E. Wainwright¹, A. Jordan², E. Fisher², C. Wilson³, D. Mullen³, H. Madhavakkannan²

¹University of Aberdeen, UK

²University of Bath, UK

³Trinity College Dublin, Ireland

Background:

Approximately 25% of young people live with chronic pain [1] often with co-morbid worry [2]. Beliefs about worry and pain are important in understanding maintenance of these phenomena and may be important in the processes that link them.

Aim:

To explore beliefs about worries, beliefs about pain and worries about pain held by adolescents with and without chronic pain.

Methods:

Adolescents with and without chronic pain aged 14-19 completed the Penn-State Worry Questionnaire [3[ and Pain Catastrophising Scale for Children [4] to contextualize qualitative data collected via an online survey.

Results:

Eighty-one participants completed the survey, 36 with chronic pain, and 45 without (mean age:16.73). Compared to adolescents without chronic pain, adolescents with chronic pain reported significantly higher general worry (F(1,78)=6.10,p=0.016) and pain catastrophizing (F(1,75)=21.37,p<0.001). Thematic analysis of qualitative data showed worry and pain both change perceptions of selfhood, distorting current and future trajectories of adolescents’ identities. Although we did not ask specifically about working lives, adolescents experiencing chronic pain spontaneously reported serious worries that pain will reduce their future career progression.

Conclusions:

Adolescents in pain may benefit from assistance identifying and reducing how pain-related worries interact with their futures and careers, and from vocational interventions to support how they negotiate modern labour markets. Adolescents need greater support in recognizing worry as part of normative development. This study has been published in a psychology journal [5]; we wanted to highlight to an occupational medical audience that adolescents in pain already worry that pain will limit their future working lives.

References:

[1] King, S., Chambers, C. T., Huguet, A., MacNevin, R. C., McGrath, P. J., Parker, L., & MacDonald, A. J. (2011). The epidemiology of chronic pain in children and     adolescents revisited: a systematic review. Pain, 152(12), 2729-2738. doi: 10.1016/j.pain.2011.07.016

[2] Simons, L. E., Sieberg, C. B., & Claar, R. L. (2012). Anxiety and functional disability in a  large sample of children and adolescents with chronic pain. Pain Research and         Management, 17, 93-97. doi: 10.1016/j.jpain.2012.05.002

[3] Chorpita, B. F., Tracey, S. A., Brown, T. A., Collica, T. J., & Barlow, D. H. (1997). Assessment of worry in children and adolescents: An adaptation of the Penn State Worry Questionnaire. Behaviour Research and Therapy, 35(6), 569-581. https://doi.org/10.1016/S0005-7967(96)00116-7

[4] Crombez, G., Bijttebier, P., Eccleston, C., Mascagni, T., Mertens, G., Goubert, L., & Verstraeten, K. (2003). The child version of the pain catastrophizing scale (PCS-C): A preliminary validation. Pain, 104, 639–646. DOI:10.1016/s0304-3959(03)00121-0

[5] Wainwright, E., Jordan, A., Fisher, E., Wilson, C., Mullen, D. and Madhavakkannan, H., 2021. Beliefs about worry and pain amongst adolescents with and without chronic pain. Journal of Pediatric Psychology. 1–14 doi: 10.1093/jpepsy/jsab109