiety Sensitivity, fear of pain and pain-related disability in children and adolescents with chronic pain," published in the current issue of Pain Research & Management (Winter 2007). As a masters student, she worked at SickKids and surveyed children and adolescents from ages 8 to 17 who continued to experience pain a few years after being discharged from a pain clinic for children at the hospital.

The study was small and the data are preliminary, Martin says, but it is thought to be the first study of the link between fear of pain and increased disability in children with chronic pain.

"This study suggests that treatment designed to target this fearful responding to pain may actually help to prevent or reduce pain-related disability in children," she says.

The study was funded by a CIHR grant awarded to Dr. Patricia McGrath, the scientific director of the chronic pain clinic at SickKids, a registered Ontario psychologist and a co-author on the paper.

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