Perceptions influence pain in juvenile idiopathic arthritis

Pain beliefs in children with juvenile idiopathic arthritis (JIA) influence their longitudinal course of pain. Children who have higher pain perceptions but low disease activity levels consider themselves more disabled and damaged by their JIA and limit exercise more; these beliefs appear to be highly consistent over time.

Thastum and Herlin asked 47 children with JIA to complete the child's version of the Survey of Pain Attitudes (with subscales of control, disability, harm, and medical cure) and a 3-week pain diary at study entry (T1) and 2 years later (T2). The children's parents completed the Childhood Health Assessment Questionnaire (CHAQ), a measure of children's functional status.

Disease-related variables measured at T1 explained 40% of the variance of pain at T2. T1 cognitive beliefs predicted an additional significant 7% of the variance in T2 pain scores after controlling for T1 pain, CHAQ score, and disease activity. At T2, the high-pain group had substantially different health belief scores concerning disability and harm than the other children.

The authors noted that assessment of pain-specific beliefs and other psychological factors associated with pain may be useful in treatment of children with JIA and in identifying children who may benefit from behavioral intervention.