The Relationship between Stressors and Pain-Related Clinical Outcomes in Pediatric Chronic Pain Patients.

Anjana Jagpal,Katherine S Salamon,Keri Hainsworth,Kim Anderson Khan,Susan T Tran,Ratka Galijot

doi:10.3390/children8010021

Abstract

Youth with chronic pain and youth who have experienced stressors are at risk for poor outcomes; however, little is known about the intersection of pain and stressors. This study aims to understand the prevalence of stressors among youth with chronic pain and the relationship between stressors and pain-related outcomes. Seven hundred and seventy youth with chronic pain aged 8–18 (Mage = 14.15 years, 70% female) reported pain characteristics, stressors, anxiety, disability, and quality of life. Most participants (82%) endorsed at least one stressor. A greater number of stressors was significantly related to greater anxiety and disability, and lower levels of quality of life. School stressors were significantly associated with functional disability; family, school, and peer stressors were significantly associated with anxiety and quality of life. Stressors are common in youth with chronic pain, and the presence of stressors is related to greater functional impairment. The results of this preliminary study using semi-structured clinical interviews suggest the importance of developing a validated measure that encompasses a wide variety of stressors for youth with pain. Future research on patient-reported stressors, relative intensity, and impact are needed.

Highlights

It is well established that youth with chronic pain suffer from functional disability and poor health-related quality of life, resulting in emotional distress and anxiety [1,2,3,4]
The current study aimed to explore the frequency and nature of stressors experienced by youth with chronic pain and examine the effects of stressors on pain-related clinical outcomes
A dose–response relationship was present across all outcomes where an increasing number of stressors was significantly associated with anxiety, functional disability, and significantly lower quality of life in youth with chronic pain

Summary

Introduction

It is well established that youth with chronic pain suffer from functional disability and poor health-related quality of life, resulting in emotional distress and anxiety [1,2,3,4]. An examination of youth with recurrent abdominal pain found that they experienced greater daily stressors than youth without pain, and that these stressors were related to greater somatic symptoms [5]. Stressors disrupt overall functioning leading to poor health-related quality of life and can negatively impact mental health [8,9]. Considering evidence that the experience of multiple stressors can negatively impact physical and mental health in an additive fashion, youth with chronic pain who experience stressors in addition to their pain may be more functionally disabled as a result

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Discussion

Conclusion