Bedree, H., Tran, S.T., Fortunato, J., & Essner, B.S. (2024, April). More discordance, worse pain: Exploring child-parent agreement on anxiety and depressive symptoms and implications for pain intensity among youth with disorders of gut-brain interaction [Poster Presentation]. The Society of Pediatric Psychology Annual Conference, New Orleans, LA, United States.

Abstract

Introduction

Among youth with disorders of gut-brain interaction (DGBIs), pain is a common symptom and associated with cognitive and affective symptoms. Greater discrepancies between child and parent report of youth mental health symptoms are associated with worse functional impairment among youth with chronic pain. We aim to examine the impact of caregiver-child concordance on mental health symptoms among youth with DGBIs on pain.

Methods

Youth with DGBIs and caregiver dyads (N = 152; Mage = 13.89, SD = 2.89; 73% female; 81.58% White/non-Hispanic) completed measures of anxiety, depressive symptoms, and pain through a pediatric neurogastroenterology clinical registry. Standardized difference scores were calculated by subtracting child T-Score from caregiver T-score for child anxiety and depressive symptoms. Dyads were grouped according to those within one, two, or three SDs of the absolute difference of agreement. Bivariate correlations examined level of concordance and child-reported pain.

Results

Youth reported moderate pain (M = 5.10, SD = 2.96) on 11-point numeric rating scale. Most youth-caregiver difference scores were within 1 SD for both anxiety (n = 107) and depressive symptoms (n = 113) T-scores. For groups with difference scores within 1 and 2 SDs, there were no associations between mental health symptoms and child-reported pain. However, for dyads within 3 SDs of agreement on depressive symptoms (n = 7), larger difference scores were associated with worse child pain, r(0.76), p = 0.047. Notably, caregivers reported higher depressive symptoms (T-Score = 57.49, SD = 10.34) than youth (T-Score = 46.86, SD = 14.27) for this group.

Conclusions

Most youth-caregiver dyads had high concordance on anxiety and depressive symptoms reports and difference scores were not associated with youth pain. Yet, for dyads with greater discordance (3 SDs), disagreement was related to greater pain. Addressing discrepancies in the presence of co-occurring mental health symptoms may alleviate pain symptoms for this population.

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