Psychological mediators in the relationship between paediatric chronic pain and adjustment: An investigation of acceptance, catastrophising and kinesiophobia

Background and aim: Acceptance, catastrophising and kinesiophobia have been identified within the adult literature as important processes in the relationship between pain intensity and functioning. While these constructs have received some attention within paediatric chronic pain, research is still in its infancy in understanding how these processes relate to one another and pain-related outcomes. The current study aimed to explore the mediating roles of acceptance, catastrophising, and kinesiophobia in the relationship between pain severity and adjustment. Methods: A sample of 129 adolescents (aged 12-18 years) with heterogeneous pain conditions completed self report measures of: pain intensity, acceptance, catastrophising, kinesiophobia, disability, anxiety, depression and quality of life once. Multiple mediation analysis was used to compare the specific mediating effects of the three processes in the relationship between pain and functioning. Results: The current study demonstrated that acceptance and kinesiophobia partially mediated the effects of pain across measures of disability and quality of life, while catastrophising mediated the relationship between pain and emotional distress. Conclusions: The results demonstrated that all three processes play an important role in the well-being of adolescents with chronic pain, and support emerging models, which adopt a more encompassing perspective of paediatric chronic pain.