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.