Coping in children with headache as predictors of adjustment and the relationships between parent and child coping styles

The effectiveness of children's mechanisms for coping with painful experiences will moderate the impact of these stressful circumstances in areas such as school, social relationships, level of disability, and in dealing with various medical procedures (Holden, Rawlins, & Gladstein, 1998; McGrath, 1990). The literature on coping has mainly focused on adults or healthy school-aged children (Ross & Ross, 1984). This study investigated the relationships between pain coping strategies and level of adjustment (e.g., low pain severity, depression, anxiety, and functional disability) in 35 children with headache and 34 "pain-free" children. The similarities between child and parent coping styles were also examined. Each child and parent completed a questionnaire consisting of items relating to pain coping strategies, depression, anxiety, functional disability, self-esteem, and family history of pain. For children with headache it was found that: approach coping was significantly related to pain severity and perceived pain controllability scores, problem-focused avoidance coping was significantly related to functional disability scores, and emotion-focused avoidance coping was significantly related to anxiety and depression scores. For the "pain-free" group it was found that: emotion-focused coping was significantly related to anxiety scores, and approach, problem-focused avoidance, and emotion-focused avoidance coping were significantly related to perceived pain controllability scores. There were no significant relationships found between parent and child coping scores for behavioral and cognitive coping strategies for both the headache and "pain-free" groups. Implications for pediatric pain management are discussed.