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Mundal I, Schei J, Lydersen S, Thomsen PH, Nøvik TS, Kvitland LR. Prevalence of chronic and multisite pain in adolescents and young adults with ADHD: a comparative study between clinical and general population samples (the HUNT study). Eur Child Adolesc Psychiatry 2024; 33:1433-1442. [PMID: 37386203 PMCID: PMC11098922 DOI: 10.1007/s00787-023-02249-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 06/19/2023] [Indexed: 07/01/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) and chronic pain are prevalent and associated. We examined the prevalence and distribution of chronic pain in adolescents and young adults with ADHD using 9-years longitudinal data (from T1:2009-2011 to T3:2018-2019) with three time points from a clinical health survey compared to two age-matched reference population-based samples. Mixed-effect logistic regression and binary linear regression were used to estimate the probability for chronic and multisite pain at each time point and to compare the prevalence of chronic pain with the reference populations. The prevalence of chronic and multisite pain was high in those with ADHD, especially in female young adults, with highly prevalent chronic pain at 9 years of follow-up (75.9%) compared to 45.7% in females in the reference population. The probability of having pain was only statistically significant for chronic pain in males at 3 years of follow-up (41.9%, p = 0.021). Those with ADHD were at higher risk of reporting single-site and multisite pain compared to the general population at all measurement points. Longitudinal studies should be tailored to further understand the complex sex differences of comorbid chronic pain and ADHD in adolescents, exploring predictive factors of pain assessing long-term associations with bodyweight, psychiatric comorbidities, and possible mechanisms of stimulant use effects on pain.
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Affiliation(s)
- Ingunn Mundal
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
- Department of Health and Social Sciences, Molde University College, Molde, Norway.
- Kristiansund Community Mental Health Centre, Division of Psychiatry, Møre and Romsdal Hospital Trust, Kristiansund, Norway.
| | - Jorun Schei
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Stian Lydersen
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Per Hove Thomsen
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Psychiatry, Aarhus N, Denmark
| | - Torunn Stene Nøvik
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Levi R Kvitland
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- St. Olavs University Hospital, Trondheim, Norway
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2
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Fernández-León P, Lima-Serrano M, Gil-García E, Cáceres-Matos R. Alcohol use among children and adolescents with chronic pain. Scoping review. ENFERMERIA CLINICA (ENGLISH EDITION) 2024; 34:130-140. [PMID: 38484935 DOI: 10.1016/j.enfcle.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 01/28/2024] [Indexed: 04/21/2024]
Abstract
AIM To examine and map alcohol consumption in children and adolescents with chronic pain (CP). METHOD A scoping review of international databases (CINAHL, WOS, PubMed, PsycINFO, Scopus, Embase, and MEDLINE) and grey literature was conducted between September 2022 and February 2023. Documents addressing the relationship between alcohol consumption and CP in children and adolescents, published in English and Spanish between 2012 and 2023, were included. Those papers with a population suffering from CP derived from neurodegenerative diseases, chronic infectious diseases or cognitive impairment were excluded. We assessed the level of evidence (LE) and the degree of recommendation (DR) of the studies included in accordance with the Scottish Intercollegiate Guidelines Network. Finally, 11 documents were considered out of the 479 reviewed. RESULTS The relationship between substance consumption and CP in adolescents is a scarcely investigated topic. While there is a trend towards lower rates of alcohol consumption in youth with pain, there is evidence suggesting an association, particularly in cases of intense pain. The use of various substances, both legal and illegal, for pain management underscores the importance of comprehensively addressing this phenomenon in this population. CONCLUSIONS Further research is needed to assess the relationship between alcohol consumption in children and adolescents with CP.
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Affiliation(s)
- Pablo Fernández-León
- Grupo de Investigación PAIDI-CTS 969 Innovación en Cuidados y Determinantes Sociales en Salud, Departamento de Enfermería, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, Spain.
| | - Marta Lima-Serrano
- Grupo de Investigación PAIDI-CTS 969 Innovación en Cuidados y Determinantes Sociales en Salud, Departamento de Enfermería, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, Spain
| | - Eugenia Gil-García
- Grupo de Investigación PAIDI-CTS 1050 Cuidados Complejos, Cronicidad y Resultados en Salud, Departamento de Enfermería, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, Spain
| | - Rocío Cáceres-Matos
- Grupo de Investigación PAIDI-CTS 1050 Cuidados Complejos, Cronicidad y Resultados en Salud, Departamento de Enfermería, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, Spain
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3
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Secci ME, Kelley LK, Avegno EM, Holmgren EB, Chen L, Rein SL, Engi SA, Quinlan V, Wilson L, Gilpin NW, Wills TA. Adolescent Alcohol Exposure Produces Sex-Specific Long-term Hyperalgesia via Changes in Central Amygdala Circuit Function. Biol Psychiatry 2024; 95:207-219. [PMID: 37717844 PMCID: PMC10866691 DOI: 10.1016/j.biopsych.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 08/31/2023] [Accepted: 09/04/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND Exposure to alcohol during adolescence produces many effects that last well into adulthood. Acute alcohol use is analgesic, and people living with pain report drinking alcohol to reduce pain, but chronic alcohol use produces increases in pain sensitivity. METHODS We tested the acute and lasting effects of chronic adolescent intermittent ethanol (AIE) exposure on pain-related behavioral and brain changes in male and female rats. We also tested the long-term effects of AIE on synaptic transmission in midbrain (ventrolateral periaqueductal gray [vlPAG])-projecting central amygdala (CeA) neurons using whole-cell electrophysiology. Finally, we used circuit-based approaches (DREADDs [designer receptors exclusively activated by designer drugs]) to test the role of vlPAG-projecting CeA neurons in mediating AIE effects on pain-related outcomes. RESULTS AIE produced long-lasting hyperalgesia in male, but not female, rats. Similarly, AIE led to a reduction in synaptic strength of medial CeA cells that project to the vlPAG in male, but not female, rats. Challenge with an acute painful stimulus (i.e., formalin) in adulthood produced expected increases in pain reactivity, and this effect was exaggerated in male rats with a history of AIE. Finally, CeA-vlPAG circuit activation rescued AIE-induced hypersensitivity in male rats. CONCLUSIONS Our findings are the first, to our knowledge, to show long-lasting sex-dependent effects of adolescent alcohol exposure on pain-related behaviors and brain circuits in adult animals. This work has implications for understanding the long-term effects of underage alcohol drinking on pain-related behaviors in humans.
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Affiliation(s)
- Maria E Secci
- Department of Physiology, Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana
| | - Leslie K Kelley
- Department of Physiology, Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana
| | - Elizabeth M Avegno
- Department of Physiology, Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana; Alcohol and Drug Abuse Center of Excellence, Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana
| | - Eleanor B Holmgren
- Department of Anatomy and Cell Biology, Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana
| | - Lily Chen
- Department of Anatomy and Cell Biology, Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana
| | - Sydney L Rein
- Department of Anatomy and Cell Biology, Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana
| | - Sheila A Engi
- Department of Anatomy and Cell Biology, Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana
| | - Virginia Quinlan
- Department of Physiology, Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana
| | - Lisa Wilson
- Department of Anatomy and Cell Biology, Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana
| | - Nicholas W Gilpin
- Department of Physiology, Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana; Neuroscience Center of Excellence, Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana; Alcohol and Drug Abuse Center of Excellence, Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana; Veterans Affairs Southeast Louisiana Healthcare System, New Orleans, Louisiana
| | - Tiffany A Wills
- Department of Anatomy and Cell Biology, Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana; Alcohol and Drug Abuse Center of Excellence, Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana.
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Petrini L, Arendt-Nielsen L. Pain catastrophizing in the elderly: An experimental pain study. Scand J Pain 2024; 24:sjpain-2023-0035. [PMID: 38452201 DOI: 10.1515/sjpain-2023-0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 11/29/2023] [Indexed: 03/09/2024]
Abstract
OBJECTIVES Pain catastrophizing in the aging population has not been studied in great detail. Existing investigations have reported conflicting results on the effects of age on pain catastrophizing in relation to pain responses. This study investigated the relationship between pain catastrophizing, and its individual components (rumination, magnification, and helplessness), and the responses to standardized experimental pain stimuli in old and young, healthy adults. METHODS Sixty-six volunteers (32 old: 65-87, 18 females; 34 young: 20-35, 17 females) participated in the study. Pain catastrophizing including the components of rumination, magnification, and helplessness was assessed with the pain catastrophizing scale (PCS). Experimental pain was induced by applying predefined pressure stimulations to the trapezius muscle. Pain intensity and unpleasantness were assessed using numerical rating scales. Pain catastrophizing levels and pain responses were statistically compared between the two age groups. RESULTS Elderly individuals reported significantly (p = 0.028) lower scores of pain catastrophizing (Med = 5; interquartile range [IQR] = 14) than younger individuals; this difference was driven by the significantly lower components of rumination (Med = 2; IQR = 4; p = 0.017) and helplessness (Med = 2; IQR = 7; p = 0.049). A larger proportion of young (57.8%) rated pain catastrophizing at high levels, with scores above the 75th percentile (Med = 20). Additionally, elderly reported the lowest pain intensity (Med = 5; p = 0.034) and pain unpleasantness (Med = 4.5; p = 0.011) responses to the experimental pressure stimuli. In the elderly group, pain unpleasantness was positively and significantly associated with pain catastrophizing (r s = 0.416, p = 0.021), rumination (r s = 0.42, p = 0.019), and helplessness (r s = 0.434, p = 0.015), respectively. No associations were found in the young group. CONCLUSIONS Elderly reported lower PCSs than young adults. Rumination and helplessness were reduced in the elderly group. The elderly population showed positive correlations between catastrophizing levels and pain unpleasantness to standardized pressure pain stimuli. Results supported the view that elderly possess resilience over specific domains of pain catastrophizing that could counteract pain perception due to physiological decline.
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Affiliation(s)
- Laura Petrini
- Center for Neuroplasticity and Pain (CNAP), SMI, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Selma Lagerløfs Vej 249, DK-9220, Aalborg, Denmark
| | - Lars Arendt-Nielsen
- Center for Neuroplasticity and Pain (CNAP), SMI, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Selma Lagerløfs Vej 249, DK-9220, Aalborg, Denmark
- Department of Gastroenterology & Hepatology, Mech-Sense, Clinical Institute, Aalborg University Hospital, Selma Lagerløfs Vej 249, DK-9220, Aalborg, Denmark
- Steno Diabetes Center North Denmark, Clinical Institute, Aalborg University Hospital, Aalborg, Denmark
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Boileau NR, Thompson-Phillips KA, Goodin BR, Lynch-Milder MK, Evans CT, Adetayo T, Rudolph AF, Stoll ML, Weiser P, Fobian AD, Gowey MA, Wakefield EO. Pain-Related Stigma and Its Associations With Clinical and Experimental Pain Severity in Youth With Chronic Musculoskeletal Pain Conditions. J Pediatr Psychol 2023; 48:842-851. [PMID: 37500594 PMCID: PMC10588972 DOI: 10.1093/jpepsy/jsad048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 07/12/2023] [Accepted: 07/18/2023] [Indexed: 07/29/2023] Open
Abstract
OBJECTIVE Many children with chronic musculoskeletal pain conditions experience stigma which can have negative downstream consequences. This study compares ratings of clinical pain (current pain intensity and pain interference), experimental pain (temporal summation, cold water tolerance, and cold pain intensity), and pain-related stigma among three groups of youth with rheumatic conditions. The relations among ratings of pain-related stigma and pain variables were explored. METHODS Eighty-eight youth aged 8-17 years with a diagnosis of juvenile idiopathic arthritis (JIA = 32), juvenile fibromyalgia (JFM = 31), or non-specific chronic pain (NSCP = 25) completed measures of clinical pain ratings (average 7-day pain intensity, day of assessment pain (DoA), and pain interference), experimental pain (cold pain tolerance, cold pain intensity, and temporal summation of mechanical pain), and pain-related stigma. Data analysis compared pain-related stigma and pain ratings across the three groups and examined the relations among pain-related stigma and pain ratings. RESULTS Youth with JFM reported higher ratings of clinical pain and pain-related stigma than their counterparts with NSCP or JIA. However, there were no differences in experimental pain. Pain-related stigma was associated with greater ratings of pain interference, particularly for those with JIA and NSCP. Pain-related stigma was also associated with greater average daily pain intensity but not DoA. CONCLUSION Youth with medically unexplained pain report greater stigma and worse pain than their peers; thus, robust assessment of pain in this population is necessary. Future work should longitudinally explore the impact of pain-related stigma on pain outcomes and treatment responses.
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Affiliation(s)
| | | | - Burel R Goodin
- Department of Psychology, University of Alabama at Birmingham, USA
- Department of Anesthesiology, Washington University in St. Louis, USA
| | | | - Corinne T Evans
- Department of Psychology, University of Alabama at Birmingham, USA
| | - Tolulope Adetayo
- Department of Psychology, University of Alabama at Birmingham, USA
| | | | - Matthew L Stoll
- Department of Pediatrics, Division of Pediatric Rheumatology, University of Alabama at Birmingham, USA
| | - Peter Weiser
- Department of Pediatrics, Division of Pediatric Rheumatology, University of Alabama at Birmingham, USA
| | - Aaron D Fobian
- Department of Psychiatry & Behavioral Neurobiology, University of Alabama at Birmingham, USA
| | - Marissa A Gowey
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, & Nutrition, University of Alabama at Birmingham, USA
| | - Emily O Wakefield
- Division of Pain and Palliative Medicine, Connecticut Children’s Medical Center, USA
- Division of Pediatric Psychology, Connecticut Children’s Medical Center, USA
- Department of Pediatrics, University of Connecticut School of Medicine, USA
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Salazar-Méndez J, Núñez-Cortés R, Suso-Martí L, Ribeiro IL, Garrido-Castillo M, Gacitúa J, Mendez-Rebolledo G, Cruz-Montecinos C, López-Bueno R, Calatayud J. Dosage matters: Uncovering the optimal duration of pain neuroscience education to improve psychosocial variables in chronic musculoskeletal pain. A systematic review and meta-analysis with moderator analysis. Neurosci Biobehav Rev 2023; 153:105328. [PMID: 37516218 DOI: 10.1016/j.neubiorev.2023.105328] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/13/2023] [Accepted: 07/25/2023] [Indexed: 07/31/2023]
Abstract
The aim was to examine the moderator effect of duration of PNE (total minutes) on changes in psychosocial variables after treatment in people with chronic musculoskeletal pain. PubMed/MEDLINE, Embase, Web of Science, Scopus and CINHAL databases were systematically searched from inception to 6 February 2023. A mixed-effects meta-regression was performed to determine the moderator effect of PNE duration. Twenty-three studies involving 2352 patients were included. Meta-analysis revealed a statistically significant effect in favour of PNE on pain neurophysiology knowledge, anxiety symptoms, catastrophizing and kinesiophobia. The total duration of PNE ranged from 40 to 720 min. A linear relationship was observed between longer duration of PNE (total minutes) and changes of psychosocial variables. In addition, a dose of 100, 200 and 400 min of PNE was estimated to exceed the minimum clinically important difference described in the literature for kinesiophobia (mean difference = -8.53 points), anxiety symptoms (mean difference = -1.88 points) and catastrophizing (mean difference = -7.17 points). Clinicians should provide a more tailored PNE to address psychosocial variables.
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Affiliation(s)
| | - Rodrigo Núñez-Cortés
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain; Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile.
| | - Luis Suso-Martí
- Exercise Intervention for Health Research Group (EXINH-RG), Department Cf Physiotherapy, University of Valencia, Spain
| | - Ivana Leão Ribeiro
- Departamento de Kinesiología, Facultad de Ciencias de la Salud, Universidad Católica del Maule, Talca, Chile
| | | | - José Gacitúa
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Talca, Chile
| | - Guillermo Mendez-Rebolledo
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Talca, Chile; Laboratorio de Investigación Somatosensorial y Motora, Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Chile
| | - Carlos Cruz-Montecinos
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain; Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Rubén López-Bueno
- Exercise Intervention for Health Research Group (EXINH-RG), Department Cf Physiotherapy, University of Valencia, Spain; National Research Centre for the Working Environment, Copenhagen, Denmark; Department of Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Spain
| | - Joaquín Calatayud
- Exercise Intervention for Health Research Group (EXINH-RG), Department Cf Physiotherapy, University of Valencia, Spain; National Research Centre for the Working Environment, Copenhagen, Denmark
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Baumann-Larsen M, Zwart JA, Dyb G, Wentzel-Larsen T, Stangeland H, Storheim K, Stensland SØ. Killing pain? A prospective population-based study on trauma exposure in childhood as predictor for frequent use of over-the-counter analgesics in young adulthood. The HUNT study. Psychiatry Res 2023; 327:115400. [PMID: 37574601 DOI: 10.1016/j.psychres.2023.115400] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 07/14/2023] [Accepted: 07/30/2023] [Indexed: 08/15/2023]
Abstract
Frequent and increasing use of over-the-counter analgesics (OTCA) is a public health concern. Pain conditions and psychological distress are related to frequent OTCA use, and as exposure to potentially traumatic events (PTE) in childhood appears to increase risk of experiencing such symptoms, we aimed to assess childhood PTEs and related symptoms in adolescence as predictors for frequent OTCA use in young adulthood. Prospective population survey data were used (n = 2947, 59.1% female, 10-13 years follow-up). Exposure to PTEs, symptoms of post-traumatic stress, anxiety and depression, musculoskeletal pain and headache were assessed in adolescence (13-19 years). Use of OTCA was assessed in young adulthood (22-32 years) and use of OTCA to treat musculoskeletal pain and headache served as separate outcomes in ordinal logistic regression analyses. Overall, exposure to childhood PTEs, particularly direct interpersonal violence, was significantly and consistently related to more frequent use of OTCA to treat musculoskeletal pain and headaches in young adulthood. Adjusting for psychological symptoms and pain attenuated associations, indicating that these symptoms are of importance for the relationship between traumatic events and OTCA use. These findings emphasize the need to address symptomatology and underlying causes at an early age.
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Affiliation(s)
- Monica Baumann-Larsen
- Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - John-Anker Zwart
- Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Grete Dyb
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Tore Wentzel-Larsen
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway; Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
| | - Helle Stangeland
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Kjersti Storheim
- Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway; Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
| | - Synne Øien Stensland
- Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway; Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
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8
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Salazar-Méndez J, Leão Ribeiro I, Garrido-Castillo M, Gacitúa J. Effects of pain neuroscience education on psycho-emotional and cognitive variables in individuals with chronic musculoskeletal pain: a systematic review of randomised clinical trials. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2023. [DOI: 10.1080/21679169.2022.2162962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
| | - Ivana Leão Ribeiro
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Bogota, Chile
- Departamento de Kinesiología, Facultad de Ciencias de la Salud, Universidad Católica del Maule, Talca, Chile
| | | | - José Gacitúa
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Bogota, Chile
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Strømme SH, Guddal MH, Fenstad AM, Visnes H, Zwart JA, Storheim K, Johnsen MB. Musculoskeletal pain is not clearly associated with the risk of anterior cruciate ligament reconstruction in adolescents. BMJ Open Sport Exerc Med 2023; 9:e001453. [PMID: 37200775 PMCID: PMC10186394 DOI: 10.1136/bmjsem-2022-001453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2023] [Indexed: 05/20/2023] Open
Abstract
Objectives The purpose of this study was to investigate whether self-reported musculoskeletal pain (MSP) was associated with a future anterior cruciate ligament reconstruction (ACLR). Methods In this population-based prospective cohort study, we included 8087 participants from the adolescent part of the Trøndelag Health Study (Young-HUNT) in Norway. The exposure was self-reported MSP from the Young-HUNT3 study (2006-2008), which was categorised into two MSP load groups (high MSP and low MSP) based on frequency and number of pain sites. The outcome was ACLRs recorded in the Norwegian Knee Ligament Register between 2006 and 2019. Logistic regression was used to investigate association between MSP load and ACLR, given as ORs with 95% CIs. All tests were two-sided and p values of ≤0.05 were considered statistically significant. Results 8087 adolescents were included. We identified a total of 99 ACLRs, with 6 ACLRs (0.9%) in adolescents who reported high MSP load and 93 ACLRs (1.3%) among those who reported low MSP load. Adolescents reporting high MSP load had 23% lower odds of an ACLR (OR 0.77, 95% CI 0.31 to 1.91) compared with adolescents with low MSP load. However, the CIs were very wide. Conclusion Self-reported high MSP load in adolescents was not associated with increased risk of future ACLR. Although the number of participants was high, the relatively few cases of ACLR mean that we cannot be conclusive about the presence or absence of an association.
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Affiliation(s)
- Sofie Hammernes Strømme
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
| | - Maren Hjelle Guddal
- Department of Research and Innovation, Oslo University Hospital, Oslo, Norway
| | - Anne Marie Fenstad
- Department of Orthopaedic Surgery, Haukeland University Hospital, Bergen, Norway
| | - Håvard Visnes
- Department of Orthopaedic Surgery, Haukeland University Hospital, Bergen, Norway
- Oslo Sports Trauma Research Center, Norwegian School of Sports Sciences, Oslo, Norway
- Department of Orthopedics, Sørlandet Hospital, Kristiansand, Norway
| | - John-Anker Zwart
- Department of Research and Innovation, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Oslo University Hospital, Oslo, Norway
| | - Kjersti Storheim
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
- Department of Research and Innovation, Oslo University Hospital, Oslo, Norway
| | - Marianne Bakke Johnsen
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
- Department of Research and Innovation, Oslo University Hospital, Oslo, Norway
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10
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Farrant B, Denny S, Vroegop P, Fenaughty J, Clark TC. Prevalence, severity and impact of chronic pain among a representative cross-sectional study of New Zealand high school students. J Paediatr Child Health 2023; 59:144-152. [PMID: 36334005 PMCID: PMC10100059 DOI: 10.1111/jpc.16263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 10/10/2022] [Accepted: 10/11/2022] [Indexed: 11/06/2022]
Abstract
AIM To report the prevalence of self-reported chronic pain and severity among young people in New Zealand and explore the relationships between pain and mental health, substance use, socialisation and school engagement. METHODS Prevalence of self-reported chronic pain frequency and severity are reported from an anonymous, representative cross-sectional self-administered health and well-being questionnaire by students aged 12-18 years in New Zealand. Multivariable models exploring chronic pain and mental health, substance use, socialisation and school engagement are reported controlling for age, sex, ethnicity, socio-economic status, disability and history of sexual abuse. RESULTS Overall, 22.8% (95% confidence interval (CI) 21.2-24.5) of young people reported chronic pain for 6 months or more, with 3.2% (95% CI 3.1-4.5) reporting severe pain weekly or more often. Females and rural adolescents were more likely to report chronic and severe pain. Asian youth reported less pain than other ethnic groups. Increased severity of pain was associated more with poorer daily functioning and socialising than with frequency of pain. Severe pain occurring weekly or more often was more common among students who had a disability (2.3% 95% CI 1.8-2.7 vs. 9.8%, 95% CI 7.2-12.5) or a history of sexual abuse (2.4% 95% 1.9-2.9 vs. 8.5%, 95% CI 6.3-10.5). Those reporting chronic pain had higher proportions of self-reported significant depressive symptoms, lower well-being, lower school engagement and lower access to health care, particularly for those reporting higher levels of intensity and frequency of pain. CONCLUSIONS Chronic pain is common in adolescent populations, and has a significant association with decreased daily functioning, socialising, school engagement and mental well-being. Adolescents with chronic pain report significant unmet health-care needs.
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Affiliation(s)
- Bridget Farrant
- Department of Paediatrics, Faculty of Medical Health Sciences, University of Auckland, Auckland, New Zealand.,Kidz First Centre for Youth Health, Counties Manukau District Health Board, Auckland, New Zealand
| | - Simon Denny
- Department of Paediatrics, Faculty of Medical Health Sciences, University of Auckland, Auckland, New Zealand.,Mater Young Adult Health Centre, Brisbane, Queensland, Australia
| | - Paul Vroegop
- Department of Psychological Medicine, Faculty of Medical Health Sciences, University of Auckland, Auckland, New Zealand.,Chronic Pain Service, Counties Manukau District Health Board, Auckland, New Zealand
| | - John Fenaughty
- School of Counselling, Human Services and Social Work, Faculty of Education and Social Work, University of Auckland, Auckland, New Zealand
| | - Terryann C Clark
- School of Nursing, Faculty of Medical Health Sciences, University of Auckland, Auckland, New Zealand
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11
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Senger-Carpenter T, Scott EL, Isaman DJM, Lenko R, Seng J, Ploutz-Snyder R, Robinson-Lane SG, Cofield C, Chen B, Voepel-Lewis T. Biopsychosocial Attributes of Single-region and Multi-region Body Pain During Early Adolescence: Analysis of the ABCD Cohort. Clin J Pain 2022; 38:670-679. [PMID: 36094004 PMCID: PMC9561068 DOI: 10.1097/ajp.0000000000001069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 08/30/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Multi-region pain during adolescence is associated with a higher symptom burden and lower quality of life. The purpose of this study was to describe and compare the biopsychosocial attributes of single-region and multi-region pain among healthy young adolescents. MATERIALS AND METHODS We analyzed data from 10,320 children aged 10.6 to 14 years who self-reported pain in the Adolescent Brain and Cognitive Development Study. Pain was coded as single-region or multi-region based on body map data. RESULTS One in 5 young adolescents indicated recent multi-region pain. Sequential regression supported improved model fit when psychological and sociocultural factors were added to a biological model of pain; however, these models improved the classification of multi-region but not single-region pain. A significant interaction effect of sex and puberty remained constant across models with increased odds of pain at each advancing pubertal stage for both sexes compared with prepuberty, but no difference between girls and boys at late puberty (adjusted odds ratio [OR]=2.45 [1.72, 3.49] and adjusted OR=1.63 [1.20, 2.23], respectively). Psychological factors improved the classification of multi-region pain with significant effects of anxiety, somatic symptoms, and somnolence. Finally, compared with White and non-Hispanic children, Black and Hispanic children were less likely to report pain (adjusted OR=0.70 [0.61, 0.80]; adjusted OR=0.88 [0.78, 0.99], respectively) but had significantly higher pain interference when pain was present (adjusted OR=1.49 [1.29, 1.73] and adjusted OR=1.20 [1.06, 1.35], respectively). DISCUSSION Pain is a biopsychosocial phenomenon, but psychological and sociocultural features may be more relevant for multi-region compared with single-region pain during early adolescence.
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Affiliation(s)
| | - Eric L. Scott
- Michigan Medicine Department of Pediatrics, The University of Michigan, Ann Arbor, MI 48109
- Michigan Medicine Department of Anesthesiology at The University of Michigan, Ann Arbor, MI 48109
| | - Deanna JM Isaman
- School of Nursing, The University of Michigan, Ann Arbor, MI 48109
| | - Rachel Lenko
- School of Nursing, The University of Michigan, Ann Arbor, MI 48109
| | - Julia Seng
- School of Nursing, The University of Michigan, Ann Arbor, MI 48109
| | | | | | - Cherie Cofield
- School of Nursing, The University of Michigan, Ann Arbor, MI 48109
| | - Bingxin Chen
- School of Nursing, The University of Michigan, Ann Arbor, MI 48109
| | - Terri Voepel-Lewis
- School of Nursing, The University of Michigan, Ann Arbor, MI 48109
- Michigan Medicine Department of Pediatrics, The University of Michigan, Ann Arbor, MI 48109
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12
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Smedbråten K, Grotle M, Jahre H, Richardsen KR, Småstuen MC, Skillgate E, Øiestad BE. Lifestyle behaviour in adolescence and musculoskeletal pain 11 years later: The Trøndelag Health Study. Eur J Pain 2022; 26:1910-1922. [PMID: 35851511 PMCID: PMC9545098 DOI: 10.1002/ejp.2012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 06/29/2022] [Accepted: 07/09/2022] [Indexed: 11/19/2022]
Abstract
Background There is limited knowledge on the association between lifestyle behaviour in adolescence and musculoskeletal pain in young adulthood. This study aimed to investigate whether an accumulation of adverse lifestyle behaviours in adolescents with and without musculoskeletal pain at baseline, was associated with persistent musculoskeletal pain (pain duration ≥3 consecutive months the last year) 11 years later. Methods Longitudinal data from the Trøndelag Health Study in Norway including 1824 adolescents (13–19 years old) was analysed. The outcome was persistent musculoskeletal pain (≥3 months). The number of adverse lifestyle behaviours (low physical activity level, sleep problems, insufficient fruit/vegetables consumption, smoking, frequent alcohol intoxication [drunkenness] and/or illicit drug use) were summed up to comprise an ordinal variable and analysed with 0 or 1 adverse behaviours as the reference. Multiple logistic regression analyses, stratified by individuals with and without baseline musculoskeletal pain, were conducted. The results were expressed as odds ratios (ORs) with 95% confidence intervals (CIs). Results In adolescents with musculoskeletal pain at baseline, reporting ≥ four adverse lifestyle behaviours increased the odds of persistent musculoskeletal pain (OR 2.23, 95% CI 1.36, 3.66) 11 years later. Two and three adverse behaviours were not associated with future persistent musculoskeletal pain. In adolescents without musculoskeletal pain at baseline, an accumulation of adverse lifestyle behaviours was not associated with future persistent musculoskeletal pain. Conclusion An accumulation of adverse lifestyle behaviours in adolescents with musculoskeletal pain at baseline was associated with persistent musculoskeletal pain 11 years later, but not in adolescents without musculoskeletal pain at baseline. Significance An accumulation of four or more adverse lifestyle behaviours in adolescents with musculoskeletal pain was associated with persistent musculoskeletal pain in young adulthood. In future health care of adolescents with musculoskeletal pain, lifestyle behaviours should be assessed, with emphasis on accumulation of multiple adverse lifestyle behaviours. Focusing on an accumulation of multiple adverse lifestyle behaviours, rather than each individual behaviour, might provide a potential area for future research and interventions targeting musculoskeletal pain in youth.
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Affiliation(s)
- K. Smedbråten
- Department of Physiotherapy, Faculty of Health Sciences Oslo Metropolitan University Norway
| | - M. Grotle
- Department of Physiotherapy, Faculty of Health Sciences Oslo Metropolitan University Norway
- Research and Communication Unit for Musculoskeletal Health Oslo University Hospital Norway
| | - H. Jahre
- Department of Physiotherapy, Faculty of Health Sciences Oslo Metropolitan University Norway
| | - K. R. Richardsen
- Department of Physiotherapy, Faculty of Health Sciences Oslo Metropolitan University Norway
| | - M. C. Småstuen
- Department of Physiotherapy, Faculty of Health Sciences Oslo Metropolitan University Norway
| | - E. Skillgate
- Musculoskeletal & Sports Injury Epidemiology Center Sophiahemmet University Sweden
- Institute of Environmental Medicine Karolinska Institutet Sweden
| | - B. E. Øiestad
- Department of Physiotherapy, Faculty of Health Sciences Oslo Metropolitan University Norway
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13
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Associations between pain, self-efficacy, sleep duration, and symptoms of depression in adolescents: a cross-sectional survey. BMC Public Health 2021; 21:1617. [PMID: 34482826 PMCID: PMC8418745 DOI: 10.1186/s12889-021-11680-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 08/29/2021] [Indexed: 11/23/2022] Open
Abstract
Background Although pain has been identified as an important public health problem among adolescents, few studies have investigated possible protective and risk factors for pain. The main aim of the present study was to investigate associations between prevalence of daily pain, self-efficacy, sleep duration, and symptoms of depression in a representative sample of Norwegian adolescents. Methods A comprehensive cross-sectional survey was completed by 12,867 junior high school students and high school students (response rate: 90%) aged 14–19 years. Logistic regression models were adjusted for age, gender, and parental educational level. Results We found a high prevalence of daily pain among adolescents, especially among girls (19%) compared with boys (7%). Short sleep duration was associated with increased odds ratios (ORs) of pain in the shoulders/neck (OR 1.3; 95% CI 1.3–2.0) and stomach (1.7; 1.2–2.4). Symptoms of depression were associated with increased ORs for all measured types of daily pain, including head (3.7; 3.0–4.6), shoulders/neck (3.9; 3.1–4.8), joints/muscles (4.3; 3.3–5.6), and stomach (5.5; 4.1–7.4). By contrast, self-efficacy was not associated with any form of daily pain. Conclusion Given the burden of pain, high incidence of pain problems, and strong association between pain and depression and, to some degree, short sleep duration, co-occurring symptoms may be an important area for research in the public health field. The results highlight the importance of early identification and prevention. Longitudinal studies are needed to understand better pain problems and their underlying mechanisms with the aim of developing targeted interventions.
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14
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Jahre H, Grotle M, Småstuen M, Guddal MH, Smedbråten K, Richardsen KR, Stensland S, Storheim K, Øiestad BE. Risk factors and risk profiles for neck pain in young adults: Prospective analyses from adolescence to young adulthood-The North-Trøndelag Health Study. PLoS One 2021; 16:e0256006. [PMID: 34383846 PMCID: PMC8360564 DOI: 10.1371/journal.pone.0256006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 07/29/2021] [Indexed: 11/18/2022] Open
Abstract
The objective was to investigate risk factors and risk profiles associated with neck pain in young adults using longitudinal data from the North-Trøndelag Health Study (HUNT). Risk factors were collected from adolescents (13-19 years of age), and neck pain was measured 11 years later. The sample was divided into two: Sample I included all participants (n = 1433), and Sample II (n = 832) included only participants who reported no neck/shoulder pain in adolescence. In multiple regression analyses in Sample I, female sex (OR = 1.9, 95% CI [1.3-2.9]), low physical activity level (OR = 1.6, 95% CI [1.0-2.5]), loneliness (OR = 2.0, 95% CI [1.2-3.5]), headache/migraine (OR = 1.7, 95% CI [1.2-2.6]), back pain (OR = 1.5, 95% CI [1.0-2.4]) and neck/shoulder pain (OR = 2.0, 95% [CI 1.3-3.0]) were associated with neck pain at the 11-year follow-up. Those with a risk profile including all these risk factors had the highest probability of neck pain of 67% in girls and 50% in boys. In Sample II, multiple regression analyses revealed that female sex (OR = 2.2, 95% CI [1.3-3.7]) and perceived low family income (OR = 2.4, 95% CI [1.1-5.1]) were associated with neck pain at the 11-year follow-up. Girls and boys with a perceived low family income had a 29% and 17% higher probability of neck pain than adolescents with a perceived high family income. The risk profiles in both samples showed that co-occurrence of risk factors, such as headache/migraine, neck/shoulder pain, back pain, low physical activity level, loneliness, and perceived low family income cumulatively increased the probability of neck pain in young adulthood. These results underline the importance of taking a broad perspective when studying, treating, and preventing neck pain in adolescents.
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Affiliation(s)
- Henriette Jahre
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
| | - Margreth Grotle
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
- Research and Communication Unit for Musculoskeletal Health (FORMI), Clinic for Surgery and Neurology, Oslo University Hospital, Oslo, Norway
| | - Milada Småstuen
- Department of Nursing, Oslo Metropolitan University, Oslo, Norway
| | - Maren Hjelle Guddal
- Research and Communication Unit for Musculoskeletal Health (FORMI), Clinic for Surgery and Neurology, Oslo University Hospital, Oslo, Norway
| | - Kaja Smedbråten
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
| | | | - Synne Stensland
- Research and Communication Unit for Musculoskeletal Health (FORMI), Clinic for Surgery and Neurology, Oslo University Hospital, Oslo, Norway
- Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), Oslo, Norway
| | - Kjersti Storheim
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
- Research and Communication Unit for Musculoskeletal Health (FORMI), Clinic for Surgery and Neurology, Oslo University Hospital, Oslo, Norway
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15
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Molenaar B, Willems C, Verbunt J, Goossens M. Achievement Goals, Fear of Failure and Self-Handicapping in Young Elite Athletes with and without Chronic Pain. CHILDREN-BASEL 2021; 8:children8070591. [PMID: 34356570 PMCID: PMC8305616 DOI: 10.3390/children8070591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 07/08/2021] [Accepted: 07/08/2021] [Indexed: 12/05/2022]
Abstract
Background: Pain is a common problem in elite athletes. This exploratory study compares goal orientations towards sport, fear of failure, self-handicapping and pain catastrophizing between active young elite athletes with and without chronic pain (CP) complaints (longer than three months). It examines the associations between chronic pain, fear of failure, goal orientations, self-handicapping and pain catastrophizing in young elite athletes. We explore how far goal orientation can be explained by these factors. Methods: Young elite athletes completed an online questionnaire. Data analysis: Independent samples t-test, correlational analyses and multivariate regression analyses. Results: Participants were 132 young elite athletes (mean 16 years); data for 126 were analyzed. A total of 47% reported current pain, of which 60% had CP. Adolescents with CP showed significantly more pain intensity, fear of failure, self-handicapping and mastery–avoidance goals than those without. Pain intensity was significantly related to fear of failure, self-handicapping, pain catastrophizing and mastery–avoidance. Self-handicapping and fear of failure contributed significantly to mastery–avoidance variance. Performance–avoidance and –approach goals were explained by fear of failure. Conclusion: CP was common, with sufferers showing more fear of failure and self-handicapping strategies, and being motivated to avoid performing worse (mastery–avoidance). Self-handicapping and fear of failure influenced mastery–avoidance orientation, and fear of failure explained part of performance–avoidance and –approach orientations. Longitudinal studies should explore the role of these factors in the trajectory of CP in these athletes.
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Affiliation(s)
- Bodile Molenaar
- Department of Rehabilitation Medicine, Care and Public Health Research Institute, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands; (B.M.); (C.W.); (J.V.)
| | - Charlotte Willems
- Department of Rehabilitation Medicine, Care and Public Health Research Institute, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands; (B.M.); (C.W.); (J.V.)
- Adelante Center of Expertise in Rehabilitation and Audiology, Zandbergsweg 111, 6432 CC Hoensbroek, The Netherlands
| | - Jeanine Verbunt
- Department of Rehabilitation Medicine, Care and Public Health Research Institute, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands; (B.M.); (C.W.); (J.V.)
- Adelante Center of Expertise in Rehabilitation and Audiology, Zandbergsweg 111, 6432 CC Hoensbroek, The Netherlands
| | - Mariëlle Goossens
- Department of Rehabilitation Medicine, Care and Public Health Research Institute, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands; (B.M.); (C.W.); (J.V.)
- Department of Clinical Psychological Sciences, Experimental Psychology, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands
- Correspondence: ; Tel.: +31-43-388-2160
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16
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Marin TJ, Hayden JA, Lewinson R, Mahood Q, Pepler D, Katz J. A Systematic Review of the Prospective Relationship Between Bullying Victimization and Pain. J Pain Res 2021; 14:1875-1885. [PMID: 34188534 PMCID: PMC8236267 DOI: 10.2147/jpr.s313470] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 05/21/2021] [Indexed: 01/22/2023] Open
Abstract
Objective This systematic review synthesized evidence about the relationship between childhood bullying victimization and chronic pain, with a focus on the temporal nature of the relationship and moderating factors, such as the type and intensity of victimization. Method We included prospective cohort studies that examined the relationship between childhood bullying victimization and pain measured at least three months later. We conducted electronic searches of Medline, EMBASE, PsycINFO, and CINAHL up to June 30, 2019. Standard methodological procedures consistent with Cochrane reviews of prognosis studies were used (PROSPERO record ID 133146). Results We included four longitudinal studies (6275 participants) in this review. The mean age of participants at baseline ranged from 10 to 14 years and the follow-up periods ranged from 6 months to 12 years. Two of the four studies were judged as having high risk of bias. Meta-analysis of results from four studies revealed increased risk of pain among victimized compared to non-victimized youth (adjusted OR [95% CI] = 1.45 [1.06-1.97], but the effect size was small and not clinically important. Only one study examined the inverse association (ie, from pain to victimization), and there was not enough evidence to conduct a meaningful analysis of the proposed moderators. Conclusions Study findings were limited by few prospective studies. Meta-analytic findings suggested that victimization may incur some risk for later pain, although the evidence was judged to be very low quality. High-quality studies that measure and report the nuances of bullying victimization are needed to test the proposed moderator models.
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Affiliation(s)
- Teresa J Marin
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Jill A Hayden
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Rebecca Lewinson
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Quenby Mahood
- SickKids Hospital, Hospital Library, Toronto, Ontario, Canada
| | - Debra Pepler
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Joel Katz
- Department of Psychology, York University, Toronto, Ontario, Canada
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17
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Fegran L, Johannessen B, Ludvigsen MS, Westergren T, Høie M, Slettebø Å, Rohde G, Helseth S, Haraldstad K. Experiences of a non-clinical set of adolescents and young adults living with persistent pain: a qualitative metasynthesis. BMJ Open 2021; 11:e043776. [PMID: 33875442 PMCID: PMC8057544 DOI: 10.1136/bmjopen-2020-043776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE Around 15%-30% of adolescents and young adults (AYAs) experience persistent or chronic pain. The purpose of this study was to synthesise evidence from qualitative primary studies on how AYAs in a non-clinical population experience living with persistent pain. METHOD A qualitative metasynthesis guided by Sandelowski and Barroso's guidelines was used. The databases Medline, Embase, Cinahl, PsycINFO, Mednar and ProQuest were searched for studies from 1 January 2005 to 15 February 2021. Inclusion criteria were AYAs aged 13-24 years with first-hand experience of living with persistent, recurrent or episodic non-clinical pain in any body site. Pain associated with a medical diagnosis, malignant diseases, medical procedures or sport activities was excluded. RESULTS Of 2618 screened records, data from nine studies conducted in a Western cultural context including 184 participants (127 female and 57 male aged 11-28 years) were analysed into metasummaries and a metasynthesis. Headaches was the most focused pain condition (n=5), while three of the studies did not specify type of pain. The participants' experiences were characterised by (1) juggling pain with everyday life; (2) exploring sources of information to manage pain; (3) AYAs' use of medication to find relief and (4) non-pharmacological strategies for pain relief. CONCLUSION These AYAs experience of how pain influences everyday life, and their striving to find relief from pain by support from family, friends, professionals and the Internet should be strongly respected. Public health nurses and other healthcare professionals encountering AYAs need to respect their pain experiences, and to support them in healthy coping strategies. Further studies on this issue are needed, especially research focusing on AYAs pain in exposed populations and AYAs from non-Western cultures.
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Affiliation(s)
- Liv Fegran
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Vest-Agder, Norway
- Department of Pediatrics, Sørlandet Sykehus HF, Kristiansand, Norway
| | - Berit Johannessen
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Vest-Agder, Norway
| | - Mette Spliid Ludvigsen
- Department of Clinical Medicine, Randers Regional Hospital, Randers, Midtjylland, Denmark
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
| | - Thomas Westergren
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Vest-Agder, Norway
| | - Magnhild Høie
- Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway
| | - Åshild Slettebø
- Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway
| | - Gudrun Rohde
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Vest-Agder, Norway
- Department of Clinical Research, Sørlandet Sykehus HF, Kristiansand, Norway
| | - Sølvi Helseth
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Kristin Haraldstad
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Vest-Agder, Norway
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18
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A High Psychological and Somatic Symptom Profile and Family Health Factors Predict New or Persistent Pain During Early Adolescence. Clin J Pain 2021; 37:86-93. [PMID: 33165022 DOI: 10.1097/ajp.0000000000000896] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 10/27/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Persistent or recurrent pain is common among adolescents and is associated with poor functioning. The purpose of this study was to determine whether preteens who present with pain, and higher, co-occurring psychological and somatic symptoms (PSS) are at higher risk for persistent pain than other children. MATERIALS AND METHODS We conducted a secondary analysis of the longitudinal Adolescent Brain and Cognitive Development database (version 2.0.1) that includes 11,863 children aged 9 to 12 years. We differentiated children into baseline Pain/PSS profiles using the Child Behavior Checklist assessments of pain, cognitive-fogginess, somatic symptoms, depression, and anxiety and the Sleep Disorder Survey-Children somnolence subscale. We examined whether Pain/PSS profile predicted 1-year new/persistent pain when controlled for child characteristics and intergenerational mental health factors. RESULTS Four profiles were differentiated: No Pain/Low PSS, No Pain/High PSS, Pain/Low PSS, Pain/High PSS. Trauma exposure and family symptoms were associated with increased odds of being in the higher PSS groups. Baseline symptom profile predicted 14% of the variance in new/persistent pain at 1-year. Compared with the No Pain/Low PSS group, an increased odds of 1-year new or persistent pain was found in children with No Pain/High PSS (adjusted odds ratio [OR]: 1.44; [95% confidence interval: 1.14, 1.82]), Pain/Low PSS (adjusted OR: 4.69 [4.01, 5.48]) and Pain/High PSS (adjusted OR: 5.48 [4.35, 6.91]). DISCUSSION Preteen children with higher comorbid Pain/PSS symptomology were at higher risk for new or persistent pain at 1 year when controlled for important child and family characteristics. Findings support the importance of considering co-occurring symptoms when evaluating children with pain.
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19
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Gårdvik KS, Rygg M, Torgersen T, Lydersen S, Indredavik MS. Psychiatric morbidity, somatic comorbidity and substance use in an adolescent psychiatric population at 3-year follow-up. Eur Child Adolesc Psychiatry 2021; 30:1095-1112. [PMID: 32671493 PMCID: PMC8295167 DOI: 10.1007/s00787-020-01602-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 07/08/2020] [Indexed: 12/28/2022]
Abstract
Knowledge is scarce on the course of psychiatric disorders in adolescence. We aimed to assess changes in the frequency of psychiatric disorders, somatic disorders, pain, and substance use in a clinical psychiatric cohort from adolescence to young adulthood. This study is part of the Health Survey in Department of Children and Youth, St. Olavs Hospital, Norway. At age 13-18 years, 717 (43.5% of eligible) participated in the first study visit (T1) in 2009-2011, 549 were reassessed 3 years later with telephone interview (T2), and 464 had diagnostic evaluation at both time points. Data included: ICD-10 diagnoses (T1), DSM-IV diagnoses (T2), self-reported pain and substance use (T1 and T2). The overall rate of psychiatric disorders decreased (T1 vs. T2: 94.8% vs. 72.2%, p < 0.001); while, an increased rate of anxiety disorders was marked among girls (37.5% vs. 55.9%, p < 0.001), with accompanying raised frequencies of psychiatric comorbidity (14.1% vs. 42.6%, p < 0.001), somatic comorbidity (9.4% vs. 19.5%, p = 0.001), chronic pain (31.6% vs. 49.4%, p < 0.001), smoking, alcohol use and trying illicit drugs. Chronic pain, smoking and trying illicit drugs were associated with persisting psychiatric disorders, with highest risk differences for girls (RD = 25.4%, p = 0.002, RD = 15.6%, p = 0.008, RD = 18.0%, p = 0.001, respectively). Three out of four adolescents still had a psychiatric disorder after 3 years. Unlike boys, girls had an increasing rate of anxiety disorders and comorbidities. Chronic pain, smoking and trying illicit drugs were associated with persisting psychiatric disorders. Despite methodological limitations, these findings emphasize the importance of early targeted intervention for adolescents with psychiatric disorders.
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Affiliation(s)
- Kari Skulstad Gårdvik
- Department of Mental Health, Faculty of Medicine and Health Sciences, Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Trondheim, Norway.
- Division of Mental Health Care, Department of Children and Youth, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
| | - Marite Rygg
- Department of Clinical and Molecular Medicine (IKOM), Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Pediatrics, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Terje Torgersen
- Division of Mental Health Care, Department of Østmarka, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Stian Lydersen
- Department of Mental Health, Faculty of Medicine and Health Sciences, Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Trondheim, Norway
| | - Marit Sæbø Indredavik
- Department of Clinical and Molecular Medicine (IKOM), Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
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Marusak HA, Iadipaolo AS, Cohen C, Goldberg E, Taub JW, Harper FWK, Bluth MH, Rabinak CA. Martial Arts-Based Therapy Reduces Pain and Distress Among Children with Chronic Health Conditions and Their Siblings. J Pain Res 2020; 13:3467-3478. [PMID: 33402843 PMCID: PMC7778380 DOI: 10.2147/jpr.s283364] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 12/18/2020] [Indexed: 01/14/2023] Open
Abstract
Objective Test whether a martial arts-based therapy, Kids Kicking Cancer (KKC), can reduce pain and emotional distress in children with cancer, other chronic health conditions (e.g., sickle cell), and healthy siblings. Methods This study surveyed children’s pain and distress levels immediately before and after a 1-hr in-person KKC class. Eligible participants were enrolled in standard KKC classes, were diagnosed with a chronic health condition (e.g., cancer, sickle cell) or were the sibling of a child diagnosed and were between the ages of 5–17 years (inclusive). Children reported on their pain and distress using Likert-style scales (Coloured Analog Scale and modified FACES scale, respectively). Friedman test was used to test for overall changes in pain and distress, and within subgroups. Age and sex effects were evaluated using Spearman’s rank-order correlation. Additional Yes/No questions were administered regarding KKC satisfaction and use of techniques. Results Fifty-nine youth (19 cancer patients, 17 non-cancer patients, 23 siblings; 5–17 yrs, 26 females) completed this study. Overall, there was a significant reduction in pain (p = 0.033) and emotional distress (p < 0.001) after a 1-hr class, with 50% and 89% of youth reporting a reduction in pain and distress, respectively. On average, pain levels remained within the mild/moderate range on average (i.e., pre vs. post levels; pre: M = 1.67, post: M = 1.33) and emotional distress went from mild/moderate to none/mild distress, on average (pre: M = 1.92, post: M = 1.08). Youth with higher pre-class pain and distress reported greater reductions (p = 0.001 and p < 0.001, respectively). The reduction in pain appeared to be most pronounced with cancer and non-cancer patients. In contrast, the reduction in distress appeared to be most pronounced among healthy siblings. However, overall, reductions in pain and distress did not significantly differ among subgroups (i.e., cancer patients, non-cancer patients, siblings), and change in pain and distress was not associated with age or sex. Ninety-six percent of youth would recommend KKC to others and 81% reported using KKC techniques (e.g., the Breath BrakeTM or other martial arts techniques) outside of class, such as at home. Conclusion Results support the more widespread application of KKC as a psychosocial intervention for reducing pain and distress in various pediatric populations.
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Affiliation(s)
- Hilary A Marusak
- Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, MI, USA.,Merrill Palmer Skillman Institute, Wayne State University, Detroit, MI, USA.,Population Studies and Disparities Research Program, Karmanos Cancer Institute, Detroit, MI, USA
| | - Allesandra S Iadipaolo
- Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, USA
| | | | - Elimelech Goldberg
- Kids Kicking Cancer, Southfield, MI, USA.,Department of Pediatrics, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Jeffrey W Taub
- Department of Pediatrics, School of Medicine, Wayne State University, Detroit, MI, USA.,Department of Oncology, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Felicity W K Harper
- Population Studies and Disparities Research Program, Karmanos Cancer Institute, Detroit, MI, USA.,Department of Oncology, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Martin H Bluth
- Kids Kicking Cancer, Southfield, MI, USA.,Department of Pathology, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Christine A Rabinak
- Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, MI, USA.,Merrill Palmer Skillman Institute, Wayne State University, Detroit, MI, USA.,Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, USA.,Department of Pharmaceutical Sciences, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, USA
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Severity of Chronic Pain in German Adolescent School Students. Clin J Pain 2020; 37:118-125. [DOI: 10.1097/ajp.0000000000000898] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 10/26/2020] [Indexed: 02/02/2023]
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Richardson PA, Harrison LE, Heathcote LC, Rush G, Shear D, Lalloo C, Hood K, Wicksell RK, Stinson J, Simons LE. mHealth for pediatric chronic pain: state of the art and future directions. Expert Rev Neurother 2020; 20:1177-1187. [PMID: 32881587 PMCID: PMC7657989 DOI: 10.1080/14737175.2020.1819792] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 09/02/2020] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Chronic pain conditions are common among children and engender cascading effects across social, emotional, and behavioral domains for the child and family. Mobile health (mHealth) describes the practice of delivering healthcare via mobile devices and may be an ideal solution to increase access and reach of evidence-based behavioral health interventions. AREAS COVERED The aim of this narrative review is to present a state-of-the-art overview of evidence-based mHealth efforts within the field of pediatric chronic pain and consider new and promising directions for study. Given the nascent nature of the field, published mHealth interventions in all stages of development are discussed. Literature was identified through a non-systematic search in PubMed and Google Scholar, and a review of reference lists of papers that were identified as particularly relevant or foundational (within and outside of the chronic pain literature). EXPERT OPINION mHealth is a promising interventional modality with early evidence suggesting it is primed to enhance behavioral health delivery and patient outcomes. There are many exciting future directions to be explored including drawing inspiration from digital health technology to generate new ways of thinking about the optimal treatment of pediatric chronic pain.
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Affiliation(s)
- Patricia A. Richardson
- Departments of Pediatric Psychology and Pediatric Pain and Palliative Medicine, Helen DeVos Children’s Hospital, Grand Rapids, MI, USA
- Department of Pediatrics and Human Development, Michigan State University College of Human Medicine, East Lansing, MI, USA
| | - Lauren E. Harrison
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Lauren C. Heathcote
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Gillian Rush
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Deborah Shear
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Chitra Lalloo
- Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Canada
- Institute for Health Policy, Management & Evaluation, University of Toronto, Toronto, Canada
| | - Korey Hood
- Division of Pediatric Endocrinology and Diabetes, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Rikard K. Wicksell
- Department of Clinical Neuroscience, Division for Psychology, Karolinska Institutet, Stockholm, Sweden
| | - Jennifer Stinson
- Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Canada
- Lawrence S. Bloomberg, Faculty of Nursing, The University of Toronto, Toronto, Canada
| | - Laura E. Simons
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, USA
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Skarstein S, Helseth S, Kvarme LG. It hurts inside: a qualitative study investigating social exclusion and bullying among adolescents reporting frequent pain and high use of non-prescription analgesics. BMC Psychol 2020; 8:112. [PMID: 33115532 PMCID: PMC7592354 DOI: 10.1186/s40359-020-00478-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 10/16/2020] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Being bullied and socially excluded interferes with the fundamental need for humans to belong to a social group, which is necessary for well-being. This might underpin pain and the use of non-prescription analgesics. AIM The aim of the study was to gain insight into how social exclusion and bullying affect well-being in adolescents reporting frequent pain and high use of non-prescription analgesics. METHODS A phenomenological hermeneutical method based on in-depth interviews was used. Nineteen teenagers, 14-16 years of age voluntarily participated in the study. Those included had frequent pain and used non-prescription analgesics daily or several times a week. RESULTS Bullying and social exclusion affects thoughts, feelings and attitudes and thereby the quality of life of the adolescents we interviewed. They described feelings such as sadness, loneliness and depression, and a sense of being an outsider among peers was common. It also appears that bullying has significant potential to spread in a school environment. CONCLUSION The adolescents were self-aware and well-articulated. They conceptualised their experiences of being socially excluded and bullied. They described being socially excluded and bullied by peers as painful and they used non-prescription analgesics to alleviate pain. Teachers and health professionals should be aware of frequent pain and high use of non-prescribed analgesic medication as signs of psychosocial stress caused by social exclusion and bullying. Social exclusion and bullying should be systematically mapped, and targeted interventions implemented.
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Affiliation(s)
- Siv Skarstein
- Faculty of Health and Science, Oslo Metropolitan University, St. Olavs Plass, P.O. Box 4, 0130 Oslo, Norway
| | - Sølvi Helseth
- Faculty of Health and Science, Oslo Metropolitan University, St. Olavs Plass, P.O. Box 4, 0130 Oslo, Norway
| | - Lisbeth Gravdal Kvarme
- Faculty of Health and Science, Oslo Metropolitan University, St. Olavs Plass, P.O. Box 4, 0130 Oslo, Norway
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Baseline Characteristics of a Dyadic Cohort of Mothers With Chronic Pain and Their Children. Clin J Pain 2020; 36:782-792. [PMID: 32701524 DOI: 10.1097/ajp.0000000000000864] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES A growing body of research has demonstrated a robust link between parental chronic pain and child pain and psychological function. Although the association between parent and child pain is strong, there are limited data to understand environmental and behavioral processes that account for the association and how this develops over time. This longitudinal cohort study was designed to understand the potential mechanisms that confer risk or resilience for chronic pain among child offspring of mothers with chronic pain. METHODS The current paper presents baseline data on the cohort to describe the pain and psychosocial characteristics of mothers with chronic pain and their 8- to 12-year-old children. A total of 400 mothers with chronic pain and their children were enrolled into the longitudinal study and completed measures of pain, physical, and psychosocial functioning. RESULTS Mothers reported a range of pain and pain-related disability and were grouped into 4 pain grades (PGs) representing different pain and disability levels. Mothers in these groups differed on rates of widespread pain and opioid use. Maternal PGs also differed by physical function, fatigue, sleep disturbance, and psychological function. Most children in this sample reported pain and psychosocial symptoms in the nonclinical range, and child variables did not differ by maternal PG. Maternal disability and function were concurrently associated with child psychosocial function. DISCUSSION While maternal PGs map broadly onto several dimensions of maternal functioning, they were not significantly related to child pain or function. Results may help identify potential protective factors in the intergenerational transmission of risk for chronic pain.
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Grasaas E, Helseth S, Fegran L, Stinson J, Småstuen M, Haraldstad K. Health-related quality of life in adolescents with persistent pain and the mediating role of self-efficacy: a cross-sectional study. Health Qual Life Outcomes 2020; 18:19. [PMID: 32000787 PMCID: PMC6993393 DOI: 10.1186/s12955-020-1273-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 01/15/2020] [Indexed: 12/26/2022] Open
Abstract
Background Persistent pain has a high prevalence among adolescents. Pain has been shown to reduce all aspects of the adolescent’s health-related quality of life (HRQOL). In adult patients with pain, self-efficacy has been shown to mediate the relationship between pain intensity, disability and depression. However, little is known about whether self-efficacy acts as a mediating variable in the relationship between persistent pain and HRQOL sub-scale scores in a school-based population of adolescents. Objectives To describe the experience of pain, HRQOL and self-efficacy, and to explore the association between pain intensity, general self-efficacy and HRQOL in adolescents with persistent pain by testing self-efficacy as a possible mediator. Methods The study participants were 78 adolescents with persistent pain, aged 16–19 years, who were recruited from five high schools in southern Norway. All participants completed an electronic survey consisting of the Lubeck Pain Questionnaire, which included a visual analogue scale (VAS) measuring pain intensity, the General Self-Efficacy Scale (GSE) and the KIDSCREEN-52 Questionnaire measuring HRQOL. Statistical analyses were conducted using the PROCESS macro for SPSS developed by Andrew Hayes. Results All participants reported pain in multiple locations, of which the head was most common (88.5%). Mean (SD) pain intensity score of the participants was 5.4 (1.8). The study sample had poor HRQOL, with mean (SD) scores for several sub-scales ranging from 45.2 (21.0) to 91.0 (13.3) on a 0–100 scale. The associations between pain intensity and the HRQOL sub-scales of physical well-being, psychological well-being, mood, self-perception, autonomy and school environment were mediated by self-efficacy. The highest degree of mediation and, thus, the largest indirect effect was estimated for the HRQOL sub-scale physical well-being (67.2%). Conclusions This school-based sample of adolescents with persistent pain had impaired HRQOL. Up to 67% of the reduction in the HRQOL sub-scale scores for physical well-being, psychological well-being, mood, self-perception, autonomy and school environment could be explained by the mediating variable self-efficacy. Thus, future pain-management interventions that aim to increase HRQOL in school-based populations of adolescents with persistent pain should consider promoting self-efficacy and providing more targeted interventions. Trial registration ClinicalTrials.gov ID NCT03551977.
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Affiliation(s)
- Erik Grasaas
- Department of Health and Nursing Science, Faculty of Health and Sport Sciences, University of Agder, Postbox 422, 4604, Kristiansand, Norway.
| | - Sølvi Helseth
- Department of Health and Nursing Science, Faculty of Health and Sport Sciences, University of Agder, Postbox 422, 4604, Kristiansand, Norway.,Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Liv Fegran
- Department of Health and Nursing Science, Faculty of Health and Sport Sciences, University of Agder, Postbox 422, 4604, Kristiansand, Norway
| | - Jennifer Stinson
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada.,Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada.,Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada
| | - Milada Småstuen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Kristin Haraldstad
- Department of Health and Nursing Science, Faculty of Health and Sport Sciences, University of Agder, Postbox 422, 4604, Kristiansand, Norway
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Arruda GAD, Coledam DHC, Oliveira ARD, Neri FDS, Greca JPDA, Cardoso JR. PROPOSAL AND TEST-RETEST RELIABILITY OF A SCALE FOR CERVICAL, THORACIC, AND LUMBAR SPINE PAIN IN BRAZILIAN YOUNG PEOPLE. REVISTA PAULISTA DE PEDIATRIA 2019; 37:450-457. [PMID: 30624540 PMCID: PMC6821472 DOI: 10.1590/1984-0462/;2019;37;4;00001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 06/24/2018] [Indexed: 11/22/2022]
Abstract
Objective: To propose and analyze the test-retest reliability of an instrument to
verify the presence and intensity of pain in the cervical, thoracic and
lumbar spine in Brazilian young people. Methods: This reliability study enrolled a sample of 458 participants (13 to 20
years). Two groups were formed for each sex according to the range of days
for the test-retest (10±3 and 28±2 days). For analysis of spinal pain, a
drawing of the human body with cervical, thoracic and lumbar spine areas
delimited was presented. The following question was presented: during a
normal day, do you feel pain in any of these regions of your spine? If so,
what is the intensity from 0 to 10 (mark on the line)? The starting point,
with the number 0, corresponded to no pain, and the number 10 to severe
pain. The agreement of frequency and of intensity of pain was verified by
Kappa test and Bland-Altman plot, respectively. Results: Intraclass correlation coefficients ranged from 0.71 (confidence interval of
95% - 95%CI - 0.59-0.79) to 0.94 (95%CI 0.90-0.96). The results concerning
the agreement of pain scores showed the mean differences to be close to 0,
and the largest mean difference was -0.40 (95%CI -5.14-4.34). The agreement
in reported pain ranged from 72.2 (Kappa 0.43; 95%CI
0.28-0.58) to 90.1% (Kappa 0.76; 95%CI 0.60-0.92). Conclusions: This instrument was shown to be a reliable manner to verify the pain in
different regions of the spine in Brazilian young people.
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Malmborg JS, Bremander A, Olsson MC, Bergman AC, Brorsson AS, Bergman S. Worse health status, sleeping problems, and anxiety in 16-year-old students are associated with chronic musculoskeletal pain at three-year follow-up. BMC Public Health 2019; 19:1565. [PMID: 31771551 PMCID: PMC6880415 DOI: 10.1186/s12889-019-7955-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 11/18/2019] [Indexed: 11/10/2022] Open
Abstract
Background Chronic musculoskeletal pain is common in adolescents, and it has been shown that adolescents with pain may become young adults with pain. Pain often coincides with psychosomatic symptoms in adults, but little is known about longitudinal associations and predictors of pain in adolescents. The aim was to investigate chronic musculoskeletal pain and its associations with health status, sleeping problems, stress, anxiety, depression, and physical activity in 16-year-old students at baseline, and to identify risk factors using a three-year follow-up. Methods This was a longitudinal study of 256 students attending a Swedish upper secondary school. Questionnaires regarding chronic musculoskeletal pain and distribution of pain (mannequin), health status (EQ-5D-3 L), sleeping problems (Uppsala Sleep Inventory), stress symptoms (single-item question), anxiety and depression (Hospital Anxiety and Depression Scale), and physical activity (International Physical Activity Questionnaire) were issued at baseline and follow-up. Student’s t-test and chi2 test were used for descriptive statistics and logistic regression analyses were used to study associations between chronic pain and independent variables. Results Fifty-two out of 221 students at baseline (23.5%) and 39 out of 154 students at follow-up (25.3%) were categorized as having chronic musculoskeletal pain. Chronic musculoskeletal pain at follow-up was separately associated with reporting of an EQ-5D value below median (OR 4.06, 95% CI 1.83–9.01), severe sleeping problems (OR 3.63, 95% CI 1.69–7.82), and possible anxiety (OR 4.19, 95% CI 1.74–10.11) or probable anxiety (OR 3.82, 95% CI 1.17–12.48) at baseline. Similar results were found for associations between chronic musculoskeletal pain and independent variables at baseline. In multiple logistic regression analysis, chronic musculoskeletal pain at baseline was a predictor of chronic musculoskeletal pain at follow-up (OR 2.99, 95% CI 1.09–8.24, R2 = 0.240). Conclusion Chronic musculoskeletal pain at baseline was the most important predictor for reporting chronic musculoskeletal pain at the three-year follow-up, but a worse health status, severe sleeping problems, and anxiety also predicted persistence or development of chronic musculoskeletal pain over time. Interventions should be introduced early on by the school health services to promote student health.
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Affiliation(s)
- Julia S Malmborg
- The Rydberg Laboratory for Applied Sciences, Halmstad University, Box 823, SE-301 18, Halmstad, Sweden. .,Spenshult Research and Development Center, Bäckagårdsvägen 47, SE-302 74, Halmstad, Sweden.
| | - Ann Bremander
- Department of Regional Health Research, University of Southern Denmark, Winsløvsparken 19.3, DK-5000, Odense, Denmark.,Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Engelshøjgade 9A, DK-6400, Sønderborg, Denmark.,Department of Clinical Sciences Lund, Section of Rheumatology, Lund University, Box 117, SE-221 00, Lund, Sweden
| | - M Charlotte Olsson
- The Rydberg Laboratory for Applied Sciences, Halmstad University, Box 823, SE-301 18, Halmstad, Sweden
| | - Anna-Carin Bergman
- Spenshult Research and Development Center, Bäckagårdsvägen 47, SE-302 74, Halmstad, Sweden
| | - A Sofia Brorsson
- Spenshult Research and Development Center, Bäckagårdsvägen 47, SE-302 74, Halmstad, Sweden
| | - Stefan Bergman
- Department of Clinical Sciences Lund, Section of Rheumatology, Lund University, Box 117, SE-221 00, Lund, Sweden.,Primary Health Care Unit, Department of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Box 454, SE-405 30, Gothenburg, Sweden
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Bilbao A, Leixner S, Wei S, Cantacorps L, Valverde O, Spanagel R. Reduced sensitivity to ethanol and excessive drinking in a mouse model of neuropathic pain. Addict Biol 2019; 24:1008-1018. [PMID: 31237390 DOI: 10.1111/adb.12784] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The co-occurrence of chronic pain and alcohol use disorders (AUDs) involves complex interactions between genetic and neurophysiological aspects, and the research has reported mixed findings when they both co-occur. There is also an indication of a gender-dependent effect; males are more likely to use alcohol to cope with chronic pain problems than females. Recently, a new conceptualization has emerged, proposing that the negative affective component of pain drives and maintains alcohol-related behaviors. We studied in a longitudinal fashion alterations in alcohol drinking patterns and pain thresholds in a mouse model of chronic neuropathic pain in a sex-dependent manner. Following partial denervation (spared nerve injury [SNI]), stimulus-evoked pain responses were measured before chronic alcohol consumption, during drinking, during a deprivation phase, and following an episode of excessive drinking. During the course of alcohol drinking, we observed pronounced sex differences in pain thresholds. Male mice showed a strong increase in pain thresholds, suggesting an analgesic effect induced by alcohol over time, an effect that was not observed in female mice. SNI mice did not differ from sham-operated controls in baseline alcohol consumption. However, following a deprivation phase and the reintroduction of ethanol, male SNI mice but not female mice showed more pronounced excessive drinking than controls. Finally, we observed decreased central ethanol sensitivity in male SNI mice but not in females. Together with our finding, that ethanol is able to decrease a pain-induced negative affective memory we come to following conclusion. We propose that a lower sensitivity to the intoxicating effects of alcohol together with the ability of alcohol to reduce the negative affective component of pain may explain the higher co-occurrence of AUD in male chronic pain patients.
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Affiliation(s)
- Ainhoa Bilbao
- Institute of Psychopharmacology, Central Institute of Mental Health, Medical Faculty of Mannheim; Heidelberg University; Mannheim Germany
| | - Sarah Leixner
- Institute of Psychopharmacology, Central Institute of Mental Health, Medical Faculty of Mannheim; Heidelberg University; Mannheim Germany
| | - Shoupeng Wei
- Institute of Psychopharmacology, Central Institute of Mental Health, Medical Faculty of Mannheim; Heidelberg University; Mannheim Germany
| | - Lídia Cantacorps
- Institute of Psychopharmacology, Central Institute of Mental Health, Medical Faculty of Mannheim; Heidelberg University; Mannheim Germany
- Neurobiology of Behavior Research Group (GReNeC-NeuroBio), Department of Health and Experimental Sciences, IMIM (Hospital del Mar Medical Research Institute); Pompeu Fabra University; Barcelona Spain
| | - Olga Valverde
- Neurobiology of Behavior Research Group (GReNeC-NeuroBio), Department of Health and Experimental Sciences, IMIM (Hospital del Mar Medical Research Institute); Pompeu Fabra University; Barcelona Spain
| | - Rainer Spanagel
- Institute of Psychopharmacology, Central Institute of Mental Health, Medical Faculty of Mannheim; Heidelberg University; Mannheim Germany
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Nilsson S, Wallbing U, Alfvén G, Dalenius K, Fors A, Golsäter M, Rosvall PÅ, Wigert H, Lundberg M. Development of the Help Overcoming Pain Early (HOPE) Programme Built on a Person-Centred Approach to Support School Nurses in the Care of Adolescents with Chronic Pain-A Feasibility Study. CHILDREN-BASEL 2019; 6:children6090095. [PMID: 31450645 PMCID: PMC6770885 DOI: 10.3390/children6090095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 08/15/2019] [Accepted: 08/21/2019] [Indexed: 11/23/2022]
Abstract
Chronic pain and its consequences are major global health challenges, and the prevalence is increasing worldwide among adolescents. Adolescents spend most of their waking hours in school; however, there is limited research available on how school nurses can address chronic pain among adolescents in the Swedish school context. Therefore, we designed a person-centred intervention, known as Help Overcoming Pain Early (HOPE), to enable school nurses to offer adolescents strategies to manage their stress and pain. We used the Medical Research Council (MRC) framework for developing and designing this new complex intervention. For this study, we describe two of the four phases: (a) development and (b) feasibility and piloting. The final version of the HOPE programme consists of (i) an educational package for school nurses in the areas person-centred care, stress and pain education/management and gender perspective; and (ii) an intervention package for adolescents with chronic pain. The programme consists of four sessions during which adolescents with chronic pain have person-centred dialogues with a school nurse. The HOPE programme is based on the existing evidence of managing chronic pain and on the assumption that school nurses can support adolescents with chronic pain by using person-centred care.
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Affiliation(s)
- Stefan Nilsson
- Institute of Health and Care Sciences, and the University of Gothenburg Centre for Person-Centred Care, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden.
| | - Ulrika Wallbing
- Institute of Health and Care Sciences, and the University of Gothenburg Centre for Person-Centred Care, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
- Department of Neurobiology, Care and Sciences and Society, Division of Physiotherapy, Karolinska Institute, 141 52 Huddinge, Sweden
| | - Gösta Alfvén
- Institute of Health and Care Sciences, and the University of Gothenburg Centre for Person-Centred Care, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
- Clintec, Karolinska Institute, 141 52 Huddinge, Sweden
| | | | - Andreas Fors
- Institute of Health and Care Sciences, and the University of Gothenburg Centre for Person-Centred Care, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
- Närhälsan Research and Development Primary Health Care, Region Västra Götaland, SE 411 18 Gothenburg, Sweden
| | - Marie Golsäter
- Child Health Care and Futurum, Region Jönköping County, Barnhälsovården, Regionens hus, 551 85 Jönköping, Sweden
- CHILD Research Group, School of Health and Welfare, Jönköping University, 551 11 Jönköping, Sweden
| | - Per-Åke Rosvall
- Department of Applied Educational Sciences, Umeå University, 901 87 Umeå, Sweden
| | - Helena Wigert
- Institute of Health and Care Sciences, and the University of Gothenburg Centre for Person-Centred Care, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
| | - Mari Lundberg
- Institute of Neuroscience and Physiology, Department of Health and Rehabilitation, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
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Grasaas E, Fegran L, Helseth S, Stinson J, Martinez S, Lalloo C, Haraldstad K. iCanCope With Pain: Cultural Adaptation and Usability Testing of a Self-Management App for Adolescents With Persistent Pain in Norway. JMIR Res Protoc 2019; 8:e12940. [PMID: 31162132 PMCID: PMC6682291 DOI: 10.2196/12940] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 04/12/2019] [Accepted: 04/12/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Persistent or chronic pain is a common health problem among adolescents. Thus, it is important that they receive evidence-based strategies for symptom management. iCanCope with Pain is a mobile phone app designed to help adolescents cope with chronic pain. The app comprises 5 evidence- and theory-based features: (I) symptom trackers for pain, sleep, mood, physical function, and energy; (II) goal setting to improve pain and function; (III) a coping toolbox of pain self-management strategies; (IV) social support; and (V) age-appropriate pain education. The iCanCope with Pain app is based on theory, identified health care needs, and current best practices for pain self-management. OBJECTIVE The objectives of this study were to describe the translation and cultural adaptation of the app into the Norwegian context and evaluate the app's usability using a phased approach. METHODS Phase 1 included translation and cultural adaptation of the app into the Norwegian context. This process used an expert panel of researchers and target group representatives who were responsible for the linguistic quality assurance and assessment. In phases 2 and 3 the app's usability was tested. For phase 2, the assessments of usability and user experiences included observation, the think aloud method, audiovisual recordings, questionnaires, and individual interviews in a laboratory setting. For phase 3, the assessment of usability and user experience over a 2-week home-based test included questionnaires and individual end-user interviews. Overall, app usability was determined based on ease of use, efficiency, and user satisfaction. Qualitative data were analyzed using deductive content analysis. Descriptive statistics were calculated for quantitative data. RESULTS End users did not report any misunderstandings or discrepancies with the words or phrasing of the translated and culturally adapted app. Participants in both the laboratory- and home-based usability tests found the app self-explanatory and reported that all 5 of its features were easy to use. All tasks were completed within the allocated time frame (ie, efficiency), with few errors. Overall System Usability Scale scores were high, with average scores of 82 and 89 out of 100 from laboratory- and field-based tests, respectively. Participants liked the idea of a social support function (feature IV), although qualitative and internet server data revealed that this feature was rarely used. CONCLUSIONS This study described the cultural and linguistic adaptation and usability testing of the Norwegian version of the iCanCope with Pain app. High user satisfaction, ease of use, efficiency, and only minor errors cumulatively indicated that no changes to the app were needed, with the exception of facilitating user interaction within the social support feature. The app will be used in an upcoming randomized controlled trial with a larger sample.
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Affiliation(s)
- Erik Grasaas
- Department of Health and Nursing Science, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Liv Fegran
- Department of Health and Nursing Science, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Sølvi Helseth
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Jennifer Stinson
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada.,Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.,Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Santiago Martinez
- Department of Health and Nursing Science, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Chitra Lalloo
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada.,Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Kristin Haraldstad
- Department of Health and Nursing Science, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
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Heikkala E, Paananen M, Taimela S, Auvinen J, Karppinen J. Associations of co‐occurring psychosocial and lifestyle factors with multisite musculoskeletal pain during late adolescence—A birth cohort study. Eur J Pain 2019; 23:1486-1496. [DOI: 10.1002/ejp.1414] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 04/26/2019] [Accepted: 05/05/2019] [Indexed: 12/11/2022]
Affiliation(s)
- Eveliina Heikkala
- Medical Research Center Oulu University of Oulu and Oulu University Hospital Oulu Finland
- Rovaniemi Health Center Rovaniemi Finland
| | - Markus Paananen
- Medical Research Center Oulu University of Oulu and Oulu University Hospital Oulu Finland
| | - Simo Taimela
- Department of Orthopedics and Traumatology Helsinki University Hospital, Töölö hospital Helsinki Finland
- Clinicum, Department of Orthopedics and Traumatology University of Helsinki Helsinki Finland
| | - Juha Auvinen
- Medical Research Center Oulu University of Oulu and Oulu University Hospital Oulu Finland
- Oulunkaari Health Center Ii Finland
| | - Jaro Karppinen
- Medical Research Center Oulu University of Oulu and Oulu University Hospital Oulu Finland
- Center for Life Course Health Research University of Oulu Finland
- Finnish Institute of Occupational Health Oulu Finland
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Vaičiūnas T, Šmigelskas K. The Role of School-Related Well-Being for Adolescent Subjective Health Complaints. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1577. [PMID: 31064078 PMCID: PMC6540129 DOI: 10.3390/ijerph16091577] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 04/09/2019] [Accepted: 04/24/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND This study aimed to explore the prevalence of chronic specific-site and multisite pain in adolescents and to investigate how it can possibly be determined by school-related factors. METHODS A population-based cross-sectional study was conducted in 2014 in Lithuania as a Health Behavior in School-Aged Children (HBSC) survey. The sample consisted of 5730 school children, aged 11, 13, and 15 years. The analyzed data focused on the school-related context (relations with family, peers, and teachers; school demand, satisfaction, and bullying) of adolescents and subjective health complaints. The relationships between social support and health complaint variables were estimated using multivariate analyses. RESULTS The most common subjective health complaint among respondents was a headache. Backache, headache, and stomachache were more common among girls than boys. All somatic complaints were expressed more in younger ages. Multisite complaints were more common among girls and were associated with age-older ones reported more complaints. School-related bullying, school demand, satisfaction, and social support were the most relevant and independent factors for multisite somatic complaints among adolescents.
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Affiliation(s)
- Tomas Vaičiūnas
- Health Research Institute, Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, LT-47181 Kaunas, Lithuania.
| | - Kastytis Šmigelskas
- Department of Health Psychology, Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, LT-47181 Kaunas, Lithuania.
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Hanna F, Daas RN, El-Shareif TJ, Al-Marridi HH, Al-Rojoub ZM, Adegboye OA. The Relationship Between Sedentary Behavior, Back Pain, and Psychosocial Correlates Among University Employees. Front Public Health 2019; 7:80. [PMID: 31024881 PMCID: PMC6465323 DOI: 10.3389/fpubh.2019.00080] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 03/19/2019] [Indexed: 11/26/2022] Open
Abstract
Objectives: This study aims to investigate the relationship between levels of sedentary behavior, physical activity, and back pain and their psychosocial correlates among university employees. Methods: A cross-sectional study was conducted on both academic and non-academic professional staff at Qatar University. The data collection instrument was a combination of the International Physical Activity Questionnaire (IPAQ), the Global Physical Activity Questionnaire (GPAQ) and the Acute Low Back Pain Screening Questionnaire (ALBPSQ). Results: A total of 479 individuals (57% females) participated in the cross-sectional study. Two hundred and ninety three (61.2%) reported to have experienced back pain. The covariates adjusted odds ratios (aORs) showed that vigorous physical activity was a protective variable for those who experienced lower back pain [aOR = 0.84, 95%CI (0.56–0.98)], both lower and upper back pain [aOR = 0.61, 95% CI (0.33–0.87)] and either lower or upper back pain [aOR = 0.76, 95%CI (0.51–0.85)], respectively. Back pain was significantly higher in females than males (aORs: 1.37–2.21). Similarly, sedentary behavior (too much sitting) was significantly associated with those who experienced either LBP or UBP [aOR = 1.74, 95% CI (1.19, 2.57)]. All back pain categories were found to be significantly associated with those who reported a depressed mood. Conclusions: These findings suggest that sedentary employees are exposed to increasing occupational hazards such as back pain and mental health issues. Strategies should aim to reduce sitting time with planned and feasible physical activity interventions to be incorporated into the workplace health promotion policy to help prevent back pain, back injuries, and mental health complications.
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Affiliation(s)
- Fahad Hanna
- Master of Public Health Program, School of Public Health, Torrens University, Melbourne, VIC, Australia.,Department of Public Health, College of Health Sciences, Qatar University, Doha, Qatar
| | - Rua N Daas
- Department of Public Health, College of Health Sciences, Qatar University, Doha, Qatar
| | - Tasneem J El-Shareif
- Department of Public Health, College of Health Sciences, Qatar University, Doha, Qatar
| | - Haneen H Al-Marridi
- Department of Public Health, College of Health Sciences, Qatar University, Doha, Qatar
| | - Zaina M Al-Rojoub
- Department of Public Health, College of Health Sciences, Qatar University, Doha, Qatar
| | - Oyelola A Adegboye
- Department for Management of Science and Technology Development, Ton Duc Thang University, Ho Chi Minh City, Vietnam.,Faculty of Mathematics and Statistics, Ton Duc Thang University, Ho Chi Minh City, Vietnam
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Horn-Hofmann C, Trost Z, Hublet A, Mrug S, Van Damme J, Vervoort T. The Relationship Between Pain Severity and Alcohol Use Among School-Aged Children and Adolescents: The Moderating Role of Drinking Motives. PAIN MEDICINE 2019; 19:284-296. [PMID: 28340189 DOI: 10.1093/pm/pnx016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective Evidence from adult samples suggests a co-occurrence between pain and alcohol abuse. However, studies in adolescents are scarce and results are inconsistent, with some studies observing heightened and others observing reduced alcohol consumption in adolescents suffering from pain. We hypothesized that in adolescents the association between pain and alcohol use will be moderated by drinking motives. Methods Data from a large representative sample of Flemish school children and adolescents (N = 10,650, 50.8% boys, age range = 10-21 years, Mage = 14.33 years) were collected as part of the World Health Organization collaborative Health Behaviour in School-Aged Children (HBSC) survey. Pain severity was graded based on a pediatric pain classification system that accounts for both pain intensity and disability. Alcohol consumption was operationalized using two variables: frequency of drinking and drunkenness. The Drinking Motives Questionnaire-Revised was used to capture drinking motives; it assesses four motive categories (enhancement, coping, social, and conformity). Results Findings indicated that higher pain severity was associated with greater frequency of alcohol use and drunkenness. However, drinking motives moderated this association. The positive association between pain severity and drinking frequency was stronger in case of high conformity motives. Likewise, the association between pain severity and drunkenness frequency was stronger at high levels of conformity motives and reached significance only at high levels of coping motives. Conclusions Our findings suggest that specific drinking motives are linked to problematic alcohol use in adolescents with pain. Future studies using a longitudinal design are needed to draw conclusions about direction of effects.
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Affiliation(s)
| | - Zina Trost
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | | | - Sylvie Mrug
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | | | - Tine Vervoort
- Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
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Musculoskeletal Multisite Pain and Patterns of Association After Adjusting for Sleep, Physical Activity, and Screen Time in Adolescents. Spine (Phila Pa 1976) 2018; 43:1432-1437. [PMID: 29557924 DOI: 10.1097/brs.0000000000002646] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Cross-sectional. OBJECTIVE This study aims to describe how pain at multiple body sites is associated after controlling for other predictive factors such as age, sex, sleeping hours, time spent in physical activity, and time spent in screening based activities in adolescents aged 13 to 19 years. SUMMARY OF BACKGROUND DATA The prevalence of multisite pain in adolescents is high, but studies investigating the patterns of association between painful body sites are scarce. METHODS Pain for the last 3 months was assessed using Nordic Musculoskeletal Questionnaire. In addition, data on time spent in moderate and vigorous physical activity, sleeping, and in screen based activities were also assessed. RESULTS In univariable analysis of associations, there is a significant association between most painful body sites (odds ratio [OR\ between 1.52 and 3.73, P < 0.05). After controlling for age, sex, physical activity, sleep and screen time, most of the previous associations remain significant (OR between 1.50 and 3.07, P < 0.05). CONCLUSION This study's results seem to suggest that pain at one body site is more important in determining multiple painful body sites than demographic or lifestyle factors. Longitudinal studies exploring the association and chronology of multisite pain are needed. LEVEL OF EVIDENCE 3.
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36
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Jaakkola J, Rantanen A, Luopa P, Koivisto AM, Joronen K. Self-rated health, symptoms and health behaviour of upper secondary vocational students by field of study. Scand J Caring Sci 2018; 33:144-155. [PMID: 30273958 DOI: 10.1111/scs.12613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 07/15/2018] [Indexed: 11/28/2022]
Abstract
This article examines the self-rated health, symptoms and health behaviour of upper secondary vocational students in Finland. The data consist of the responses of first- and second-year vocational students (n = 34 554) to the 2013 School Health Promotion Survey. The data were analysed statistically and processed separately for girls and boys. Associations between self-rated health, symptoms and health behaviour and fields of study were examined by cross-tabulation. Statistical significance was measured using the chi-squared test. Self-rated health, symptoms and health behaviour were found to have a statistically significant association with field of study (p < 0.001). Vocational students in different fields had different experiences of health, different symptoms and different health behaviours. The results complement existing evidence about disparities in well-being among young people in the context of education.
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Affiliation(s)
- Jenni Jaakkola
- Faculty of Social Sciences, Health Sciences, University of Tampere, Tampere, Finland
| | - Anja Rantanen
- Faculty of Social Sciences, Health Sciences, University of Tampere, Tampere, Finland
| | - Pauliina Luopa
- National Institute for Health and Welfare, Helsinki, Finland
| | - Anna-Maija Koivisto
- Faculty of Social Sciences, Health Sciences, University of Tampere, Tampere, Finland
| | - Katja Joronen
- Faculty of Social Sciences, Health Sciences, University of Tampere, Tampere, Finland
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37
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Voepel-Lewis T, Caird MS, Tait AR, Farley FA, Li Y, Malviya S, Hassett A, Weber M, Currier E, de Sibour T, Clauw DJ. A cluster of high psychological and somatic symptoms in children with idiopathic scoliosis predicts persistent pain and analgesic use 1 year after spine fusion. Paediatr Anaesth 2018; 28:873-880. [PMID: 30302887 DOI: 10.1111/pan.13467] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 07/09/2018] [Accepted: 07/23/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Persistent postoperative pain is a significant problem for many children, particularly for those undergoing major surgery such as posterior spine fusion. More than two-thirds report persistent pain after spine fusion, yet factors that may contribute to poorer outcomes remain poorly understood. AIMS This prospective, longitudinal study examined how psychologic and somatic symptoms cluster together in children aged 10-17 years with idiopathic scoliosis, and tested the hypothesis that a higher psychological and somatic symptom cluster would predict worse pain outcomes 1 year after fusion. METHODS Otherwise healthy children with idiopathic scoliosis completed preoperative surveys measuring recent pain intensity, pain location(s), somatic symptom severity, painDETECT (neuropathic-type pain symptoms), pain interference, fatigue, depression, anxiety, and pain catastrophizing. Pain outcome data were collected during hospitalization, and at 1 year after surgery. RESULTS Ninety-five children completed baseline surveys and a cluster analysis differentiated 28 (30%) with a high symptom profile that included; higher depression, fatigue, pain interference, catastrophizing, and painDETECT scores. High symptom cluster membership independently predicted higher pain interference at 1 year (β 9.92 [95% CI 6.63, 13.2], P < 0.001). Furthermore, children in this high symptom cluster reported significantly higher pain intensity and painDETECT scores, and had a 50% higher probability of continued analgesic use at 1 year compared to those in the Low Symptom Cluster (95% CI 21.3-78.5, P = 0.001). CONCLUSION Findings from this exploratory study suggest a need to comprehensively assess children with scoliosis for preoperative signs and symptoms that may indicate an underlying vulnerability for persistent pain. This, in turn may help guide a comprehensive perioperative treatment strategy to mitigate the potential for long-term pain trajectories.
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Affiliation(s)
- Terri Voepel-Lewis
- Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan
| | - Michelle S Caird
- Department of Orthopedic Surgery, University of Michigan, Ann Arbor, Michigan
| | - Alan R Tait
- Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan
| | - Frances A Farley
- Department of Orthopedic Surgery, University of Michigan, Ann Arbor, Michigan
| | - Ying Li
- Department of Orthopedic Surgery, University of Michigan, Ann Arbor, Michigan
| | - Shobha Malviya
- Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan
| | - Afton Hassett
- Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan
| | - Monica Weber
- Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan
| | - Emily Currier
- Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan
| | - Trevor de Sibour
- Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan
| | - Daniel J Clauw
- Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan
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Gobina I, Villberg J, Välimaa R, Tynjälä J, Whitehead R, Cosma A, Brooks F, Cavallo F, Ng K, de Matos MG, Villerusa A. Prevalence of self-reported chronic pain among adolescents: Evidence from 42 countries and regions. Eur J Pain 2018; 23:316-326. [DOI: 10.1002/ejp.1306] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 08/07/2018] [Accepted: 08/07/2018] [Indexed: 11/05/2022]
Affiliation(s)
- Inese Gobina
- Department of Public Health and Epidemiology; Institute of Public Health; Rīga Stradinš University; Rīga Latvia
| | - Jari Villberg
- Faculty of Sport and Health Sciences; University of Jyväskylä; Jyväskylä Finland
| | - Raili Välimaa
- Faculty of Sport and Health Sciences; University of Jyväskylä; Jyväskylä Finland
| | - Jorma Tynjälä
- Faculty of Sport and Health Sciences; University of Jyväskylä; Jyväskylä Finland
| | | | - Alina Cosma
- Child and Adolescent Health Research Unit (CAHRU); School of Medicine; University of St Andrews; St Andrews UK
| | - Fiona Brooks
- Faculty of Health; University of Technology Sydney; Ultimo New South Wales Australia
| | - Franco Cavallo
- Department of Public Health and Paediatrics; School of Medicine; University of Torino; Torino Italy
| | - Kwok Ng
- Physical Education and Sport Sciences Department; University of Limerick; Limerick Ireland
| | | | - Anita Villerusa
- Department of Public Health and Epidemiology; Institute of Public Health; Rīga Stradinš University; Rīga Latvia
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Relationship between pubertal timing and chronic nonspecific pain in adolescent girls: the Young-HUNT3 study (2006-2008). Pain 2018; 158:1554-1560. [PMID: 28520646 DOI: 10.1097/j.pain.0000000000000950] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The aim of this study was to examine a possible relationship between early puberty and chronic nonspecific pain in 13- to 18-year-old girls. All adolescents in Nord-Trøndelag County, Norway, were invited to participate in the Young-HUNT3 study (2006-2008). Of the invited girls, 81% answered the questionnaire and of these 3982 were 13 to 18 years of age. Menarche and perceived physical maturation were used as exposure measures. Early menarche was defined as <12 years, normal menarche as ≥12 and <14 years, and late menarche as ≥14 years. Perceived physical maturation was divided into maturing earlier, the same or later than others of their own age. The main outcome measure was chronic nonspecific pain, defined as pain in at least one location not related to any known disease or injury, for at least once a week during the last 3 months. The median age at menarche was 13.2 years. Chronic nonspecific pain was more prevalent among girls with early menarche (68%, 95% CI: 64%-72%) compared to girls with either normal (55%, 95% CI: 53%-57%), late (50%, 95% CI: 46%-54%), or no menarche (35%, 95% CI: 29%-40%). The association persisted after adjusting for age, body mass index, socioeconomic factors, and anxiety and depression. A similar association was found between girls that perceived themselves as earlier physically matured than their peers and chronic nonspecific pain. Headache/migraine was the most common type of chronic nonspecific pain regardless of menarcheal age. In all reported locations, pain was more prevalent in the group with early menarche compared to normal or late menarche.
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Risk factors of non-specific spinal pain in childhood. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2018; 27:1119-1126. [PMID: 29450642 DOI: 10.1007/s00586-018-5516-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 01/12/2018] [Accepted: 02/05/2018] [Indexed: 12/12/2022]
Abstract
PURPOSE Non-specific spinal pain can occur at all ages and current evidence suggests that pediatric non-specific spinal pain is predictive for adult spinal conditions. A 5-year long, prospective cohort study was conducted to identify the lifestyle and environmental factors leading to non-specific spinal pain in childhood. MATERIALS AND METHODS Data were collected from school children aged 7-16 years, who were randomly selected from three different geographic regions in Hungary. The risk factors were measured with a newly developed patient-reported questionnaire (PRQ). The quality of the instrument was assessed by the reliability with the test-retest method. Test (N = 952) and validity (N = 897) datasets were randomly formed. Risk factors were identified with uni- and multivariate logistic regression models and the predictive performance of the final model was evaluated using the receiver operating characteristic (ROC) method. RESULTS The final model was built up by seven risk factors for spinal pain for days; age > 12 years, learning or watching TV for more than 2 h/day, uncomfortable school-desk, sleeping problems, general discomfort and positive familiar medical history (χ2 = 101.07; df = 8; p < 0.001). The probabilistic performance was confirmed with ROC analysis on the test and validation cohorts (AUC = 0.76; 0.71). A simplified risk scoring system showed increasing possibility for non-specific spinal pain depending on the number of the identified risk factors (χ2 = 65.0; df = 4; p < 0.001). CONCLUSION Seven significant risk factors of non-specific spinal pain in childhood were identified using the new, easy to use and reliable PRQ which makes it possible to stratify the children according to their individual risk. These slides can be retrieved under Electronic Supplementary Material.
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Andias R, Neto M, Silva AG. The effects of pain neuroscience education and exercise on pain, muscle endurance, catastrophizing and anxiety in adolescents with chronic idiopathic neck pain: a school-based pilot, randomized and controlled study. Physiother Theory Pract 2018; 34:682-691. [DOI: 10.1080/09593985.2018.1423590] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Rosa Andias
- School of Health Sciences, University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | | | - Anabela G. Silva
- School of Health Sciences, University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
- CINTESIS.UA, University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
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Abstract
OBJECTIVE To investigate self-reported pain in young adults with a low birth weight. MATERIALS AND METHODS This study was a part of a long-term follow-up study of preterm very low birth weight (VLBW; birth weight ≤1500 g), term small for gestational age (SGA; birth weight <10th percentile adjusted for sex and parity), and control young adults born during 1986 to 1988. Of the 300 individuals invited, 216 (62 VLBW, 67 term SGA, and 87 controls) completed a pain questionnaire. Of these, 151 (70%) had answered a pain severity question at 19 years. Chronic pain was defined as pain lasting for >6 months and being moderate, severe, or very severe during the past 4 weeks. RESULTS The prevalence of chronic pain at 26 years was 16% in the VLBW group, 21% in the term SGA group, and 7% in the control group. The VLBW and the term SGA groups had higher odds ratios for chronic pain (crude OR, 2.6; 95% CI, 0.9-7.6 for the VLBW group and crude OR, 3.6; 95% CI, 1.3-9.9 for the term SGA group vs. controls). The main results remained after adjusting for potential confounding factors. Some attenuation was observed when adjusting for anxiety and depressive problems. Moderate to very severe pain increased from 16% to 41% in the term SGA group from 19 to 26 years, whereas less changes were seen in the VLBW and the control groups. DISCUSSION Results of our study imply that pain should be in focus when conducting long-term follow-up programs of individuals with a low birth weight.
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Østerås B, Sigmundsson H, Haga M. Physical Fitness Levels Do Not Affect Stress Levels in a Sample of Norwegian Adolescents. Front Psychol 2017; 8:2176. [PMID: 29326625 PMCID: PMC5733357 DOI: 10.3389/fpsyg.2017.02176] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 11/29/2017] [Indexed: 01/23/2023] Open
Abstract
Physical inactivity, low physical fitness, and perceived stress during adolescence are presumed to be risk factors for various disorders and subjective health complaints. On the other hand, physical activity and physical fitness, as well as mindfulness qualities, are regarded as prerequisites for health and well-being in children and adolescent, possibly by moderating the negative effects of stress and protecting against stress-related health complaints. Previous studies have suggested gender differences in the relationship between physical activity/physical fitness and psychological variables. The main objective in this study was to evaluate how physical fitness, along with mindfulness qualities (MAAS-A), pain, and BMI, relate to stress (PSQ) in adolescents. Secondary objectives were to explore the relationship between physical fitness, mindfulness (MAAS-A), and BMI more explicitly in the study sample, as well as to evaluate possible gender differences. The cross-sectional sample included 102 Norwegian pupils in 10th grade (15 or 16 years). Study measurements were four items from the Test of Physical Fitness (TPF), the Norwegian version of the four-factor Perceived Stress Questionnaire (PSQ), the Norwegian version of the Mindful Attention Awareness Scale-Adolescent (MAAS-A), and BMI (recorded in terms of self-reported height and weight). Additionally, pain was measured in terms of localization, number of pain sites, duration, and intensity (Visual analogue scale; VAS). According to the regression analyses, physical fitness could not explain any variation in stress among the adolescents. Nevertheless, there were some negative associations between one stress factor (lack of joy) and components of physical fitness at a group level, possibly influenced by conditions not measured in this study. As opposed to physical fitness, mindfulness qualities, and to some degree gender, seemed to explain variation in stress among the adolescents. None of the physical fitness components were associated to mindfulness (MAAS-A), but some components seemed negatively related to BMI, particularly among the males. Among the females, higher physical fitness (in terms of endurance) seemed related to reduced number of pain sites. Of note, the cross-sectional design did not allow us to determine any causal direction among the variables.
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Affiliation(s)
- Berit Østerås
- Department of Neuromedicine and Movement Science (INB), Norwegian University of Science and Technology, Trondheim, Norway.,Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Hermundur Sigmundsson
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Monika Haga
- Department of Neuromedicine and Movement Science (INB), Norwegian University of Science and Technology, Trondheim, Norway
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Transmission of risk from parents with chronic pain to offspring: an integrative conceptual model. Pain 2017; 157:2628-2639. [PMID: 27380502 DOI: 10.1097/j.pain.0000000000000637] [Citation(s) in RCA: 94] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Offspring of parents with chronic pain are at increased risk for pain and adverse mental and physical health outcomes (Higgins et al, 2015). Although the association between chronic pain in parents and offspring has been established, few studies have addressed why or how this relation occurs. Identifying mechanisms for the transmission of risk that leads to the development of chronic pain in offspring is important for developing preventive interventions targeted to decrease risk for chronic pain and related outcomes (eg, disability and internalizing symptoms). This review presents a conceptual model for the intergenerational transmission of chronic pain from parents to offspring with the goal of setting an agenda for future research and the development of preventive interventions. Our proposed model highlights 5 potential mechanisms for the relation between parental chronic pain and pediatric chronic pain and related adverse outcomes: (1) genetics, (2) alterations in early neurobiological development, (3) pain-specific social learning, (4), general parenting and family health, and (5) exposure to stressful environment. In addition, the model presents 3 potential moderators for the relation between parent and child chronic pain: (1) the presence of chronic pain in a second parent, (2) timing, course, and location of parental chronic pain, and (3) offspring's characteristics (ie, sex, developmental stage, race or ethnicity, and temperament). Such a framework highlights chronic pain as inherently familial and intergenerational, opening up avenues for new models of intervention and prevention that can be family centered and include at-risk children.
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Increased Substance Use and Poorer Mental Health in Adolescents With Problematic Musculoskeletal Pain. J Orthop Sports Phys Ther 2017; 47:705-711. [PMID: 28967339 DOI: 10.2519/jospt.2017.7441] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Study Design Cross-sectional study. Background Adolescents with musculoskeletal pain are thought to be at greater risk of modifiable health risk behaviors, but little is known about these behaviors in adolescents with problematic pain. Objective To describe the prevalence of substance use (tobacco smoking, alcohol consumption, and illicit drugs) and poor mental health in adolescents with problematic musculoskeletal pain, compared to those without such pain. Methods Data on self-reported pain, substance use, and poor mental health were collected from 1831 year 9 students (age range, 14-16 years). Participants were considered to have problematic pain if they reported experiencing pain at least monthly over a 6-month period that also required medication or impacted 1 or more of the following: school or work, daily activities, and leisure or sporting activities. Results Almost half (46%) of the participants experienced problematic pain. Adolescents with problematic pain, compared to those without pain, reported higher substance use and poorer mental health: tobacco smoking in the last 4 weeks, 12% versus 7% (odds ratio [OR] = 1.76; 95% confidence interval [CI]: 1.25, 2.28); alcohol consumption in the last 4 weeks, 30% versus 20% (OR = 1.68; 95% CI: 1.34, 2.11); illicit drug use, 13% versus 6% (OR = 2.18; 95% CI: 1.55, 3.07); lower Mental Health Inventory scores (β = -11.43; standard error [SE], 0.96; P<.05), indicating poorer mental health; and higher Strengths and Difficulties Questionnaire total scores (β = 3.67; SE, 0.29; P<.05), indicating greater difficulties. Conclusion Adolescents with problematic pain report higher smoking, alcohol use, and use of illicit drugs and poorer mental health than adolescents without problematic pain. The experience of problematic pain could be an important consideration for substance use and chronic disease prevention. This trial is registered with the Australian New Zealand Clinical Trials Registry (reference number ACTRN12611000606987). J Orthop Sports Phys Ther 2017;47(10):705-711. doi:10.2519/jospt.2017.7441.
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Høie M, Haraldstad K, Rohde G, Fegran L, Westergren T, Helseth S, Slettebø Å, Johannessen B. How school nurses experience and understand everyday pain among adolescents. BMC Nurs 2017; 16:53. [PMID: 28924390 PMCID: PMC5598013 DOI: 10.1186/s12912-017-0247-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 09/04/2017] [Indexed: 01/13/2023] Open
Abstract
Background Pain problems are a rapidly growing health problem found among both children and adolescent, and about 15–30% have reported chronic pain problems. School nurses in Norway meet adolescents with various ailments, including pain. Yet research on how school nurses perceive the pain experienced by adolescents is limited. The aim of the present study was to explore how school nurses explain and experience the everyday pain of adolescents. Method A qualitative study with an explorative design comprising five focus group interviews. Each group consisted of three to five school nurses. Seventeen female school nurses in five junior high schools in Norway, age range 29–65 years participated. To cover the issues a semi structured interview guide was used. The transcribed text was analysed with qualitative content analysis. Results The experience of school nurses with adolescents’ pain in everyday life is mainly that pain is a social, physical, and psychological phenomenon. School nurses experienced that everyday pain is reflecting: 1) high expectations, 2) difficult relationships and traumatic experiences and 3) an unhealthy lifestyle. School nurses have ambivalent attitudes to medicalisation of pain. Conclusion Despite of a biopsychosocial understanding of pain, the school nurses maintained referral practice of medical examinations, with the results that many adolescents became shuttlecocks in the health system. Although the school nurses´ were sceptical of the tendency towards medicalization in society, it appears that they actually help maintain this tendency.
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Affiliation(s)
- Magnhild Høie
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Kristin Haraldstad
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Gudrun Rohde
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Liv Fegran
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Thomas Westergren
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Sølvi Helseth
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway.,Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - Åshild Slettebø
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Berit Johannessen
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
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Sá S, Silva AG. Repositioning error, pressure pain threshold, catastrophizing and anxiety in adolescents with chronic idiopathic neck pain. Musculoskelet Sci Pract 2017; 30:18-24. [PMID: 28494262 DOI: 10.1016/j.msksp.2017.04.011] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 04/06/2017] [Accepted: 04/29/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Impaired proprioception, increased pain sensitivity, higher levels of anxiety and catastrophizing are present in adults with chronic idiopathic neck pain. Despite the high prevalence of neck pain, studies in adolescents are scarce. OBJECTIVES The main aim was to compare pressure pain thresholds (PPTs) and joint repositioning error (JRE) between adolescents with chronic idiopathic neck pain and adolescents without neck pain. Secondary aims were to compare these groups for catastrophizing and anxiety and to investigate the association between PPTs, JRE and psychosocial variables and pain characteristics. METHODS 80 adolescents (40 with and 40 without chronic neck pain) were assessed for: neck repositioning error, neck, upper trapezius and tibialis anterior PPTs, anxiety and catastrophizing. Neck pain was characterized in terms of intensity, frequency, duration and associated disability. MANCOVA was used for between group comparisons and Pearson and Spearman coefficients for correlational analysis. RESULTS Adolescents with neck pain showed higher levels of catastrophizing (p < 0.001) and anxiety (trait: p < 0.001; state: p = 0.028), lower PPTs (p < 0.001) and higher JRE (p < 0.001) than asymptomatic controls. Pain intensity, frequency and duration were moderately correlated with anxiety, and disability was moderately correlated with anxiety (r between 0.43 and 0.50, p < 0.05) and catastrophizing (r = 0.40, p < 0.05). CONCLUSIONS This study suggests that functional changes and maladaptive cognitive processes are present in adolescents with neck pain aged 16-18 years old. These findings need to be replicated in future studies.
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Affiliation(s)
- Sofia Sá
- School of Health Sciences, University of Aveiro, Portugal
| | - Anabela G Silva
- School of Health Sciences, University of Aveiro, Portugal; Center for Health Technology and Services Research (CINTESIS.UA), Universidade de Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal.
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Haraldstad K, Christophersen KA, Helseth S. Health-related quality of life and pain in children and adolescents: a school survey. BMC Pediatr 2017; 17:174. [PMID: 28738818 PMCID: PMC5525195 DOI: 10.1186/s12887-017-0927-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 07/19/2017] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Pain problems are common in children and adolescents. Measures of health-related quality of life (HRQoL) can be used to assess children's subjective perspectives of pain experience and its impact on their life. The aims of the study were to describe HRQoL and the prevalence of pain in a nonclinical population of children and adolescents, and to analyze the relationships between HRQoL, pain, sex, and age in a sample of children and adolescents aged 8-18 years. METHODS This cross-sectional study involved a cluster sample of 20 randomly selected schools drawn within a region of Norway. The final study sample included 1099 children and adolescents. We measured HRQoL using the generic questionnaire KIDSCREEN-52 and pain using questions from the Lübeck Pain-Screening Questionnaire. Multiple regression was used to analyze relationships between HRQoL and sex, age, and pain. RESULTS The response rate was 74%. A large percentage of the sample, 60%, reported pain, and girls reported significantly more pain than boys, 76% of the girls in the age group 16-18 years reported pain. The KIDSCREEN-52 scores differed between girls and boys, and on average, girls reported a significantly lower HRQoL than boys on most dimensions. Pain problems were associated with lower HRQoL, and older girls were most impaired by pain. CONCLUSIONS The findings from this study indicate that pain problems are highly prevalent in children, and more prevalent in girls than in boys. HRQoL was impaired for all 10 dimensions of the KIDSCREEN-52 in children with pain. The subscales self-perception, psychological well-being, mood, relationship with parents, and school environment were most affected.
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Affiliation(s)
- Kristin Haraldstad
- Faculty of Health- and Sport Sciences, University of Agder, P.O box 422, 4604, Kristiansand, Norway.
| | | | - Sølvi Helseth
- Faculty of Health- and Sport Sciences, University of Agder, P.O box 422, 4604, Kristiansand, Norway.,Faculty of Health, Oslo and Akershus University College of Applied Sciences, P.O box 4 St Olavs Plass, 0130, Oslo, Norway
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Silva AG, Sa-Couto P, Queirós A, Neto M, Rocha NP. Pain, pain intensity and pain disability in high school students are differently associated with physical activity, screening hours and sleep. BMC Musculoskelet Disord 2017; 18:194. [PMID: 28511650 PMCID: PMC5434614 DOI: 10.1186/s12891-017-1557-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 05/06/2017] [Indexed: 12/31/2022] Open
Abstract
Background Studies exploring the association between physical activity, screen time and sleep and pain usually focus on a limited number of painful body sites. Nevertheless, pain at different body sites is likely to be of different nature. Therefore, this study aims to explore and compare the association between time spent in self-reported physical activity, in screen based activities and sleeping and i) pain presence in the last 7-days for 9 different body sites; ii) pain intensity at 9 different body sites and iii) global disability. Methods Nine hundred sixty nine students completed a questionnaire on pain, time spent in moderate and vigorous physical activity, screen based time watching TV/DVD, playing, using mobile phones and computers and sleeping hours. Univariate and multivariate associations between pain presence, pain intensity and disability and physical activity, screen based time and sleeping hours were investigated. Results Pain presence: sleeping remained in the multivariable model for the neck, mid back, wrists, knees and ankles/feet (OR 1.17 to 2.11); moderate physical activity remained in the multivariate model for the neck, shoulders, wrists, hips and ankles/feet (OR 1.06 to 1.08); vigorous physical activity remained in the multivariate model for mid back, knees and ankles/feet (OR 1.05 to 1.09) and screen time remained in the multivariate model for the low back (OR = 2.34. Pain intensity: screen time and moderate physical activity remained in the multivariable model for pain intensity at the neck, mid back, low back, shoulder, knees and ankles/feet (Rp2 0.02 to 0.04) and at the wrists (Rp2 = 0.04), respectively. Disability showed no association with sleeping, screen time or physical activity. Conclusions This study suggests both similarities and differences in the patterns of association between time spent in physical activity, sleeping and in screen based activities and pain presence at 8 different body sites. In addition, they also suggest that the factors associated with the presence of pain, pain intensity and pain associated disability are different.
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Affiliation(s)
- Anabela G Silva
- School of Health Sciences, University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal. .,Center for Health Technology and Services Research (CINTESIS), Piso 2, edifício nascente, Rua Dr. Plácido da Costa, s/n, 4200-450, Porto, Portugal.
| | - Pedro Sa-Couto
- Center for Research and Development in Mathematics and Applications (CIDMA), Department of Mathematics (DMAT), University of Aveiro, Aveiro, Portugal
| | - Alexandra Queirós
- School of Health Sciences, University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal.,Institute of Electronics and Telematics Engineering of Aveiro (IEETA), University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal
| | - Maritza Neto
- Primary Healthcare Center, Av. Dr. Rocha Madail,S/N, Ílhavo, Portugal
| | - Nelson P Rocha
- Institute of Electronics and Telematics Engineering of Aveiro (IEETA), University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal.,Department of Medical Sciences, University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal
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Voepel-Lewis T, Caird MS, Tait AR, Malviya S, Farley FA, Li Y, Abbott MD, van Veen T, Hassett AL, Clauw DJ. A High Preoperative Pain and Symptom Profile Predicts Worse Pain Outcomes for Children After Spine Fusion Surgery. Anesth Analg 2017; 124:1594-1602. [DOI: 10.1213/ane.0000000000001963] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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