Abstract

Adults with chronic pain have elevated rates of suicidal ideation (SI; increased thoughts of death/dying, thinking life is not worthwhile) and suicide completion compared to the general population. However, there has been little research on pain and SI during adolescence and none with clinical samples. The aims of this study were to compare rates and identify predictors of SI in adolescents with and without chronic pain. Chronic pain patients (CPP; n =95, Mage = 15.6, SD = 2.6) from a pediatric pain management clinic and age- and sex-matched peers without chronic pain (n = 91, Mage = 15.1, SD = 2.0) from the community completed online surveys assessing pain intensity, functional disability, and psychosocial functioning. A dichotomous SI variable was coded based on SI items from the Mood and Feeling Questionnaire; a positive response on any SI item indicated the presence of SI. The frequency of SI was similar among CPP (38%) and peers (29%), χ2 (1, N = 186) = 1.81, p > .05. Simultaneous logistic regression (Nagelkerke R2 = .54) demonstrated that higher functional disability (B = .06) and loneliness (B = .10) and lower self-worth (B = -.90, p’s <.05) predicted the presence of SI in CPP. Only lower self-worth (Nagelkerke R2 = .42; B = -1.32, p < .05) predicted SI in peers. Pain intensity and family functioning were not significant predictors. Unlike adults, adolescents with chronic pain did not report SI more frequently than adolescents from the community. A different pattern of predictors emerged by group and a factor unique to chronic pain (functional disability) was associated with SI in CPP. Future investigations on suicidal behavior in youth with chronic pain and changes in SI during the transition from adolescence to adulthood are warranted. Adults with chronic pain have elevated rates of suicidal ideation (SI; increased thoughts of death/dying, thinking life is not worthwhile) and suicide completion compared to the general population. However, there has been little research on pain and SI during adolescence and none with clinical samples. The aims of this study were to compare rates and identify predictors of SI in adolescents with and without chronic pain. Chronic pain patients (CPP; n =95, Mage = 15.6, SD = 2.6) from a pediatric pain management clinic and age- and sex-matched peers without chronic pain (n = 91, Mage = 15.1, SD = 2.0) from the community completed online surveys assessing pain intensity, functional disability, and psychosocial functioning. A dichotomous SI variable was coded based on SI items from the Mood and Feeling Questionnaire; a positive response on any SI item indicated the presence of SI. The frequency of SI was similar among CPP (38%) and peers (29%), χ2 (1, N = 186) = 1.81, p > .05. Simultaneous logistic regression (Nagelkerke R2 = .54) demonstrated that higher functional disability (B = .06) and loneliness (B = .10) and lower self-worth (B = -.90, p’s <.05) predicted the presence of SI in CPP. Only lower self-worth (Nagelkerke R2 = .42; B = -1.32, p < .05) predicted SI in peers. Pain intensity and family functioning were not significant predictors. Unlike adults, adolescents with chronic pain did not report SI more frequently than adolescents from the community. A different pattern of predictors emerged by group and a factor unique to chronic pain (functional disability) was associated with SI in CPP. Future investigations on suicidal behavior in youth with chronic pain and changes in SI during the transition from adolescence to adulthood are warranted.

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