Social consequences of children's pain: when do they encourage symptom maintenance?

J Pediatr Psychol. 2002 Dec;27(8):689-98. doi: 10.1093/jpepsy/27.8.689.


Objective: To examine the influence of social factors (e.g., attention, relief from responsibility) and children's perceived competence on pediatric symptom maintenance.

Methods: Participants were 151 pediatric patients (ages 8-18) with recurrent abdominal pain. They were interviewed at a clinic visit and again 2 weeks later. The Social Consequences of Pain questionnaire assessed four types of social consequences: positive attention, negative attention, activity restriction, and privileges.

Results: Two types of social consequences (positive attention and activity restriction) predicted greater symptom maintenance, but this effect was moderated by children's perceived self-worth and academic competence. To the extent that children rated their self-worth and academic competence as low, the impact of social factors on symptom maintenance was stronger.

Conclusions: Children's success in their normal social roles may affect the extent to which they identify with the sick role and find it a rewarding alternative to other social roles.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Abdominal Pain / diagnosis*
  • Abdominal Pain / psychology*
  • Achievement
  • Adolescent
  • Attention*
  • Child
  • Cognition*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Pain Measurement
  • Self Concept
  • Social Identification
  • Social Responsibility*