Positive Psychological Factors in Pediatric Chronic Pain
Positive psychology is a recent school of psychology that seeks to understand what promotes flourishing alongside what increases risk. The current work sought to increase understanding of the positive psychology research that has been conducted to date in the area of pediatric chronic pain through a scoping review in Study 1, and to examine how certain positive psychological factors relate to well-being in children and adolescents with abdominal pain in Study 2. A list of positive psychological factors was developed for a scoping review for Study 1. An initial search yielded 24, 676 research articles and 162 were included in the final review. Coping was the most represented positive psychological factor in the included articles. The factors were categorized as favourable, unfavourable, and unclear for the purposes of description. Favourable positive psychological factors in pediatric chronic pain research included acceptance, efficacy, hope, spirituality, and some coping subtypes. Some forms of coping were related to unfavourable outcomes in youth with chronic pain, and there were factors that were not clearly related to favourable or unfavourable outcomes. Study 2 examined how a select number of positive psychological factors (i.e., optimism, mindfulness, pain self-efficacy) related to health-related quality of life and parent rated pain-related disability in a sample of youth experiencing abdominal pain, recruited from a pediatric gastroenterology service in London, Ontario. Participants included 98 youth (n = 42 male, n = 56 female) aged 8-17 years of age (M = 13.38, SD = 2.85) and one of their parents. Analyses were conducted for the full sample, for the FGID sub-group, and for the organic GID sub-group. Results for the full sample suggest that higher mindfulness, optimism, and pain self-efficacy related to higher health-related quality of life, and higher optimism and pain self-efficacy related to lower disability. Lower pain self-efficacy (full sample), and lower mindfulness (FGID sample) moderated the relation between pain and disability, suggesting that lower levels of these positive psychological factors may increase risk in these groups, consistent with the protective stabilizing theory of resilience. Overall, Studies 1 and 2 offer recommendations for future research and preliminary findings that could inform intervention research.