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Journal of Pediatric Psychology, Vol. 27, No. 8, 2002, pp. 689-698
© 2002 Society of Pediatric Psychology

Social Consequences of Children's Pain: When Do They Encourage Symptom Maintenance?

Lynn S. Walker, PhD1, Robyn Lewis Claar, MS1 and Judy Garber, PhD2

1 Vanderbilt University School of Medicine, 2 Vanderbilt University

All correspondence should be sent to Lynn S. Walker, Division of Adolescent Medicine and Behavioral Science, 436 Medical Center South, Vanderbilt University School of Medicine, Nashville, Tennessee 37232-3571. E-mail: Lynn.Walker{at}mcmail.vanderbilt.edu.

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.

Key words: recurrent abdominal pain; social learning; secondary gain; perceived competence.


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