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Pain, pain anxiety and emotional and behavioural problems in children with cerebral palsy

Abstract Purpose: Pain is commonly experienced in those with cerebral palsy (CP), and previous research suggests an increase in behavioural and emotional problems in children experiencing pain and pain anxiety. Therefore, it was hypothesised that pain intensity and pain anxiety would predict behavioural and emotional problems in children with CP. Method: Parents or guardians of 61 children (38 boys, 23 girls) with CP, aged 5–15 years completed an online questionnaire on pain intensity, pain anxiety and behavioural and emotional problems. Correlation and a multiple linear regression analyses were conducted to examine whether pain intensity and/or pain anxiety predicts behavioural and emotional problems. Results: A total of 59% of participants reported that their children with CP currently experiences pain. Multiple regression analyses revealed that pain intensity (p = 0.038) and pain anxiety (p < 0.001) both made a significant and independent contributions in predicting anxiety in children, however, pain anxiety was the only predictor that made a significant and independent contribution to the depression (p = 0.001) and the behavioural and emotional problems measure (p = 0.004). Conclusions: Whilst pain intensity appears to be associated with behavioural and emotional problems in children, pain anxiety may be more strongly associated still. Implications for Rehabilitation Pain intensity and pain anxiety may have strong associations with behavioural and emotional problems in children with Cerebral Palsy (CP) Pain anxiety may be a stronger predictor of behavioural and emotional problems than the actual pain experienced in children with CP Clinicians may need to consider how children’s perception of their pain affects their behavioural and emotional outcomes, as these may significantly affect the outcome of the rehabilitation