Chronic and recurrent pediatric pain brings significant medical, emotional, social, and economic consequences for children, adolescents and their families. Research has shown that health-related beliefs and treatment expectations are associated with the degree to which patients seek help, engage in and adhere to treatment recommendations, and/or become disabled. Adult patients with chronic pain who display readiness to change via a self-management approach to pain coping experience more positive outcomes. However, little is known about the pain-related beliefs and expectations that pediatric patients and their families have regarding chronic pain treatment and how this may relate to treatment course. Parents play a vital role in seeking health related services for adolescents and a biopsychosocial perspective of pain appears to be an important factor in the resolution of chronic pediatric pain. Parental beliefs about the nature of the adolescent's illness condition are associated with their reinforcement of pain and illness behavior. Greater pain reinforcement is associated with pediatric pain-related disability and this relationship is further moderated by the adolescent's symptoms of depression and anxiety. Given these findings, the proposed study will prospectively examine pain-related beliefs and treatment expectations as they relate to short term outcomes including pain, disability, and nonadherence in a sample of 100 adolescents with chronic, non-disease specific musculoskeletal pain and a parent. The project aims to characterize the nature of adolescent and parent pain-related beliefs, readiness to change, and treatment expectations; examine adolescent, parent, and adolescent-parent relationship factors associated with pain beliefs, readiness to change, and treatment expectations; and determine predictors of pain, disability and nonadherence at follow up. Based on relevant findings from the literature and preliminary studies, we hypothesize that adolescent and parent intrapersonal factors and adolescent-parent relationship factors will be associated with adolescent and parent beliefs and treatment expectations, which may in turn predict short term outcomes. These factors will be assessed through adolescent and parent self-report measures and information from the adolescent's medical chart. Hypotheses will be tested using correlations and multiple linear regression analysis. ? ? ?
