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Thirty-one percent of youth and 28% of parents experienced DU. Seventy percent of parents and youth were in agreement regarding their experience of DU. Youth DU was linked to higher youth catastrophic thinking about their pain. Parent DU was linked to greater youth pain interference and intensity and lower youth HRQoL. Diagnostic uncertainty is experienced by nearly a third of youth with chronic pain and their parents and is linked to worse youth pain, pain catastrophizing, and HRQoL. Diagnostic uncertainty is experienced by nearly a t