517: Family Profiles Differentiate Risk for Intergenerational Transmission of Irritable Bowel Syndrome

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Chronic primary visceral / pelvic pain, Psychology, Pain in special populations (e.g. neonates, children, teens, elderly, neurodegenerative diseases)

Background and Aims: Children are at increased risk of developing irritable bowel syndrome (IBS) if a parent has IBS, suggesting mechanisms of intergenerational transmission within the family. However, patterns of family factors that predict risk in early childhood, prior to when symptoms typically emerge, have not been identified. In a sample of parents with IBS and their young children without chronic abdominal pain, this study aimed to identify subgroups representing different constellations of family factors. We also tested subgroup differences on two outcomes associated with children’s risk for developing IBS: child emotional functioning and parental protectiveness towards children’s pain.

Methods: Baseline data from 194 parents with IBS (M age = 39.1) and their 4–7-year-old child (M age = 5.5) without chronic abdominal pain participating in a randomized controlled trial testing a preventative behavioral intervention were included. Latent profile analysis identified subgroups from family variables including socioeconomic status (SES; family income, parent education), pain burden (household members with chronic pain, parent IBS symptom severity), family functioning (family resilient coping, social support), parental psychological functioning (pain catastrophizing, anxiety, depression, positive affect), and parenting stress. Wald tests examined mean differences between subgroups on risk outcomes: child emotional functioning and parental protectiveness.

Results: A four-group solution fit best. Group 1 (8%) reported low SES, moderate pain burden, and mixed parent psychological and family functioning (some functioning variables were low, others high). Group 2 (28%) reported high SES, high pain burden, and low parental psychological and family functioning. Group 3 (52%) reported high SES, low pain burden, and high parental psychological and family functioning. Group 4 (12%) reported low SES, high pain burden, mixed family functioning, and low parental psychological functioning, including highest pain catastrophizing. Child emotional functioning was lower in Group 2 than other groups; parental protectiveness was higher in Group 4 than Group 3.

Conclusions: Results highlight heterogeneity among families experiencing parental IBS and suggest distinct mechanisms may confer risk for intergenerational transmission of pain within different subgroups. Findings extend prior research demonstrating that parental protectiveness may be important in intergenerational transmission of pain. Early identification of family factors like high pain burden, low parental psychological functioning and high pain catastrophizing may differentiate IBS parents with increased protectiveness and inform targeted prevention in adult patients with chronic pain, which has strong potential to interrupt intergenerational transmission of pain. Future analyses will follow families longitudinally to examine child pain outcomes and response to intervention across subgroups.

References: Jones, M. P., Faresjö, Å., Beath, A., Faresjö, T., & Ludvigsson, J. (2020). Abdominal Pain in Children Develops With Age and Increases With Psychosocial Factors. Clinical Gastroenterology and Hepatology, 18(2), 360-367.e1. https://doi.org/10.1016/j.cgh.2019.04.036.

Levy, R. L., Murphy, T. B., van Tilburg, M. A. L., Kuklinski, M. R., Bailey, J. A., Aalfs, H., Badillo, I., Diakhate, H., & Palermo, T. M. (2024). Protocol for a randomized controlled trial of an internet-based prevention intervention for young children at-risk for functional abdominal pain. Trials, 25(1), 549. https://doi.org/10.1186/s13063-024-08371-8.

Levy, R. L., Whitehead, W. E., Walker, L. S., Von Korff, M., Feld, A. D., Garner, M., & Christie, D. (2004). Increased Somatic Complaints and Health-Care Utilization in Children: Effects of Parent IBS Status and Parent Response to Gastrointestinal Symptoms. Official Journal of the American College of Gastroenterology | ACG, 99(12), 2442.

Stone, A. L., & Wilson, A. C. (2016). Transmission of risk from parents with chronic pain to offspring: An integrative conceptual model. Pain, 157(12), 2628–2639. https://doi.org/10.1097/j.pain.0000000000000637.

Presenting Author: Francesca R. Querdasi
Submitting Author: Francesca Querdasi

Senior Author: Tonya Palermo

IASP 2026 Global Year theme of Neuropathic Pain: No

• Francesca R. Querdasi: PhD - Seattle Children’s Research Institute / University of Washington
• Caitlin Murray: PhD - Seattle Children’s Research Institute / University of Washington
• Peyton Johnson: BA - Seattle Children’s Research Institute / University of Washington
• Rona L. Levy: PhD - University of Washington
• Tasha B. Murphy: PhD - University of Washington
• Miranda van Tilburg: PhD - University of North Carolina at Chapel Hill / Cape Fear Valley Medical Center
• Margaret Kuklinski: PhD - University of Washington
• Jennifer Bailey: PhD - University of Washington
• Hafsah Diakhate: BA - Seattle Children's Research Institute
• Kristen Daniels: BA - Seattle Children's Research Institute
• Isabel Badillo: BA - Seattle Children's Research Institute
• Tonya Palermo: PhD - Seattle Children’s Research Institute / University of Washington