Stanford Elizabeth A, Chambers Christine T, Biesanz Jeremy C, Chen Edith
Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, BC V6T 1Z4, Canada Departments of Pediatrics and Psychology, Dalhousie University & IWK Health Centre, Halifax, NS, Canada.
Pain. 2008 Aug 15;138(1):11-21. doi: 10.1016/j.pain.2007.10.032. Epub 2008 Feb 21.
Recurrent pains are a complex set of conditions that cause great discomfort and impairment in children and adults. The objectives of this study were to (a) describe the frequency of headache, stomachache, and backache in a representative Canadian adolescent sample and (b) determine whether a set of psychosocial factors, including background factors (i.e., sex, pubertal status, parent chronic pain), external events (i.e., injury, illness/hospitalization, stressful-life events), and emotional factors (i.e., anxiety/depression, self-esteem) were predictive of these types of recurrent pain. Statistics Canada's National Longitudinal Survey of Children and Youth was used to assess a cohort of 2488 10- to 11-year-old adolescents up to five times, every 2 years. Results showed that, across 12-19 years of age, weekly or more frequent rates ranged from 26.1%-31.8% for headache, 13.5-22.2% for stomachache, and 17.6-25.8% for backache. Chi-square tests indicated that girls had higher rates of pain than boys for all types of pain, at all time points. Structural equation modeling using latent growth curves showed that sex and anxiety/depression at age 10-11 years was predictive of the start- and end-point intercepts (i.e., trajectories that indicated high levels of pain across time) and/or slopes (i.e., trajectories of pain that increased over time) for all three types of pain. Although there were also other factors that predicted only certain pain types or certain trajectory types, overall the results of this study suggest that adolescent recurrent pain is very common and that psychosocial factors can predict trajectories of recurrent pain over time across adolescence.
复发性疼痛是一组复杂的病症，会给儿童和成人带来极大的不适和功能损害。本研究的目的是：(a) 描述加拿大具有代表性的青少年样本中头痛、胃痛和背痛的发生频率；(b) 确定一组社会心理因素，包括背景因素（即性别、青春期状态、父母慢性疼痛）、外部事件（即受伤、疾病/住院、生活应激事件）和情绪因素（即焦虑/抑郁、自尊）是否可预测这些类型的复发性疼痛。加拿大统计局的儿童和青少年全国纵向调查用于对2488名10至11岁青少年组成的队列进行评估，每两年评估一次，共评估五次。结果显示，在12至19岁期间，头痛的每周或更频繁发生率在26.1%-31.8%之间，胃痛为13.5%-22.2%，背痛为17.6%-25.8%。卡方检验表明，在所有时间点，所有类型疼痛的女孩发生率均高于男孩。使用潜在增长曲线的结构方程模型表明，10至11岁时的性别和焦虑/抑郁可预测所有三种类型疼痛的起始点和终点截距（即表明随时间疼痛程度较高的轨迹）和/或斜率（即随时间增加的疼痛轨迹）。尽管也有其他因素仅预测某些疼痛类型或某些轨迹类型，但总体而言，本研究结果表明青少年复发性疼痛非常普遍，社会心理因素可预测整个青春期复发性疼痛随时间的轨迹。
