Assessment and Treatment of Psychological Factors in Pediatric Chest Pain Cassandra J. McDonnell, MA a , Kamila S. White, PhD b, * ASSESSMENT AND TREATMENT OF PSYCHOLOGICAL FACTORS IN PEDIATRIC CHEST PAIN Chest pain is a common complaint among the pediatric population. Community surveys indicate that 4% to 10% of students report experiencing chest pain within the past 2 weeks, 1,2 and chest pain or discomfort is the primary complaint of 0.14% to 0.6% of patients in pediatric emergency departments. 2–6 Although most cases are not found to be associated with organic causes, chest pain may be associated with many organic diagnoses that vary widely in morbidity and mortality. 7 As such, a complaint of chest pain or discomfort by a pediatric patient raises the possibility of serious illness and often precipitates a comprehensive medical evaluation. 8 What- ever the diagnostic outcome of this evaluation, psychological assessment and treat- ment may be relevant for many patients with chest pain. For patients with causes of organic chest pain that require medical treatment, psychological interventions may facilitate lifestyle changes and adherence to treat- ment regimens. Psychologists may also assist patients and their families in coping with the stress of a troubling or uncertain prognosis. Treatment of psychological disor- ders such as depression or anxiety can make pain less burdensome and improve overall quality of life. This work was partially supported by the University of Missouri-Saint Louis by a Dissertation Fellowship (awarded to C.J.M.) and University Research Funds (awarded to K.S.W.). The authors have nothing to disclose. a Department of Psychology, University of Missouri-Saint Louis, One University Boulevard, 231 Stadler Hall, St Louis, MO 63121, USA b Department of Psychology, University of Missouri-Saint Louis, One University Boulevard, 212 Stadler Hall, St Louis, MO 63121, USA * Corresponding author. E-mail address: whiteks@umsl.edu KEYWORDS  Chest pain  Pediatric  Recurrent pain  Anxiety  Psychopathology Pediatr Clin N Am 57 (2010) 1235–1260 doi:10.1016/j.pcl.2010.09.010 pediatric.theclinics.com 0031-3955/10/$ – see front matter Ó 2010 Elsevier Inc. All rights reserved.