Anesthesiology and Critical Care Medicine, The Children’s Hospital of Philadelphia

Objective Examine whether the relation between protective parenting responses to pain and functional disability is mediated by pain catastrophizing in adolescents with chronic musculoskeletal pain and their parents over time. Methods Adolescents aged 11–18 years and their parents reported on parental protective responses to pain (PPRP), pain catastrophizing scale (PCS), and Functional Disability Inventory (FDI) before Time 1 (T1) and 2 months after Time 2 (T2) an initial interdisciplinary pain clinic evaluation. Results PCS was a significant mediator of the PPRP–FDI relationship at T1 and T2 for the ad-olescents and T2 for their parents. A decrease in PPRP over time was associated with T2 PCS, which in turn was associated with T2 FDI for adolescents and their parents. Conclusion Parental protectiveness is asso-ciated with disability indirectly through pain catastrophizing at the initial visit and follow-up. Decreases in parent protectiveness, potentially initiated through the initial evaluation, were related to lower levels of dis-ability at follow-up through pain catastrophizing. Key words adolescents; catastrophizing; disability; pain. Chronic pain affects 25–30 % of children in the United States (Perquin et al., 2000; Zeltzer, Tsao, Bursch, & Myers, 2006). Chronic pain is generally defined as pai