Pain experience and pain coping strategies in children with juvenile idiopathic arthritis

Objective. To compare reactions to cold pressor pain and pain coping strate gies of patients with juvenile idiopathic arthritis (JIA), healthy children , and their parents. Methods. We studied 16 children with JIA and one of their parents and 14 he althy children and one of their parents. Patients with JIA were selected fr om the patient population by fulfilling criteria for inclusion in a "high p ain" group (n = 7) of patients with modest clinical arthritis activity, but who presented daily reports of pain in connection with everyday activities , and a "low pain" group (n = 9) who presented significant clinical arthrit is activity, but who had only a few complaints of pain related to everyday activities. Dependent variables included pain threshold, discomfort, intens ity and tolerance to cold pressor pain, and pain coping strategies. Results. Patients with JIA exhibited significantly lower mean pain toleranc e than healthy children. Disease duration correlated with both experimental and clinical pain measures, and JIA patients used significantly more Behav ioral Distraction than healthy children. Correlations were found between ch ildren's and parents' use of Approach and Distraction related coping strate gies. Correlations were also found for the coping strategy of Catastrophizi ng in the JIA patient group. For experimental pain coping strategies, a sig nificant correlation was found between the JIA patients' and their parents' use of Distraction. For the JIA patients Positive Self-statements and Beha vioral Distraction were inversely correlated with the clinical pain measure s. In both children and parents the experimental pain coping strategies of Catastrophizing and Distraction were associated with the experimental pain response measures, and low pain JIA patients tended to use more Distraction pain coping strategies than high pain patients. Conclusion. The results indicate that JIA patients may differ from healthy children with regard tc, their responses to experimental pain as well as to their use of pain coping strategies. Pain coping strategies of JIA patient s were associated with pain coping strategies of their patents, and use of pain coping strategies was associated with both experimental and clinical p ain experience.