Topical Review: Perfectionism and Pediatric Chronic Pain: Theoretical Underpinnings, Assessment, and Treatment.

Objective: To use the biopsychosocial model and current literature to clarify conceptual underpinnings between chronic pain and perfectionism in youth, provide recommendations for assessment and treatment of co-existing perfectionism and chronic pain conditions, and suggest a research agenda.

Methods: Current literature is used to identify biopsychosocial factors common between pediatric chronic pain and perfectionism, preliminary research findings are presented, and suggestions are made for research that will help inform inclusion and adaptations of assessment tools and interventions to address perfectionism.

Results: Biopsychosocial factors that may contribute to the observed relationship between chronic pain and perfectionism seen in many youth are identified. For example, cognitive factors known to be associated with perfectionism (e.g., rumination) may also contribute to pain-related catastrophizing and disability. Biopsychosocial factors may serve as mediating variables between perfectionism and pain-related outcomes among youth with chronic pain and their parents.

Conclusions: Research assuming a biopsychosocial perspective is needed to clarify observed links between chronic pain and perfectionism in youth. Findings related to the characterization of perfectionism in pediatric chronic pain will inform how assessment and treatment tools can better identify and address perfectionism.