(163) - Alexithymia in adolescents with and without chronic pain

Abstract

Alexithymia refers to a deficit in emotional awareness and is elevated in adults with chronic pain, and associated with greater pain interference and pain-related affective distress. Prior studies demonstrate that depression and anxiety symptoms partially account for elevated levels of alexithymia in adults with compared to without chronic pain. However, limited research has examined alexithymia in adolescents with chronic pain compared to healthy adolescents, or how alexithymia relates to pain characteristics. The current study compares alexithymia in adolescents with and without chronic pain, assesses whether depression and anxiety contribute to group differences, and examines associations between alexithymia and pain characteristics. Forty-four adolescents, ages 14–17 years, 22 with chronic pain (from an interdisciplinary pain clinic) and 22 healthy controls participated. Adolescents completed the Toronto Alexithymia Scale (TAS-20), comprised of 3 subscales: difficulty identifying feelings (DIF), difficulty describing feelings (DDF) and externally-oriented thinking (EOT); PROMIS depression and anxiety scales, and ratings of pain intensity, pain bothersomeness, and pain interference (0–10 NRS). We found that TAS-20 total (F(1, 42) = 4.54, p = .039) and DIF (F(1, 42) = 12.33, p = .001) were higher in adolescents with chronic pain compared to healthy controls. In subsequent ANCOVA analysis, there was no effect of depression, anxiety or age on group differences. Pain bothersomeness (r = .56, p = .001) and pain interference were positively correlated with DIF (r = .56, p < .001). Pain interference was also associated with TAS-20 Total (r = .41, p = .03). Pain intensity was not related to TAS-20 scores. The current study suggests adolescents with chronic pain have elevated alexithymia, particularly difficulty identifying feelings, even when accounting for depression and anxiety symptoms. Consistent with adult literature, alexithymia (particularly DIF) was associated with greater pain interference and bothersomeness, but not with pain intensity. Future research is needed on larger samples and using longitudinal designs to better understand relationships between alexithymia, depression and anxiety in adolescents with chronic pain.