Biopsychosocial Attributes of Single-region and Multi-region Body Pain During Early Adolescence

Senger-Carpenter, Thea; Scott, Eric L.; Isaman, Deanna J. M.; Lenko, Rachel; Seng, Julia S.; Ploutz‐Snyder, Robert; Robinson‐Lane, Sheria G.; Cofield, Cherie; Chen, Bingxin; Voepel‐Lewis, Terri

doi:10.1097/ajp.0000000000001069

Cited by 3 publications

(2 citation statements)

References 74 publications

(163 reference statements)

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“…Findings of greater self-reported pubertal maturity as a risk factor for pain incidence across both sexes are consistent with several cross-sectional 36,56,59,65 and longitudinal 26,30,31 studies. For example, higher pubertal status was found to predict greater likelihood of back pain 2 to 3 years later in both Dutch and US adolescents, independent of age.…”

Section: Discussionsupporting

confidence: 85%

Pubertal development and pain incidence and characteristics in children: a 1-year prospective cohort study of a national sample

Lopez

Gupta

et al. 2023

Pain

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Sex differences in pain become apparent during puberty. However, the influence of key pubertal characteristics and pubertal hormones on pain is largely unknown. We examined the prospective associations between self-reported and hormone-indicated pubertal characteristics and pain incidence and severity in 10- to 11-year-old pain-free youth in the Adolescent Brain Cognitive Development (ABCD) Study over 1 year. Puberty was measured at baseline and follow-up with self-report (Pubertal Development Scale [PDS]) and hormonal assessment (salivary dehydroepiandrosterone [DHEA], testosterone, and estradiol). Pain status (yes/no), intensity, and interference (0-10 numerical rating scale) in the past month were self-reported at follow-up. Pubertal maturity, progression, and asynchrony were examined in relation to pain onset and severity through confounder-adjusted generalized estimating equations modified Poisson and linear mixed regression models. Among 6631 pain-free youth at baseline, 1-year incident pain was 30.7%. In both sexes, higher PDS scores were associated with greater risk of pain onset (relative risk [RR] = 1.10 to 1.27, Ps < 0.01). In boys, higher PDS item variance was associated with greater pain incidence (RR = 1.11, 95% CI, 1.03-1.20) and interference (beta = 0.40, 95% CI, 0.03-0.76); higher PDS overall and gonadal scores were associated with higher pain intensity (Ps < 0.05). Associations with hormones were seen in boys only, with each 10-fold higher testosterone levels associated with a 40% lower risk of pain incidence (95% CI, −55% to −22%) and 1.30-point lower (95% CI, −2.12 to −0.48) pain intensity, and higher DHEA levels were associated with lower pain intensity (P = 0.020). Relationships between pubertal development and pain in peripubertal adolescents are sex specific and puberty measurement specific and warrant further investigation.

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Section: Discussionsupporting

confidence: 85%

Pubertal development and pain incidence and characteristics in children: a 1-year prospective cohort study of a national sample

Lopez

Gupta

et al. 2023

Pain

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“…We also report the child's self-reported pain location as single region vs multiregion (Ն2 body regions; eg, head and neck, abdomen and pelvis, chest, back). 37,38 Children also self-reported their past-month pain intensity (0, no pain, to 10, worst pain) and pain interference with normal activities (0, not at all, to 10, stopped me from doing anything).…”

Section: Self-reported Painmentioning

confidence: 99%

Associations of Co-occurring Symptom Trajectories With Sex, Race, Ethnicity, and Health Care Utilization in Children

et al. 2023

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ImportanceCo-occurring physical and psychological symptoms during childhood and early adolescence may increase risk of symptom persistence into adulthood.ObjectiveTo describe co-occurring pain, psychological, and sleep disturbance symptom (pain-PSS) trajectories in a diverse cohort of children and the association of symptom trajectory with health care utilization.Design, Setting, and ParticipantsThis cohort study was a secondary analysis of longitudinal data from the Adolescent Brain Cognitive Development (ABCD) Study, collected between 2016 and 2022 at 21 research sites across the US. Participants included children with 2 to 4 complete annual symptom assessments. Data were analyzed from November 2022 to March 2023.Main Outcomes and MeasuresFour-year symptom trajectories were derived from multivariate latent growth curve analyses. Pain-PSS scores, including depression and anxiety, were measured using subscales from the Child Behavior Checklist and the Sleep Disturbance Scale of Childhood. Nonroutine medical care and mental health care utilization were measured using medical history and Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) items.ResultsA total of 11 473 children (6018 [52.5%] male; mean [SD] age at baseline, 9.91 [0.63] years) were included in analyses. Four no pain-PSS and 5 pain-PSS trajectories were supported with good or excellent model fit (predicted probabilities, 0.87-0.96). Most children (9327 [81.3%]) had asymptomatic or low, intermittent, or single symptom trajectories. Approximately 1 in 5 children (2146 [18.7%]) had moderate to high co-occurring symptom trajectories that persisted or worsened. Compared with White children, there was a lower relative risk of having moderate to high co-occurring symptom trajectories among Black children (adjusted relative risk ratio [aRRR] range, 0.15-0.38), Hispanic children (aRRR range, 0.58-0.67), and children who identified as another race (including American Indian, Asian, Native Hawaiian, and other Pacific Islader; aRRR range, 0.43-0.59). Less than half of children with moderate to high co-occurring symptom trajectories used nonroutine health care, despite higher utilization compared with asymptomatic children (nonroutine medical care: adjusted odds ratio [aOR], 2.43 [95% CI, 1.97-2.99]; mental health services: aOR, 26.84 [95% CI, 17.89-40.29]). Black children were less likely to report nonroutine medical care (aOR, 0.61 [95% CI, 0.52-0.71]) or mental health care (aOR, 0.68 [95% CI, 0.54-0.87]) than White children, while Hispanic children were less likely to have used mental health care (aOR, 0.59 [95% CI, 0.47-0.73]) than non-Hispanic children. Lower household income was associated with lower odds of nonroutine medical care (aOR, 0.87 [95% CI, 0.77-0.99]) but not mental health care.Conclusions and RelevanceThese findings suggest there is a need for innovative and equitable intervention approaches to decrease the potential for symptom persistence during adolescence.

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Influence of chronotype on pain incidence during early adolescence

Li,

Groenewald,

Tham

et al. 2024

Pain

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During adolescence major shifts in sleep and circadian systems occur with a notable circadian phase delay. Yet, the circadian influence on pain during early adolescence is largely unknown. Using 2 years of data from the Adolescent Brain Cognitive Development study, we investigated the impact of chronotype on pain incidence, moderate-to-severe pain, and multiregion pain 1 year later in U.S. adolescents. Based on the Munich ChronoType Questionnaire, chronotype was calculated as the midpoint between sleep onset and offset on free days, corrected for sleep debt over the week. Adolescents reported pain presence over the past month, and if present, rated pain intensity (0-10 numerical rating scale; ≥ 4 defined as moderate-to-severe pain) and body site locations (Collaborative Health Outcomes Information Registry Body Map; ≥2 regions defined as multiregion pain). Three-level random intercept logistic regression models were specified for each pain outcome, adjusting for baseline sociodemographic and developmental characteristics. Among 5991 initially pain-free adolescents (mean age 12.0 years, SD 0.7), the mean chronotype was 3:59 am (SD 97 minutes), and the 1-year incidence of pain, moderate-to-severe pain, and multiregion pain was 24.4%, 15.2%, and 13.5%, respectively. Each hour later chronotype at baseline was associated with higher odds of developing any pain (odds ratio [OR] = 1.06, 95% confidence interval [CI] = 1.01, 1.11), moderate-to-severe pain (OR = 1.10, 95% CI = 1.05-1.17), and multiregion pain (OR = 1.08, 95% CI = 1.02-1.14) during 1-year follow-up. In this diverse U.S. adolescent sample, later chronotype predicted higher incidence of new-onset pain.

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Biopsychosocial Attributes of Single-region and Multi-region Body Pain During Early Adolescence

Cited by 3 publications

References 74 publications

Pubertal development and pain incidence and characteristics in children: a 1-year prospective cohort study of a national sample

Pubertal development and pain incidence and characteristics in children: a 1-year prospective cohort study of a national sample

Associations of Co-occurring Symptom Trajectories With Sex, Race, Ethnicity, and Health Care Utilization in Children

Influence of chronotype on pain incidence during early adolescence

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