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

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.

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

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.

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.

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.