Examining parent adverse childhood experiences as a distal risk factor in pediatric chronic pain

Disclosures: This research was supported by research funding awarded to M. Noel from the Vi Riddell Pediatric Pain Initiative, Alberta Children's Hospital Foundation and Alberta Children's Hospital Research Institute, and the Canadian Institutes of Health Research Strategy for Patient-Oriented Research 'Chronic Pain Network'. The authors report no conflicts of interest. chronic pain. Third, our sample was limited to youth with clinically-significant chronic pain; thus, results may not generalize to youth who are not receiving tertiary treatment for chronic pain either because their pain is less severe and does not require tertiary treatment or because they face barriers in accessing tertiary treatment. The current sample was also predominately White, female (with the majority of parents being mothers), and of higher socioeconomic status. Future research that examines the role of parent ACEs in pediatric chronic pain in a more diverse sample is needed to explicate the relevance of the current findings to a broader population. This was the first study to examine the relation between parent ACEs and child chronic pain in a clinical sample of youth with chronic pain. Our findings revealed that parent ACEs significantly predicted parent chronic pain status and parent depressive symptoms, but not parent anxiety symptoms, parent PTSD symptoms, or youth pain, when key sociodemographic factors were controlled. Contrary to our hypothesis, these results suggest that an intergenerational cascade from parent ACEs to parent health to child chronic pain was not present in the current sample. Further research is needed to more comprehensively examine the role of parent ACEs in the development and maintenance of child chronic pain. Specifically, research that identifies neurobiological and psychosocial mechanisms mediating a potential association is needed. Since ACEs are not deterministic of poor outcomes, with protective factors moderating the intergenerational impact of ACEs [5,76,80,90], research that identifies both risk and protective factors will be crucial for designing interventions that halt the continuation of poor health outcomes across generations.