Parental Validation and Invalidation in Parent-Adolescent Discussion of Worry and Pain.

Abstract

Background: Parental responses to an adolescent's pain impact pain-related variables, yet limited research has focused on parent-adolescent pain communication. Additionally, patterns have rarely been examined through comparisons of dyads where the adolescent has chronic pain versus those without.

Aims: To examine the impact of parental validation and invalidation on adolescent pain-related variables (i.e. functional disability, pain catastrophizing, pain intensity).

Methods: Parent-adolescent dyads, including adolescents with chronic pain (CP; n = 32) and with no chronic pain (NCP; n = 61), completed questionnaires and two discussion tasks: a worry discussion and a pain discussion. Parental responses were coded using the Validating and Invalidating Behaviors Coding Scale.

Results: Parental invalidation was significantly greater in the worry task compared to the pain task (F(1, 91) = 4.16, p =.04). In the pain task, greater parental validation predicted higher adolescent functional disability (β = 0.32, p =.02), with significantly stronger effects in the CP group. Validation also predicted adolescent pain catastrophizing (worry: β =.35, p =.02; pain: β = 0.30, p =.03), with significantly greater effects in the CP group. In the worry task, validation showed both linear (β = -0.34, p =.03) and curvilinear (β = -0.25, p =.005) relationships with changes in adolescent pain intensity.

Conclusions: Chronic pain status and discussion content are associated with adolescent-reported variables during parent-adolescent interactions. Greater attention to intra- and interpersonal variables is needed to understand how pain communication unfolds between parents and adolescents.