Anxiety and psychosocial stress as predictors of headache and abdominal pain in urban early adolescents

Abstract

Objective: To examine the relations among anxiety, psychosocial stress, and headache and abdominal pain complaints within the context of the Biobehavioral Model of Pediatric Pain.

Methods: Adolescents from urban schools serving a predominantly African-American population completed measures of pain, anxiety, witnessing violence, problem situations, and victimization at the end of the seventh grade (N = 502) and 6 months later (longitudinal N = 289).

Results: A high prevalence of weekly headaches (40%) and abdominal pain (36%) was reported. Anxiety partially mediated relations between psychosocial stress and pain at Time 1, particularly for problem situations. Longitudinal models showed that adolescents reporting higher levels of pain at Time 1 reported greater increases in victimization and anxiety at Time 2. Changes in pain were positively correlated with changes in anxiety and stress variables.

Conclusions: Implications for understanding the causes and correlates of headache and abdominal pain in normal children are discussed.