Parental chronic pain and internalizing symptoms in offspring: the role of adolescents’ social competence – the HUNT study

Jannike Kaasbøll,1,2 Stian Lydersen,2 Ingunn Ranøyen,2,3 Wendy Nilsen,4 Marit S Indredavik2,3 1Department of Health Research, SINTEF, Trondheim, Norway; 2Department of Mental Health, Faculty of Medicine and Health Sciences, Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Norwegian University of Science and Technology (NTNU), Trondheim, Norway; 3Department of Children and Youth, Division of Mental Health Care, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; 4The Work Research Institute, OsloMet – Oslo Metropolitan University, Oslo, Norway Background: A growing body of research suggests that the children of parents with chronic pain are at risk for internalizing symptoms. The mechanisms of such associations have not been as thoroughly examined. The aim of the present study was to investigate whether adolescents’ social competence mediates the association between parental chronic pain and offspring internalizing symptoms as well as whether these associations are moderated by adolescent gender. Methods: The current study was based on cross-sectional data from the Nord-Trøndelag Health Study (HUNT 3), a Norwegian population-based health survey conducted in 2006–2008. The present sample comprised adolescents who had both parents participating (n=9,681). Structural equation modeling was used for the data analysis. Results: Our results indicated that the association between concurrent maternal and paternal chronic pain and offspring’s symptoms of anxiety and depression was partly mediated by low social competence for girls (b(SE)=0.060 [0.030], P=0.043) but not for boys (b(SE)=−0.059 [0.040], P=0.146). This suggests that these associations are moderated by offspring gender. Conclusion: The study extends the existing literature on the possible pathways between parental chronic pain and internalizing symptoms in the offspring. Identifying protective factors in the pathways between parental chronic pain and mental distress in children could guide measures that promote the wellbeing of the child and family of chronic pain sufferers. Keywords: chronic pain, adolescents, social competence, anxiety, depression, sex differences