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Ohanian DM, Holmbeck GN. Bidirectional, longitudinal associations between chronic pain and family functioning in youth with spina bifida. FAMILIES, SYSTEMS & HEALTH : THE JOURNAL OF COLLABORATIVE FAMILY HEALTHCARE 2023; 41:478-487. [PMID: 37471047 PMCID: PMC10799168 DOI: 10.1037/fsh0000822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
INTRODUCTION Chronic pain does not reside within an individual. Pain is affected by and affects larger systems (e.g., families). We examined longitudinal, bidirectional associations between chronic pain and family functioning in spina bifida (SB). We hypothesized a bidirectional association between pain and family functioning (cohesion and conflict); youth chronic pain status would be associated with maladaptive family functioning and maladaptive family functioning would be associated with youth chronic pain status. METHOD Participants were from an ongoing longitudinal study of adolescents with SB (N = 140, 53.6% female, ages 8-15 at Time 1). Data were collected every 2 years, with this study using data from Times 1 and 2 (T1, T2; T1: 2006-2009, T2: 2008-2011). Parents reported on youth demographics and family functioning. Youth reported on family functioning and pain; pain was dichotomized into a categorical variable (chronic pain vs. no chronic pain). Family functioning (cohesion and conflict) was also assessed using observational data. RESULTS Youth chronic pain status was associated with decreased family conflict (child report) and increased cohesion (parent report) over time. Increased family conflict (parent report) was associated with a greater likelihood of reporting chronic pain 2 years later. Findings were nonsignificant between observed family conflict or cohesion and chronic pain in either direction. DISCUSSION With the presence of an additional stressor (chronic pain) families increase cohesion and reduce conflict. Increased conflict may increase a child's vulnerability of developing chronic pain. It is critical that interventions for both pain and family functioning in SB are guided by a strengths-based model. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Diana M Ohanian
- Department of Physical Medicine and Rehabilitation, Rehabilitation Psychology/Neuropsychology, University of Michigan
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Cacioppo M, Menard H, Olivari Philiponnet C, Le Pabic E, Brochard C, Peyronnet B, Violas P, Riffaud L, Bonan I. Prevalence and risk factors for scoliosis in adults with closed and open spina bifida: A large, cross-sectional study. Ann Phys Rehabil Med 2022; 66:101685. [PMID: 35717001 DOI: 10.1016/j.rehab.2022.101685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 04/06/2022] [Accepted: 05/16/2022] [Indexed: 12/04/2022]
Abstract
BACKGROUND Scoliosis develops in a proportion of children with myelomeningocele; however, little is known about scoliosis in adulthood and in other forms of spina bifida (SB). OBJECTIVES The aims of this study were to describe the prevalence of scoliosis and identify risk factors for its development in a large cohort of adults with open and closed SB. METHODS This was a cross-sectional study of data from 580 adults with SB attending their first consultation at a French multidisciplinary referral centre for SB. Sex, anatomical location and type of SB (open or closed), neurological level, back pain and ambulatory status (new Functional Ambulation Classification [new FAC]) were compared in adults with and without scoliosis. These characteristics were used to determine scoliosis risk factors. RESULTS In total, 331 adults fulfilled the inclusion criteria: 221 had open and 110 had closed SB. Of these, 176 (53%) had scoliosis: 57% open and 45% closed SB. As compared with individuals without scoliosis, those with scoliosis more frequently had open SB (p=0.03), more cranially located SB (p<0.0001), more severe neurological deficits (p≤0.02) and poorer walking ability (mean new FAC score 3.5 [SD 3.3] vs 6.1 [2.6], [p<0.0001]). In total, 69% had chronic back pain, with no difference in frequency between those with and without scoliosis. The odds of scoliosis was associated with asymmetrical motor level and a new FAC score <4 (odds ratio 0.46, p<0.006, and 0.75, p<0.0001, respectively). CONCLUSION About half of adults with open and closed SB had scoliosis. Back pain was frequent in those both with and without scoliosis. Individuals with low walking ability and an asymmetrical motor level should be monitored early and continuously to limit the consequences of scoliosis during their lifetime. A major issue is to determine how scoliosis evolves and to determine appropriate monitoring and treatment strategies for individuals at risk.
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Affiliation(s)
- Marine Cacioppo
- Department of Physical Medicine and Rehabilitation, Rennes University Hospital, Rennes 35033, France; Department of Physical Medicine and Rehabilitation, Brest University Hospital, 2 avenue Foch, Brest 29200, France; Laboratoire de Traitement de l'information Médicale (LaTIM), Inserm U1101, Université Bretagne Occidentale, France; Department of Paediatric Physical Medicine and Rehabilitation, Ildys Foundation, Brest 29200, France.
| | - Hélène Menard
- Centre de référence maladies rares Spina Bifida, site constitutif du centre de référence C-MAVEM, CHU Rennes, Rennes 35000, France
| | - Camille Olivari Philiponnet
- Department of Physical Medicine and Rehabilitation, Rennes University Hospital, Rennes 35033, France; Centre de référence maladies rares Spina Bifida, site constitutif du centre de référence C-MAVEM, CHU Rennes, Rennes 35000, France
| | - Estelle Le Pabic
- CIC Inserm 1414. Clinical Data Centre, Rennes University Hospital, Rennes 35033, France
| | - Charlène Brochard
- Centre de référence maladies rares Spina Bifida, site constitutif du centre de référence C-MAVEM, CHU Rennes, Rennes 35000, France; Department of Gastro-enterology, Rennes University Hospital, Rennes 35033, France
| | - Benoit Peyronnet
- Centre de référence maladies rares Spina Bifida, site constitutif du centre de référence C-MAVEM, CHU Rennes, Rennes 35000, France; Department of Urology, Rennes University Hospital, Rennes 35033, France
| | - Philippe Violas
- Centre de référence maladies rares Spina Bifida, site constitutif du centre de référence C-MAVEM, CHU Rennes, Rennes 35000, France; Department of Orthopaedic Children surgery, Rennes University Hospital, Rennes 35033, France
| | - Laurent Riffaud
- Centre de référence maladies rares Spina Bifida, site constitutif du centre de référence C-MAVEM, CHU Rennes, Rennes 35000, France; Department of Neurosurgery, Rennes University Hospital, Rennes 35033, France; INSERM MediCIS, Unit U1099 LTSI, Rennes 1 University, Rennes, France
| | - Isabelle Bonan
- Department of Physical Medicine and Rehabilitation, Rennes University Hospital, Rennes 35033, France; Centre de référence maladies rares Spina Bifida, site constitutif du centre de référence C-MAVEM, CHU Rennes, Rennes 35000, France; Unité Empenn (ex-Visages) U1228 INSERM-INRIA, IRISA UMR CNRS 6074, Campus de Beaulieu, Rennes Cedex 35042, France
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