Date of Award


Degree Type


Degree Name

Master of Science (MS)




Katherine Kidwell

Subject Categories

Clinical Psychology | Psychology | Social and Behavioral Sciences


As many as 38% of children experience chronic pain, and of these children about 26% have a comorbid mental health diagnosis. Parents of children with a chronic health condition demonstrate elevations in stress when compared to parents with healthy children. It is likely that when chronic pain is comorbid with mental health disorders, parents may experience greater stress. Social isolation and financial burdens may be associated with parenting stress, which may be even higher in parents of children with chronic pain compared to parents of children without chronic pain. While most pediatric chronic pain literature focuses on how parenting behaviors (or “protective behaviors”) can amplify or reduce their child’s pain, less research has examined parents’ emotional needs. A better understanding of parenting efficacy, resources, and stress is needed for parents who have children with comorbid pain and internalizing mental health disorders. Using the National Survey of Children’s Health, this study examined parent-level factors that may predict stress, including social support, financial resources, and parenting efficacy, as well as child-level factors that may be associated with higher parenting stress (anxiety/depression symptom severity), with child chronic pain as a moderator to allow comparisons between parents of children with and without chronic pain. Analyses were conducted in a sample of parents of children with and without chronic pain (N = 3080, M child age = 11.7, 55.6% female, 50.1% with pain). Moderation analyses were conducted to examine if child chronic pain was a moderator of the relationships between parent-level and child mental health predictors with parenting stress as an outcome. Results indicated that lower parenting efficacy was a significant predictor of higher parenting stress (b = -1.45, SE = 0.07, t = -21.98, p < 0.001). Additionally, more severe anxiety and depression symptoms each indicated more parenting stress. Financial resources and social support were surprisingly not predictive of lower parenting stress. There was a significant main effect of chronic pain on parenting stress across models. However, chronic pain was not a significant moderator, such that parenting efficacy and child mental health were not more strongly related to parenting stress in the group of parents with children with chronic pain. Attending to children’s mental health needs and parents’ perception of their coping abilities may help improve stress for parents of children with chronic pain.


Open Access

Available for download on Friday, January 17, 2025