Table 4 Study characteristics and results
Author, Year, Publication Type | Sample Size(s) | Age(s) x̄ or Mdn (Range) | % Girls | % JIA Type | Pain: Construct (Reporter) – Measure | Psychosocial Factor(s): Construct (Reporter) – Measure | Main Findings: Analysis—Result |
|---|---|---|---|---|---|---|---|
Amine 2009 [38] Article | 80 C 80 P | x̄ = 11 (6–17) -- | 59 -- | Po:32; O:43; S:26 | • PI (--) – VAS CHAQ | • HRQOL (--) – JAQQ | • Corr – Lower well-being was significantly associated with greater PI |
Anthony 2011‡ [39] Article | 51 C 51 P | x̄ = 12 (8–16) -- | 61 96 | Po:63; E:8; S:24; Ps:5 | • PI (C) – VAS PPQ (current) | • P Depression symptoms (P) – BDI • Vulnerability (P) – CVS • P Hassles & Uplifts Intensity & Frequency (P) – Hassles and Uplifts Scale | • Corr – Parent depression symptoms, child vulnerability, parent identified daily hassles (intensity and frequency), and parent identified daily uplifts (intensity) were not significantly associated with PI • Corr & HR controlling for age, gender, active joint count, and disease severity – More parent reported daily uplifts were significantly associated with greater PI |
Armbrust 2016 [40] Article | 80 C | Mdn = 10 (8–13) | 65 | Po:35; O:45; E:4; S:11; Ps:5 | • PI (C) – VAS | • School Attendance (C) – -- (yes/no) | • Corr & LoR controlling for age, disease activity, medications, disability, and fatigue – Lower school attendance was significantly associated with greater PI |
Baildam 1995 [41] Article | 29 C 29 P | x̄ = 11 (7–16) -- | 48 -- | Po:48 O:52 | • PI (C) – VAS (worst past week) | • Mental Health (P) – Rutter Parental Screening Questionnaire high (≥ 13) / low (< 13) | • Mann–Whitney U Test – Children with higher and lower Rutter scores did not significantly differ in PI |
Baloueff 1996 [42] Thesis | 60 C | x̄ = 12 (8–17) | 73 | Po:33; O:57; S:10 | • PI (C) – VAS PPQ (average of current and past week) mean and high (> 2.5 cm)/ low (< 2.5 cm) | • Behavioral Conduct, Self-Esteem, Scholastic Competence, Appearance, & Social Acceptance (C) – SPPC/A • Assertion, Cooperation, Empathy, Self-Control, & Social Skills (C) – SSRS | • Corr, MR & one-way ANOVA – Behavioral conduct, physical appearance, scholastic competence, social acceptance, self-esteem, assertion, cooperation, empathy, self-control, and social skills were not significantly associated with PI, nor did they significantly differ between high and low pain groups |
Barlow 2000 [43] Article | 116 C 178 P | * (7–17) * | 64 65 | -- | • PI (Mother, Father, & C) – VAS (current) | • P Psychosocial & Symptom Self-Efficacy (Mother & Father) – PASE | • Corr –    Greater mother’s psychosocial self-efficacy was significantly associated with lower mother and child reports of PI    Greater father’s psychosocial self-efficacy was significantly associated with lower PI as reported by the child but not themselves    Greater mother’s symptom self-efficacy was significantly associated with lower PI as reported by themselves but not their child    Father’s symptom self-efficacy was not significantly associated with their own and child reports of PI |
Barlow 2001 [44] Article | 89 C 151 P | x̄ = 12 (7–17) * | 62 58 | -- | • PI (C) – VAS (current) | • Activity, Emotion, & Symptom Self-Efficacy (C) – CASE | • Corr – Greater child activity, emotion, and symptom self-efficacy were significantly associated with lower PI |
Barlow 2002 [45] Article | 30 C 30 P | x̄ = 11 (--) x̄ = 38 (--) | 67 100 | Po:26; O:61; S:13 | • PI (C) – VAS PPQ (current) | • P Depression & Anxiety symptoms (Mother) – HADS • P Psychosocial & Symptom Self-Efficacy (Mother) – PASE | • Corr – Maternal depression and anxiety symptoms, and psychosocial and symptom self-efficacy were not significantly associated with PI |
Bromberg 2009‡ [46] Thesis | 51 C | x̄ = 12 (8–16) | 65 | Po:100 | • PI (C) – VAS PPQ (1x/day for 2 mos) | • Coping Efficacy (C) – CSQ-C assessed 1x/day for 2 mos | • HR controlling for age, disease severity, and sleep quality – Greater coping efficacy was significantly associated with lower PI |
Bromberg 2012‡ [47] Article | 51 C 51 P | x̄ = 12 (8–16) -- | 65 -- | Po:100 | • PI (C) – VAS PPQ (1x/day for 2 mos) | • Mood (C) –VAS FAS assessed 1x/day for 2 mos | • Hierarchical MLM controlling for age, disease severity, and between and within child sleep quality – Higher daily reported mood (within subjects), but not mean mood (between subjects), was significantly associated with lower PI that day |
Bruns 2008 [48] Article | 70 C 70 P | x̄ = 10 (0–16) x̄ = 37 (--) | 67 91 | Po:63; O:16; S:21 | • PI (--) – VAS (past week) | • P Caregiver Burden (P) – CBS • P Mental Health (P) – SRQ-20 | • Corr – Caregiver burden and parent mental health were not significantly associated with PI |
Connelly 2012 [49] Article | 43 C 43 P | x̄ = 13 (8–17) -- | 86 90 | -- | • PI (C) – electronic VAS (3x/day for 28 days) | • Variability in positive & negative mood, ability to adaptively attenuate negative emotions, & ability to upregulate positive emotions (C) – PANAS-C assessed 3x/day for 28 days • Emotion Regulation (P) – The Emotion Regulation Scale (baseline) • Emotion Regulation (C) – Children’s Emotion Management Scale (baseline) | • Corr and LMM –    Greater variability in positive and negative emotions were significantly associated with and predictive of greater PI    A child’s ability to adaptively attenuate negative emotions was associated with, but not predictive of, lower PI    A child’s ability to adaptively upregulate positive emotions to average levels following a drop was not significantly associated with but was predictive of lower PI    Parent-reported and self-reported emotion regulation at baseline was not significantly associated with or predictive of PI |
Cornelissen 2014 [50] Article | 60 C | Mdn = 13 (7–17) | 73 | Po:48; Ps:22 | • PS (C) – Cold Detection, Cold Pain, Warm Detection, Warm Pain, Mechanical Detection, Mechanical Pain, Vibration Detection, & Pressure Pain Thresholds | • Catastrophizing (C) – PCS-C • Mental Health (C) – PSC • Trait Anxiety symptoms (C) – STAI-C | • LR –    Catastrophizing and mental health were not significantly associated with PS as measured by the child’s cold detection, cold pain, warm detection, heat pain, mechanical detection, mechanical pain, vibration detection, or pressure pain thresholds    Greater trait anxiety symptoms were significantly associated with greater PS as measured by the child’s lower mechanical detection and mechanical pain thresholds, but not by their cold detection, cold pain, warm detection, heat pain, vibration detection, or pressure pain thresholds |
Dimitrijevic Carlsson 2019 [51] Article | 45 C | Mdn = 12 (6–16) | 73 | Po:33; O:44 | • PI for temporo-mandibular joints (C) – GCPS (average of current, past week, and worst in the past week) | • Catastrophizing (C) – PCS-C • Distress (C) – PHQ-4 • Stress (C)—PSS | • Corr – Greater catastrophizing, distress, and perceived stress were significantly associated with greater temporomandibular joint PI |
Doherty 1993 [52] Article | 20 C 20 P | x̄ = 11 (8–15) -- | 55 100 | Po:15; O:55; S:30 | • PI (C & P) – VAS Child HAQ | • School absences (P) – Child HAQ | • Corr – More school absences were significantly associated with greater parent, but not child, reported PI |
El-Najjar 2014 [53] Article | 54 C 54 P | x̄ = 11 (6–15) -- | 67 -- | Po:28; O:39; E:11; S:22 | • PI (--) – VAS | • Depression symptoms (C) – CES-DC | • Corr – More depression symptoms were significantly associated with greater PI |
Hagglund 1995 [54] Article | 60 C | x̄ = 11 (7–17) | 62 | Po:35; O:55; S:10 | • PI (C) – VAS (past month) | • Social Support (C) – SSQR • Hopelessness (C) – Hopelessness Scale for Children • Sadness (C) – DES-IV | • Corr and HR controlling for age, gender, socioeconomic status, disease duration, and articular severity – Social support, hopelessness, and sadness were not significantly associated with PI |
Hanns 2018–1‡‡ [55] Thesis | 219 C | x̄ = 13 (11–16) | 57 | Po:22; O:35; E:13; S:6; Ps:13; U:11 | • PI (C) – VAS (baseline, 6, and 12 mos) mean and high (7.4)/low (0.4) | • Depression symptoms (C) – MFQ at baseline, 6, and 12 mos average and low (2 points)/high (31 points) | • LMM controlling for active/limited joint count and disability – More depression symptoms at baseline significantly predicted greater PI over time, and greater PI at baseline predicted more depression symptoms over time • Mann Whitney U-Test – More depression symptoms at baseline significantly predicted greater PI over 12 mos, and higher PI at baseline significantly predicted greater depression symptoms over 12 mos |
Hanns 2018–2‡‡ [55] Thesis | 102 C | Mdn = 13 (11–16) | 57 | Po:30; O:52; E:18 | • PI (C) – VAS | • Depression symptoms (C) – MFQ mean and high (≥ 27)/low (< 27) | • Corr and MR controlling for age, medications, diagnosis, gender – Greater depression symptoms were significantly associated with greater PI • Mann Whitney U-Test – Children with high and low depression symptoms did not significantly differ in PI |
Hoff 2006 [56] Article | 63 C 63 P | x̄ = 12 (8–17) x̄ = 40 (--) | 81 -- | Po:29; O:41; E:8; S:5; U:18 | • PI (C & P) – FPS (last few days at baseline, 6, and 12 mos) | • Depression symptoms (C) – RCADS at baseline | • LMM controlling for age, gender, income, and disease severity –    Greater depressive symptoms at baseline significantly predicted child reported, but not parent reported, PI over time when PI was low at baseline |
Jaworski 1992 [57] Thesis | 30 C 30 P | x̄ = 11 (6–17) -- | 73 -- | Po:73; O:27 | • PI (C & P) – VAS PPQ | • Depression symptoms (C) – CDI • Depression symptoms (P) – CBCL • P Punishing, Distracting, & Solicitous Pain Responses (P) – WHYMPI | • Corr –    Child reported depression symptoms were significantly associated with greater parent reported PI for the whole sample, and 12–17-year-olds, but not 6–11-year-olds    Parent reported depression symptoms, punishing, distracting, and solicitous pain responses were not significantly associated with child or parent reported PI in the whole sample, 6–11-year-olds, or 12–17-year-olds |
Klotsche 2014 [58] Article | 61 C 61 P | x̄ = 11 (3–17) -- | 66 -- | Po:67; O:21; E:5; S:2; Ps:3; U:2 | • PI (P) – VAS CHAQ (9 timepoints: baseline, 1 mos, 2 mos, 3 mos, 4 mos, 5 mos, 6 mos, 9 mos, and 12 mos) | • HRQOL Total, Emotional Functioning, School Functioning, & Social Functioning (--) – PedsQL (9 timepoints) | • Univariate and Multivariate Reg controlling for disease activity, joints, stiffness, disability, & comorbidities – Lower well-being at baseline was significantly associated with greater PI at baseline • Latent Growth Curve Mixture Modelling – A rapid increase in well-being across the first 4 timepoints was significantly associated with lower PI at baseline • Linear Reg –    Lower PI across timepoints significantly predicted better total well-being across time    Lower PI across timepoints 1–7, but not 8 and 9 significantly predicted better emotional functioning across time    Lower PI across timepoints 1–8, but not 9, significantly predicted better school and social functioning across time |
Kovalchuk 2017 [59] Article | 55 C 55 P | * (6–17) -- | 53 -- | Po:53; O:47 | • PI (P) – VAS CHAQ | • HRQOL Psychosocial (P) – CHQ | • Corr – Psychosocial well-being was not significantly associated with PI |
Kovalchuk 2018 [60] Article | 60 C 60 P 60 HCP | x̄ = 13 (5–17) -- -- | 48 100 -- | Po:48; O:52 | • PI (C & P) – VAS (current) | • HRQOL Behavior, Global Behavior, Self-Esteem, Family Cohesion, Family Activities, Mental Health, Time Impact, Emotional Impact, Emotional Role Limitations, Physical Role Limitations, & Psychosocial (P) – CHQ • Well-being (P, HCP, & C) – Global Assessment VAS | • Corr –    Behavior, global behavior, self-esteem, family cohesion, mental health, and psychosocial summary scores were not significantly associated with parent or child reported PI    Reduced engagement in family activities and greater impact on parents’ time and emotions were significantly associated with parent (but not child) reported PI    More emotional and physical role limitations in parents, and lower parent, child, and healthcare provider global assessments of well-being were significantly associated with greater parent and child reported PI |
Listing 2018 [62] Article | 953 C 953 P | x̄ = 8 (–) -- | 67 -- | Po:28; O:46; E:11; S:4; Ps:4; U:8 | • PI (P) – NRS | • HRQOL (--) – PedsQL | • LR – Greater well-being at baseline was significantly associated with lower PI at baseline • Stepwise Reg – Greater PI at baseline significantly predicted lower well-being at 36 mos |
Lomholt 2013††[64] Article | 41 C | x̄ = 14 (8–17) | 71 | Po:44; O:24; E:5; S:22; Ps:5 | • PF (C) – FPS-R (2x/day for 2 weeks) pain/pain-free groups | • Coping Behavioral Distraction, Cognitive Distraction, Catastrophizing, & Positive Self-Statements (C) – PCQ • Pain Beliefs of Control, Disability, & Harm (C) – SOPA | • Mann Whitney U-Test –    Behavioral distraction, cognitive distraction, the use of positive self-statements, and beliefs of control did not significantly differ between the pain and pain-free groups    Greater catastrophizing, beliefs of harm, and beliefs of disability were significantly higher amongst the pain group compared to the pain-free group |
Luca 2017 [65] Article | 17 C 17 P | * (4–7) -- | * -- | * | • PI (C) –SUPERKIDZ (current and past week) | • HRQOL (C & P) – PedsQL Arthritis | • Corr –    Child reported and parent reported well-being were not significantly associated with current and past week PI, respectively |
Mahler 2017 [66] Abstract | 51 C 51 P | Mdn = 13 (6–16) -- | 76 -- | Po:27; O:37; E:4; S:10; Ps:11; U:11 | • PI (--) – VAS JAMAR (past week) | • Well-being (--) – WHO-5 | • Corr – Child well-being was not significantly associated with PI |
Margetić 2005 [67] Article | 36 C | x̄ = 13 (8–16) | 61 | -- | • PI (C) – VAS (current) | • Anxiety and Depression symptoms (C) – TSC-C | • Corr and Reg – Greater depression, but not anxiety symptoms, were significantly associated with greater PI |
Oen 2009§ [69] Article | 356 C 356 P | Mdn = 9 (0–17) -- | 66 -- | Po:24; O:41; E:10; S:7; Ps:7; U:12 | • PI (--) – VAS (baseline and 6 mos) | • Well-being (--) – Global Assessment VAS assessed at baseline and 6 mos later • HRQOL (--) – JAQQ assessed at baseline and 6 mos later | • Corr – Lower well-being (VAS & JAQQ) at baseline was significantly associated with greater PI at baseline • Univariate & Multivariate Reg controlling for number of joints affected, baseline JAQQ, and time since diagnosis – Greater PI at baseline predicted lower well-being (JAQQ) at 6 mos |
Oen 2021§ [68] Article | 561 C | Mdn = 10 (–) -- | 65 -- | Po:23; O:41; E:15; S:5; Ps:6; U:10 | • PI (C) – VAS (past week at diagnosis, 3–9 mos post, and during flares) | • HRQOL (C) – JAQQ psychosocial assessed at diagnosis, 3–9 mos post, and during flares • HRQOL (C) – QoML assessed at diagnosis, 3–9 mos post, and during flares | • Corr in SEM –    Greater PI at diagnosis and 3–9 mos post diagnosis were significantly associated with lower well-being (JAQQ & QoML) at diagnosis and 3–9 mos post diagnosis, respectively    Greater PI during flares was significantly associated with lower well-being (QoML but not JAQQ) during flares |
Rashid 2018‡‡ [4] Article | 851 C 851 P | Mdn = 8 (1–16) -- | 66 -- | Po:29; O:48; E:5; S:6; Ps:8; U:3 | • PI (--) – VAS PPQ (baseline, 6 mos, and annually up to 60 months) average and 3 pain trajectories: consistently low/ improved/consistently high | • Well-being (P) – Global Assessment VAS assessed at baseline, 6 mos, and annually • Depression symptoms (--) MFQ assessed at baseline, 6 mos, and annually | • Corr –    Lower well-being and greater depression symptoms at baseline were significantly associated with greater PI at baseline and less change in PI over time    Greater PI at baseline was significantly associated with less change in well-being within 6 mos    Change in PI within 12 mos was not significantly associated with change in well-being over 12 mos • Multinomial LoR –    Well-being was significantly lower in the consistently high and improved pain groups compared to the consistently low pain group, and well-being significantly increased over 6 mos in the improved pain group compared to the consistently low pain group. No other differences emerged    Depression symptoms did not significantly differ across groups |
Ross 1993 [70] Article | 56 C 56 P | x̄ = 12 (7–17) -- | 73 -- | Po:59; O:27; E:5; S:9 | • PI (C) – VAS (3x/day for 28 days) mean | • Behavior (P) – CBCL • Depression symptoms (C) – CDI • Anxiety symptoms (C) – STAI-C • Distress (C) – CDI and STAI-C • P Maternal Distress (P) – Lanyon Psychological Screening Inventory • P Family Harmony (P) – FES | • Corr and HR controlling for range of motion, disease activity, joint activity, stiffness, number of joints affected, and other measured variables –    Behavior was not significantly associated with PI    Greater anxiety symptoms, child distress, and maternal distress were significantly associated with greater PI    Greater depression symptoms were significantly associated with but not predictive of greater PI    Greater family harmony was not associated with but predicted greater PI |
Sällfors 2004 [71] Article | 125 C | x̄ = 14 (10–17) | 66 | Po:46; O:53; S:1 | • PI (C) – VAS (usual) • PI (C) – NRS PIS (4x/day for 1 week) • PF (C) – PIS (pain free days) | • Well-being (C) – VAS CHAQ • Absences from school (C) – CHAQ | • Corr and Stepwise Reg – Lower well-being was significantly associated with greater PI (VAS & PIS) and PF • Corr – More school absences were significantly associated with greater PI (VAS & PIS) and PF |
Schanberg 2003‡ [2] Article | 41 C | x̄ = 12 (8–17) | 59 | Po:59; E:7; S:27; Ps:7 | • PI (C) – VAS PPQ 1x/day at baseline, follow up, and for 2 mos) • PF (C) – VAS PPQ (percentage of pain days) | • Depression symptoms (C) – CDI assessed at baseline • Anxiety symptoms, Social Concerns, Physiologic Anxiety, & Worry (C) – RCMAS assessed at baseline | • Corr –    Depression symptoms were not significantly associated with PI    Greater physiologic anxiety was significantly associated with greater PI and PF    Greater total anxiety symptoms, social concerns, and worry were significantly associated with greater PF |
Schanberg 2005‡ [72] Article | 51 C | x̄ = 12 (8–17) | 65 | Po:63; E:8; S:24; Ps:6 | • PI (C) – VAS PPQ (1x/day at baseline, follow up, and for 2 mos) | • Stress (C) – Daily Events Inventory assessed daily for 2 months • Mood (C) – FAS assessed daily for 2 mos • Social & School Activity Reduction (C) – RCMAS assessed daily for 2 mos | • Longitudinal Mixed Effects Models – Greater same day stress and lower same day mood were significantly associated with greater same day PI • LMM controlling for disability index, global assessment, sex, age, disease onset, stiffness, fatigue, mood, and stress –    Social, but not school, activity reduction was significantly associated with greater PI |
Selvaag 2003 [73] Article | 116 C 116 P | x̄ = 9 (4–17) x̄ = 38 (--) | 60 * | Po:35; O:51; E:3; S:4; Ps:6; U:1 | • PI (P) – VAS | • HRQOL psychosocial (--) – CHQ | • Corr – Psychosocial well-being was not significantly associated with PI |
Selvaag 2005 [74] Article | – 197 P | x̄ = 7 (1–16) -- | 61 -- | Po:30; O:56; E:4; S:7; Ps:3 | • PI (P) – VAS | • Well-being (P) – Global Assessment VAS | • Corr – Lower well-being was significantly associated with greater PI |
Shelepina 2011 [75] Abstract | 99 C | -- (14–17) | 73 | Po:49; O:16; E:15; S:19 | • PI (P) – VAS | • Schooling location (C)– -- school/home | -- – Children who were taught at home without medical indication reported significantly higher PI compared to those taught at school |
Stinson 2006–1†[76] Thesis | 76 C | x̄ = 13 (9–17) | 78 | Po:49; O:15; E:11; S:13; Ps:11; U:3 | • PI (C) – E-ouch VAS (3x/day for 14 days) • PI (C) – NRS RPI (past week) | • Pain Unpleasantness & Pain Interference (C) – E-Ouch • Pain Unpleasantness, Pain Interference Total, Pain Interference Mood, Pain Interference Relationships, Pain Interference Schoolwork, & Pain Interference Sleep (C) – RPI • Coping via Approach, Distraction, & Emotion-Focused Avoidance (C) – PCQ • HRQOL Total & Psychosocial (C) – PedsQL • HRQOL Arthritis Total, Worry, & Communication (C) – PedsQL Rheumatology | • Corr –    Greater pain unpleasantness (E-Ouch and RPI) was significantly associated with greater PI (E-Ouch and RPI) across both weeks    Greater pain interference (E-Ouch and RPI total, mood, relationships, schoolwork, sleep) was significantly associated with greater PI (E-Ouch and RPI)    Approach coping and distraction coping were not significantly associated with PI (E-Ouch) on either week    Greater emotion focused avoidance coping was significantly associated with greater PI (E-Ouch) on week 2 but not week 1    Lower total well-being, lower psychosocial well-being, lower total arthritis well-being, and more worry were significantly associated with greater PI (E-Ouch)    Communication was not significantly associated with PI (E-Ouch) |
Stinson 2006–2 [76] Thesis | 36 C | x̄ = 13 (8–17) | 67 | Po:28; O:39; E:11; S:11; Ps:6; U:6 | • PI (C) – E-ouch VAS (3x/day for 31 days; at day 7 had joint injections) • PI (C) – NRS RPI (past week) | • Pain Unpleasantness & Pain Interference (C) – E-Ouch • Pain Unpleasantness & Pain Interference (C) – RPI • Coping via Approach, Distraction, & Emotion-Focused Avoidance (C) – PCQ • HRQOL Total & Psychosocial (C) – PedsQL • HRQOL Arthritis Total, Worry, & Communication (C) – PedsQL Rheumatology | • Corr –    Greater pain unpleasantness (E-Ouch and RPI) and pain interference (E-Ouch and RPI) were significantly associated with greater PI (E-Ouch and RPI)    Approach coping, avoidance coping, and emotion-focused avoidance coping were not significantly associated with PI (E-Ouch)    Lower total well-being and total arthritis well-being were significantly associated with greater PI (E-Ouch)    Psychosocial well-being, worry, and communication were not significantly associated with PI (E-Ouch) |
Tarakci 2011 [79] Article | 52 C | x̄ = 12 (8–17) | 63 | Po:52; O:29; E:8; S:4; Ps:6; U:2 | • PI (C) – VAS CHAQ (past week) | • Depression symptoms (C) – CDI • Anxiety symptoms (C)—SCARED • Well-being (C) – CHAQ | • Corr –    Depression and anxiety symptoms were not significantly associated with PI    Lower well-being was significantly associated with greater PI |
Tarkiainen 2019 [80] Article | -- 60 P | * (4–14) -- | 65 -- | Po:85; E:13; Ps:2 | • PI (--) – VAS (8 × over 1 year) | • HRQOL psychosocial (C) – CHQ assessed 8 times throughout 1 year | • Univariate LMM – Greater PI was significantly associated with less improvement psychosocial well-being over time |
Thastum 1997 [81] Article | 15 C 15 P | x̄ = 12 (9–15) -- | 73 -- | Po:20; O:80 | • PI (C) – VAS (current) • PS (C) – Tolerance/time hand submerged • PS (C) – Threshold/time moved to button | • Coping via Catastrophizing, Distraction, & Reinterpretation (C) – preliminary PCQ | • Reg –    Greater catastrophizing was significantly associated with greater PI and lower pain threshold (PS), but not pain tolerance (PS)    Distraction and reinterpretation were not significantly associated with PI or PS (tolerance or threshold) |
Thastum 1998 [82] Article | 40 C | * (8–17) | 58 | -- | • PI (C) – VAS PPQ (current, average, worst) high (modest disease activity and pain)/low (disease activity but few pain complaints) • PS (C) – Tolerance/ time hand submerged | • Coping via Behavioral Distraction, Cognitive Distraction, Information Seeking, Seeking Social Support, Externalizing, Catastrophizing, & Positive Self-Statements (C) – PCQ | • Corr and T-test –    Greater behavioral distraction was significantly associated with lower PI (average, current, worst) but not experimental PI or PS. Behavioral distraction was significantly higher in the high pain group    Cognitive distraction, information seeking, and seeking social support were not significantly associated with PI nor did it differ between high and low pain groups    Greater externalizing was significantly associated with lower PS (i.e., higher tolerance); however, was not significantly associated with average, current, or worst PI (current and experimental) and did not differ between high and low pain groups    Greater catastrophizing was significantly associated with greater experimental PI; however, was not significantly associated with average, current, or worst PI and did not differ between high and low pain groups    Fewer positive self-statements were significantly associated with greater PI (average, current, worst); however, were not significantly associated with experimental PI and PS, and did not differ between high and low pain groups |
Thastum 2005††[25] Article | 56 C | x̄ = 11 (7–15) | 80 | Po:41; O:43; E:2; S:13; Ps:2 | • PI (C) – FPS (2x/day for 3 weeks) Mean and high (pain ≥ 1.61 & disease activity < 3)/low (remaining sample) | • Coping via Behavioral Distraction, Positive Self-Statements, Seeking Social Support, Cognitive Distraction, Catastrophizing, Externalizing, & Total (C) – PCQ • Pain Beliefs of Control, Harm, Disability, Solicitude, Medical Cure, Emotion, Total, Cognitive (disability + control + medical cure + harm), & Emotional (medical cure + emotion + solicitude) (C) – SOPA | • Corr and T-Test –    Behavioral distraction and seeking social support were not significantly associated with PI, and they did not differ between high and low pain groups    Positive self-statements were not significantly correlated with PI; however, were significantly higher in the low pain group • Corr, HR controlling for age, sex, disease duration, disease severity, disability, and pain beliefs, and T-Test –    Cognitive distraction and externalizing were not significantly associated with PI and they did not differ between high and low pain groups    Greater catastrophizing was significantly associated with greater PI (Corr, not Hierarchical Reg), and was significantly higher in the high pain groups • Corr and T-Test –    Lower control beliefs were significantly associated with greater PI and were significantly lower in the high pain group    Greater harm and disability beliefs were significantly associated with greater PI and were significantly higher in the high pain group    Emotion beliefs were not significantly associated with PI nor did they differ between high and low pain groups    Lower medical cure beliefs and higher solicitude beliefs were significantly associated with greater PI; however, did not differ between the high and low pain groups • HR controlling for age, sex, disease duration, disease severity, disability and pain coping – Worse pain beliefs (including cognitive beliefs but not emotional beliefs) were significantly associated with greater PI |
Thastum 2011††[83] Article | 47 C | * (7–15) | 83 | Po:40; O:45; S:13; Ps:2 | • PI (C) – FPS (2x/day for 3 weeks at baseline and 24 mos) Average and high (pain ≥ 1.61 & disease activity < 3)/low (remainder) | • Pain Beliefs of Control, Medical Cure, Harm, Disability, & Cognitive (disability + control + medical cure + harm) (C) – SOPA | • Corr –    Lower control beliefs at baseline and 24 mos were significantly associated with greater PI 24 mos later    Medical cure beliefs at baseline and 24 months were not significantly associated with PI at 24 mos • Corr and T-test – Greater harm and disability beliefs at baseline and 24 mos were significantly associated with greater PI 24 mos later, and significantly higher in the high pain group at 24 mos • HR controlling for disability, disease activity (and with/without baseline PI) – Greater cognitive beliefs at baseline significantly predicted PI at 24 mos |
Thompson 1987 [26] Article | 23 C 23 P | x̄ = 10 (5–15) -- | 78 100 | Po:48; O:22; S:26; U:4 | • PI (C) – VAS PPQ (current, worst, and high/low) | • Number of elevated behavior and social competence subscales, Overall Adjustment, Externalizing, Internalizing & Social Competence (P) – CBCL • P Family Relationships, Achievement, Active-Recreational Orientation, Cohesion, Conflict, Control, Expressiveness, Independence, Intellectual-Cultural Orientation, Moral-Religious Emphasis, & Organization (P) – FES | • Welch’s V – Children with 0, 1, 2, or 3 elevated behavior or social competence subscales did not significantly differ in current and worst PI • Corr and Welch’s V –    Overall Adjustment, externalizing, internalizing, social competence, family relationships, conflict, active-recreational orientation, control, moral-religious emphasis, and organization were not significantly associated with PI, nor did they significantly differ between high and low pain groups    Lower family achievement orientation was significantly associated with greater current, but not worst, PI, and it did not significantly differ between high and low pain groups    Lower family cohesion and expressiveness were significantly associated with greater worst, but not current, PI, and they did not significantly differ between high and low pain groups    Lower family independence and intellectual-cultural orientation were significantly associated with greater current, but not worst, PI, and they did not significantly differ between high and low pain groups |
Tupper 2012 [84] Thesis | 11 C | * (8–17) | * | Po:45 | • PI (C) – VAS PinGo (7x/day for 4 days) 4 categories: 0 = None, 1–30 = Mild, 31–69 = Moderate, 70–100 = Severe | • Emotional valence (C) – FAS | • GEE – There was a significantly greater probability of having no pain during times of high emotional valence (regardless of activation level) |
Tupper 2013†[3] Article | 85 C | x̄ = 13 (8–17) | 73 | Po:42; O:22; E:9; S:14; Ps:7; U:5 | • PI (C) – E-ouch VAS (3x/day for 7 days) | • HRQOL (C)—PedsQL | • LR controlling for disease activity, illness duration, age, and sex – Greater PI variability was significantly associated with lower well-being |
Upadhyay 2021 [85] Article | 16 C | x̄ = 13 (8–16) | 69 | Po:81; O:13; Ps:6 | • PI (C) – NRS PROMIS average and low (0–3)/high (> 3) | • Anxiety symptoms, Cognitive symptoms, Depression symptoms, and stress symptoms (C) – PROMIS | • Corr and T-test –    Anxiety symptoms, depression symptoms, and stress were not significantly associated with PI, nor did they significantly differ between high and low pain groups    Lower cognitive function was significantly associated with greater PI, although it did not significantly differ between high and low pain groups |
Vandvik 1990 [86] Article | 57 C 57 P | -- (7–16) -- | 67 -- | Po:32; O:32; U:37 | • PI (C) – VAS | • Psychosocial functioning (P) – CGAS • Overall adjustment, Externalizing, & Internalizing (P) – CBCL | • Corr – Psychosocial functioning, overall adjustment, externalizing, and internalizing were not significantly associated with PI |
Vuorimaa 2008§§ [89] Article | 145 C | x̄ = 12 (8–15) | 73 | Po:50; O:40 | • PF (C) – SPQ (past 3 months) | • Trait anxiety symptoms (C) – STAI-C • Depression symptoms (C) – CDI • Children were categorized into: 1) teenagers high in trait anxiety and depression; 2) children high in trait anxiety and low in depression; 3) children low in trait anxiety and depression; and 4) teenagers low in trait anxiety and depression | • Discriminant Analyses – Cluster 1 (teenagers high in anxiety and depression symptoms) experienced significantly greater PF compared to the other clusters |
Vuorimaa 2009§§ [88] Article | 142 C 142 P | x̄ = 12 (8–15) * | 73 83 | Po:50; O:50 | • PI (P) – VAS (current) | • Trait anxiety symptoms (C) – STAI-C • Depression symptoms (C) – CDI • Children were categorized into: 1) teenagers high in trait anxiety and depression; 2) children high in trait anxiety and low in depression; 3) children low in trait anxiety and depression; and 4) teenagers low in trait anxiety and depression | • Discriminant Analyses – Cluster 1 (teenagers high in anxiety and depression) experienced significantly greater PI compared to the other clusters |
Vuorimaa 2011§§ [87] Article | 142 C 142 P | x̄ = 12 (8–15) * | 73 83 | Po:50; O:50 | • PF (C) – SPQ (past 3 months) | • Depression symptoms (C) – CDI • Anxiety symptoms (C) STAI-C • Psychological, Somatic, & Social Self-Efficacy (C) – CASE • P Depressive Symptoms (P) – BDI and HADS • P Anxiety Symptoms (P) – HADS • P Psychological, Social, & Somatic Self-Efficacy (C) – PASE • P Parent Influence on Child Mood, Parent Perception of Child’s Coping, & Parent Perception of Child’s Well-being (P) – Author created | • Corr and MR –    Greater child depression and anxiety symptoms, lower child social self-efficacy, lower parent social self-efficacy, lower parent somatic self-efficacy, lower parent perception of the child’s well-being, and lower parent perception of the child’s coping were significantly associated with greater PF    Greater parent depression symptoms (not MR with HADS) were significantly associated with greater PF    Child psychological self-efficacy, child somatic self-efficacy, parent anxiety symptoms, parent psychological self-efficacy, and parent influence on child’s mood were not significantly associated with PF |
Yan 2020 [91] Article | 148 C | x̄ = 14 (8–17) | 77 | Po:18; O:53; E:13; S:7; Ps:2; U:7 | • PI (C) – NRS PROMIS (past week; multiple visits) | • Depression symptoms (C) – PROMIS assessed across multiple visits | • LMM – Increasing PI was significantly associated with an increase in depression symptoms |