Elsevier

The Journal of Pain

Volume 16, Issue 1, January 2015, Pages 31-41
The Journal of Pain

Original Report
A Developmental Analysis of the Factorial Validity of the Parent-Report Version of the Adult Responses to Children's Symptoms in Children Versus Adolescents With Chronic Pain or Pain-Related Chronic Illness

https://doi.org/10.1016/j.jpain.2014.10.005Get rights and content
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Highlights

  • Findings revealed developmental differences in the factor structure of the Adult Responses to Children's Symptoms.

  • A 4-factor model fit the data best for children and the 2 groups combined.

  • A 5-factor model fit the data best for adolescents.

Abstract

The widely used Adult Responses to Children's Symptoms measures parental responses to child symptom complaints among youth aged 7 to 18 years with recurrent/chronic pain. Given developmental differences between children and adolescents and the impact of developmental stage on parenting, the factorial validity of the parent-report version of the Adult Responses to Children's Symptoms with a pain-specific stem was examined separately in 743 parents of 281 children (7–11 years) and 462 adolescents (12–18 years) with chronic pain or pain-related chronic illness. Factor structures of the Adult Responses to Children's Symptoms beyond the original 3-factor model were also examined. Exploratory factor analysis with oblique rotation was conducted on a randomly chosen half of the sample of children and adolescents as well as the 2 groups combined to assess underlying factor structure. Confirmatory factor analysis was conducted on the other randomly chosen half of the sample to cross-validate factor structure revealed by exploratory factor analyses and compare it to other model variants. Poor loading and high cross-loading items were removed. A 4-factor model (Protect, Minimize, Monitor, and Distract) for children and the combined (child and adolescent) sample and a 5-factor model (Protect, Minimize, Monitor, Distract, and Solicitousness) for adolescents was superior to the 3-factor model proposed in previous literature. Future research should examine the validity of derived subscales and developmental differences in their relationships with parent and child functioning.

Perspective

This article examined developmental differences in the structure of a widely used measure of caregiver responses to chronic pain or pain-related chronic illness in youth. Results suggest that revised structures that differ across developmental groups can be used with youth with a range of clinical pain-related conditions.

Key words

Pediatric pain
parental behaviors
chronic pain
children
adolescents
Adult Responses to Children's Symptoms
factor analysis

Cited by (0)

M.N. is funded by a Post-PhD Fellowship Award from the Canadian Institutes of Health Research and is a trainee member of Pain in Child Health, a Strategic Training Initiative in Health Research of the Canadian Institutes of Health Research. Funding for this research was provided by NIH grants awarded to T.M.P. (R01 HD062538 and K24 HD060068), R.L.L. (R01 HD050345; R01 HD036069), and L.S.W. (R01 HD23264).

The authors have no conflicts of interest to disclose.