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. 2011 Sep-Oct;16(5):303-9.
doi: 10.1155/2011/534652.

Persistent pain in a community-based sample of children and adolescents

Samantha Fuss  1 , Gabrielle Pagé, Joel Katz
Affiliations

Persistent pain in a community-based sample of children and adolescents

Samantha Fuss et al. Pain Res Manag. 2011 Sep-Oct.

Abstract
in English, French

Background: Very few studies have investigated the psychological factors associated with the pain experiences of children and adolescents in community samples.

Objectives: To examine the lifetime prevalence of, and psychological variables associated with, persistent pain in a community sample of children and adolescents, and to explore differences according to sex, age and pain history.

Methods: Participants completed the Childhood Anxiety Sensitivity Index (CASI), the Child Pain Anxiety Symptoms Scale (CPASS), the Multidimensional Anxiety Scale for Children-10 (MASC-10), the Pain Catastrophizing Scale for Children (PCS-C) and a pain history questionnaire that assessed chronicity and pain frequency. After research ethics board approval, informed consent⁄assent was obtained from 1022 individuals recruited to participate in a study conducted at the Ontario Science Centre (Toronto, Ontario).

Results: Of the 1006 participants (54% female, mean [± SD] age 11.6±2.7 years) who provided complete data, 27% reported having experienced pain that lasted for three months or longer. A 2×2×2 (pain history, age and sex) multivariate ANOVA was conducted, with the total scores on the CASI, the CPASS, the MASC-10 and the PCS-C as dependent variables. Girls with a history of persistent pain expressed higher levels of anxiety sensitivity (P<0.001) and pain catastrophizing (P<0.001) than both girls without a pain history and boys regardless of pain history. This same pattern of results was found for anxiety and pain anxiety in the older, but not the younger, age group.

Conclusions: Boys and girls appear to differ in terms of how age and pain history relate to the expression of pain-related psychological variables. Given the prevalence of persistent pain found in the study, more research is needed regarding the developmental implications of persistent pain in childhood and adolescence.

HISTORIQUE :: Très peu d’études ont porté sur les facteurs psychologiques associés aux expériences de douleur d’enfants et d’adolescents provenant d’échantillons communautaires.

OBJECTIFS :: Examiner la prévalence à vie et les variables psychologiques de la douleur persistante dans un échantillon communautaire d’enfants et d’adolescents et explorer les différences selon le sexe, l’âge et les antécédents de douleur.

MÉTHODOLOGIE :: Les participants ont rempli l’indice de sensibilité à l’anxiété de l’enfance (CASI), l’échelle de symptômes d’anxiété liés à la douleur chez l’enfant (CPASS), l’échelle d’anxiété multidimensionnelle pour les enfants-10 (MASC-10), l’échelle de catastrophisation de la douleur chez les enfants (PCS-C) et un questionnaire d’antécédents de douleur qui évaluait la chronicité et la fréquence de la douleur. Après l’approbation d’un comité d’éthique de la recherche, 1 022 personnes recrutées pour participer à une étude menée à l’Ontario Science Centre de Toronto, en Ontario, ont donné leur autorisation ou leur consentement éclairé.

RÉSULTATS :: Sur les 1 006 participants (54 % de femmes, âge moyen [±ÉT] de 11,6±2,7 ans) qui avaient fourni des données complètes, 27 % ont déclaré avoir ressenti de la douleur pendantau moins trois mois. Les chercheurs ont effectué une ANOVA multivariée 2×2×2 (antécédents de douleur, âge et sexe), les indices totaux du CASI, de la CPASS, de la MASC-10 et de la PCS-C servant de variables dépendantes. Les filles ayant des antécédents de douleur persistante exprimaient des taux plus élevés de sensibilité à l’anxiété (P<0,001) et de catastrophisation de la douleur (P<0,001) que les filles n’ayant pas de tels antécédents et que les garçons, quels que soient leurs antécédents. Les chercheurs ont constaté le même schème de résultats relativement à l’anxiété et à l’anxiété de la douleur au sein du groupe plus âgé, mais pas du groupe plus jeune.

CONCLUSIONS :: Les garçons et les filles semblent différents pour ce qui est du lien entre l’âge ainsi que les antécédents de douleur et l’expression des variables psychologiques liées à la douleur. Étant donné la prévalence de douleur persistante constatée dans l’étude, plus de recherches s’imposent sur les répercussions de la douleur persistante sur le développement pendant l’enfance et l’adolescence.

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Figures

Figure 1)
Figure 1)
Mean ± SEM scores on the Childhood Anxiety Sensitivity Index (CASI) and the Pain Catastrophizing Scale for Children (PCS-C) according to pain history and sex. Girls with a history of persistent pain had significantly higher scores on the CASI and PCS-C than girls without a history of persistent pain. Boys did not differ significantly according to pain history. Note that the range of scores, which does not include 0, has been restricted to facilitate plotting
Figure 2)
Figure 2)
Mean ± SEM scores on the Child Pain Anxiety Symptoms Scale (CPASS) according to age, sex and pain history. In the younger age group (eight to 11 years), girls with no history of persistent pain had significantly higher scores than boys with the same pain history. In the older age group (12 to 18 years), girls with a history of persistent pain had significantly higher scores than boys with the same pain history as well as boys with no history of persistent pain. Note that the range of scores, which does not include 0, has been restricted to facilitate plotting
Figure 3)
Figure 3)
Mean ± SEM scores on the Multidimensional Anxiety Scale for Children-10 (MASC-10) according to age, sex and pain history. In the younger age group, girls with no history of persistent pain had significantly higher scores than boys with no history of pain. In the older age group, girls with a history of persistent pain had significantly higher scores than both boys with and without a history of pain. Note that the range of scores, which does not include 0, has been restricted to facilitate plotting
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