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Updated: May 13, 2026

Investigating Pain-Related Avoidance Behavior using a Robotic Arm-Reaching Paradigm
Published on: October 3, 2020
Adolescent pain catastrophizing mediates the relationship between protective parental responses to pain and
Josie S Welkom1, Wei-Ting Hwang, Jessica W Guite
1Department of Child and Adolescent Psychiatry and Behavioral Sciences, The Children’s Hospital of Philadelphia, USA. jwelkom1@jhmi.edu
Objective:
Examine whether the relation between protective parenting responses to pain and functional disability is mediated by pain catastrophizing in adolescents with chronic musculoskeletal pain and their parents over time.
Methods:
Adolescents aged 11-18 years and their parents reported on parental protective responses to pain (PPRP), pain catastrophizing scale (PCS), and Functional Disability Inventory (FDI) before Time 1 (T1) and 2 months after Time 2 (T2) an initial interdisciplinary pain clinic evaluation.
Results:
PCS was a significant mediator of the PPRP-FDI relationship at T1 and T2 for the adolescents and T2 for their parents. A decrease in PPRP over time was associated with T2 PCS, which in turn was associated with T2 FDI for adolescents and their parents.
Conclusion:
Parental protectiveness is associated with disability indirectly through pain catastrophizing at the initial visit and follow-up. Decreases in parent protectiveness, potentially initiated through the initial evaluation, were related to lower levels of disability at follow-up through pain catastrophizing.
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