Browsing by Author "Birnie, Kathryn"

Now showing 1 - 5 of 5
  • Thumbnail Image
    ItemEmbargo
    Addition of Repetitive Transcranial Magnetic Stimulation to Intensive Interdisciplinary Pain Treatment for Youth with Chronic Pain
    (2024-02-09) Epp, Spencer Daniel; Miller, Jillian Vinall; Rasic, Nivez; MacMaster, Frank; Birnie, Kathryn
    Background: Pediatric chronic pain is highly prevalent. The current gold standard of treatment are Intensive Interdisciplinary Pain Treatment (IIPT) programs, providing a multimodal range of therapies over a short time frame. Repetitive transcranial magnetic stimulation (rTMS) of the middle frontal gyrus (MFG) has been shown to be a safe and effective treatment for adults with chronic pain but has not yet been used in youth chronic pain populations. Justifying the use of rTMS to the MFG and determining the safety and tolerance of this application in a pediatric population is critical to advancing pediatric chronic pain management. Methods: 20 youth with chronic pain aged 12-18 years underwent fMRI task-based neuroimaging and completed pain questionnaires before and after IIPT at the Alberta Children’s Hospital. These patients were assessed for changes in brain response to emotional stimuli following treatment in absence of rTMS, and these brain changes were compared to changes to pain interference. 15 further patients completed the IIPT program with the inclusion of rTMS as an additional therapy and were assessed for their tolerance of rTMS and attitude towards the treatment. Results: The non-rTMS group demonstrated a significant positive correlation between a reduction in pain interference and a decrease in MFG activity over the course of treatment. The rTMS group reported similar reductions in pain interference and no major adverse events. Although uncommon, headache, light-headedness, and neck pain were the most frequently reported adverse symptoms. Neck pain was the only symptom found to be consistently exacerbated by rTMS. Pre-IIPT, participants generally expected rTMS to provide great benefit, but post-IIPT reported physio- and psychotherapies as most helpful to their recovery. Conclusions: The fMRI results from the non-rTMS group help justify the use of rTMS in the IIPT. rTMS does not appear to influence established outcomes of the IIPT positively or negatively at this time, though greater sample sizes are needed for more powerful analyses. Action should be taken to minimize minor adverse symptoms during stimulation, however, rTMS is shown to be broadly safe and tolerable for this youth chronic pain population. Future analyses should focus on the magnitude and longevity of influence of rTMS on IIPT outcomes.
  • Thumbnail Image
    ItemOpen Access
    Internet-Delivered Cognitive Behavioral Treatment for Chronic Pain in Adolescent Survivors of Childhood Cancer: A Single-group Feasibility Trial
    (2024-09-20) Patton, Michaela; Schulte, Fiona; Birnie, Kathryn; Carlson, Linda; Truong, Tony; McMurtry, Meghan
    Introduction: Two-thirds of survivors of childhood cancer experience long-term side effects from treatments, like chronic pain. No pain management interventions have been tested on youth survivors of childhood cancer. Including parents in treatment and understanding parents’ own experience with pain can help improve youth outcomes. Web-based Management of Adolescent Pain (WebMAP) is an evidence-based, online intervention that includes parents, but has not yet been tested on survivors of childhood cancer. Methods: Survivors and parents were given online questionnaires about their pain. The feasibility and acceptability of WebMAP in survivors of childhood cancer and their parents was evaluated. Qualitative interviews were conducted and analyzed using inductive thematic analysis. Results: The prospective observational study found that half of survivors of childhood cancer with chronic pain have parents with chronic pain. The intervention study found that WebMAP met acceptability benchmarks but did not meet all feasibility benchmarks. Themes that emerged from qualitative interviews included “We found the program useful” and “There were areas of the program that could be improved upon”. Conclusion: Pain is prevalent in both survivors of childhood cancer and their parents. WebMAP is acceptable but not feasible in this specific subset of survivors of childhood cancer. WebMAP may be better suited for survivors whose primary concern is pain. Survivors of childhood cancer may benefit from an intervention that addresses multiple common health sequela in this population. Qualitative interviews provide helpful considerations for pediatric health interventions, more broadly.
  • Thumbnail Image
    ItemEmbargo
    Risk and Resilience: The Role of Parent Functioning in Pediatric Chronic Pain
    (2024-09-10) Beveridge, Jaimie; Noel, Melanie; Birnie, Kathryn; Madigan, Sheri; Orr, Serena
    Objective: Pediatric chronic pain is prevalent and can significantly interfere with children’s physical, emotional, social, and educational functioning. Parent factors have been shown to play an important role in children’s chronic pain; however, research has predominately focused on parent responses to child pain to the exclusion of parents’ own functioning (i.e., their physical and mental health). The broad aim of this dissertation was to examine the association between parent functioning, specifically their own chronic pain and mental health symptoms, and child chronic pain using a multi-method approach. Methods: Three studies were conducted. The first study was a systematic review and meta-analysis of the extant literature examining associations between parent mental health and children’s chronic pain and related functioning in both clinical and community samples. The second study used daily diary data from a clinical sample of 76 youth referred to a tertiary pain program and one of their parents to examine the associations between parent chronic pain status, parent daily variability (in their anxiety, mood, protective responses, and parenting stress), and youth daily pain intensity and interference. The third study used data from 1128 mother-child dyads enrolled in a longitudinal, community-based cohort study to identify risk and resilience factors throughout childhood that moderated the intergenerational transmission of chronic pain. Results: Poorer functioning (i.e., chronic pain and/or mental health problems) in parents was significantly associated with the presence of chronic pain in community samples of children as well as the pain-related functioning of clinical samples of children with chronic pain. Parent chronic pain and mental health symptoms were related to children’s chronic pain and functioning in distinct as well as interacting ways. Several general parent and child factors were found to contribute to the association between parent functioning and child chronic pain, either increasing or decreasing the strength of the association, including ineffective parenting practices, child optimism, and child connections with adults. Conclusions: Parent functioning plays an important role in pediatric chronic pain, increasing children’s risk for poor adaptation to chronic pain, and should be more widely considered in research and clinical interventions for pediatric chronic pain.
  • Thumbnail Image
    ItemOpen Access
    Social factors associated with self-reported changes in mental health symptoms among youth in the COVID-19 pandemic: a cross-sectional survey
    (2024-02-28) Moss, Stephana J.; Stelfox, Maia; McArthur, Eric; Sriskandarajah, Cynthia; Ahmed, Sofia B.; Birnie, Kathryn; Halperin, Donna M.; Halperin, Scott A.; Harley, Micaela; Hu, Jia; Kamstra, Josh N.; Leppan, Laura; Nickel, Angie; Racine, Nicole; Russell, Kristine; Smith, Stacie; Solis, May; Tutelman, Perri R.; Stelfox, Henry T.; Fiest, Kirsten M.; Parsons Leigh, Jeanna
    Abstract Background Children and youth experienced marked impacts on day-to-day life in the COVID-19 pandemic that were associated with poorer familial and friend relationships, and greater mental health challenges. Few studies provide self-report data on mental health symptoms from children and youth themselves. We sought to examine the associations between social factors and child and youth self-reported symptoms of worsened mood, anxiety, and irritability during the COVID-19 pandemic. Methods A nationally representative cross-sectional survey was administered online to collect self-report data across 10 Canadian provinces among children (11–14 years) and youth (15–18 years), April–May 2022. Age-appropriate questions were based on The Partnership for Maternal, Newborn & Child Health and the World Health Organization of the United Nations H6 + Technical Working Group on Adolescent Health and Well-Being consensus framework and the Coronavirus Health and Impact Survey. Associations between a priori defined social factors (e.g., relationship quality) and respondent self-reported mental health were evaluated using ordinal logistic regression models adjusted for age, sex, and geographic location. Results We analyzed data from 483 (51.7%) children (11–14 years; 227, 47.0% girls) and 450 (48.3%) youth (15–18 years; 204, 45.3% girls). The parents of most children and youth had resided in Canada for over 20 years (678, 72.7%). Over one-quarter of children and youth self-identified as Black, Indigenous, or a Person of Color (134, 27.7%; 134, 29.8%, respectively). Over one-third of children and youth self-reported symptoms of worsened mood (149, 30.9%; 125, 27.8%, respectively), anxiety (181, 37.5%; 167, 37.1%, respectively), or irritability (160, 33.1%; 160, 35.6%, respectively) during, compared to pre-pandemic. In descending order of odds ratios (OR), for children and youth, worsened familial relationships (during compared to pre-pandemic) was associated with the self-reported symptoms of worsened mood (child: OR 4.22, 95%CI 2.51–6.88; youth: OR 6.65 95%CI 3.98–11.23), anxiety (child: OR 4.24, 95%CI2.69–6.75; youth: OR 5.28, 95%CI 3.17–8.86), and irritability (child: OR 2.83, 95%CI 1.76–4.56; youth: OR 6.46, 95%CI 3.88–10.90). Conclusions Self-reported data from a nationally representative sample of children and youth suggest strong associations between social factors and mental health during the COVID-19 pandemic. Interventions targeting child and youth familial relationships may positively impact child and youth mental health.
  • Thumbnail Image
    ItemOpen Access
    Testing Bidirectional Effects between Maternal and Child Depression During Middle Childhood
    (2024-09-18) Hewitt, Jackson; Madigan, Sheri; McArthur, Brae Anne; Yeates, Keith; Birnie, Kathryn; Kopala Sibley, Daniel
    Background: To date, the understanding of depression within families has primarily focused on a single direction, from parents to children. Extensive research has focused on this perspective, leading to the development of various hypotheses, such as the spillover hypothesis and the intergenerational transmission of depression. These unidirectional hypotheses suggest that parent depression influences the development of child depression. More recently, a new hypothesis has emerged – child evocative effects. This hypothesis proposes that there are more bidirectional and dynamic interactions within the family unit, wherein children can also influence parents’ depression. Objectives: Using a prospective pregnancy cohort, we tested both potentially co-occurring phenomena. First, we tested the potential bidirectional effects of mother and child depressive symptoms across four waves of data during the middle childhood period. Second, we tested whether child sex and family socioeconomic status moderated associations. Methods: This study was based on data from 1801 mothers and children from the All Our Families cohort from Calgary, Alberta. Maternal and child depression and demographic information was assessed through validated self-report measures of depressive symptoms at four timepoints (Time 1: Spring 2020, child age 9.66 years; Time 2: Spring 2021, child age 10.40 years; Time 3: Fall-Winter 2021-2022, child age 11.08 years, and Time 4: Winter 2023, child age 12.82 years). Child sex and family socioeconomic status was reported by mothers at Time 1. Results: Results of a random-intercept cross-lagged panel analysis revealed that child depression at Time 1 predicted higher maternal depression at Time 2 (β = .12; 95% CI .02, .22). Additionally, child depression at Time 2 predicted higher maternal depression at Time 3 (β = .17; 95% CI .07, .26). The obverse association was not supported. Child sex and family socioeconomic status did not moderate associations. Conclusions: Contrary to conventional theorizing, we found evidence for child-evocative effects but not maternal spillover effects of depressive symptoms. Our study sheds light on the nuances of how depression potentially develops within families and challenges conventional theorizing of a unidirectional spillover from caregiver to child depression. It establishes a framework for future research to incorporate bidirectional and potentially transactional relationships when considering depression transmission within families. Furthermore, it emphasizes the need to incorporate the complex dynamics of family interactions into prevention and intervention efforts.