Adolescent chronic pain-related functioning: concordance and discordance of mother-proxy and self-report ratings

Accurate assessment of adolescent chronic pain is critical to guiding treatment decisions. Given the multifaceted role of the parents in their children's lives, parents, and patients often each provide reports of adolescents' pain-related functioning. In order to make sense of these data, clinicians should be aware of patterns of discordance in perspectives. In this study, we aimed to examine concordance and discordance in adolescents' self-report and mothers' proxy-report of adolescents' chronic pain-related functioning. Results suggested that although there were high correlations between the raters, there were also significant discordance with mothers rating their adolescents as having greater disability in social functioning, depression, and pain-specific anxiety. Analyses suggested that high pain and being older predicted greater concordance in ratings. Findings suggest that mothers and adolescents tended to have greater concordance for more observable and shared disability (e.g., physical disability, family functioning) and greater discordance for internal experiences (e.g., pain-specific anxiety, depression). Awareness of these patterns of concordance and discordance should help clinicians in interpreting mothers' proxy-reports and adolescents' self-reports of chronic pain-related functioning.