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青少年早期单区域和多区域躯体疼痛的生物心理社会属性:ABCD 队列分析。

Biopsychosocial Attributes of Single-region and Multi-region Body Pain During Early Adolescence: Analysis of the ABCD Cohort.

机构信息

School of Nursing.

Michigan Medicine Department of Pediatrics.

出版信息

Clin J Pain. 2022 Nov 1;38(11):670-679. doi: 10.1097/AJP.0000000000001069.

Abstract

OBJECTIVES

Multi-region pain during adolescence is associated with a higher symptom burden and lower quality of life. The purpose of this study was to describe and compare the biopsychosocial attributes of single-region and multi-region pain among healthy young adolescents.

MATERIALS AND METHODS

We analyzed data from 10,320 children aged 10.6 to 14 years who self-reported pain in the Adolescent Brain and Cognitive Development Study. Pain was coded as single-region or multi-region based on body map data.

RESULTS

One in 5 young adolescents indicated recent multi-region pain. Sequential regression supported improved model fit when psychological and sociocultural factors were added to a biological model of pain; however, these models improved the classification of multi-region but not single-region pain. A significant interaction effect of sex and puberty remained constant across models with increased odds of pain at each advancing pubertal stage for both sexes compared with prepuberty, but no difference between girls and boys at late puberty (adjusted odds ratio [OR]=2.45 [1.72, 3.49] and adjusted OR=1.63 [1.20, 2.23], respectively). Psychological factors improved the classification of multi-region pain with significant effects of anxiety, somatic symptoms, and somnolence. Finally, compared with White and non-Hispanic children, Black and Hispanic children were less likely to report pain (adjusted OR=0.70 [0.61, 0.80]; adjusted OR=0.88 [0.78, 0.99], respectively) but had significantly higher pain interference when pain was present (adjusted OR=1.49 [1.29, 1.73] and adjusted OR=1.20 [1.06, 1.35], respectively).

DISCUSSION

Pain is a biopsychosocial phenomenon, but psychological and sociocultural features may be more relevant for multi-region compared with single-region pain during early adolescence.

摘要

目的

青少年时期的多区域疼痛与更高的症状负担和更低的生活质量相关。本研究的目的是描述和比较健康年轻青少年的单区域和多区域疼痛的生物心理社会特征。

材料和方法

我们分析了来自青少年大脑与认知发展研究的 10320 名年龄在 10.6 至 14 岁之间自我报告有疼痛的儿童的数据。根据身体图谱数据,疼痛被编码为单区域或多区域。

结果

五分之一的年轻青少年表示最近有多区域疼痛。序列回归支持在生物疼痛模型中加入心理和社会文化因素后模型拟合度的提高;然而,这些模型改善了多区域疼痛的分类,但不能改善单区域疼痛的分类。在每个青春期阶段,与青春期前相比,两性的疼痛风险都增加,且性别和青春期的交互效应保持不变,但在青春期后期,女孩和男孩之间没有差异(调整后的优势比[OR]为 2.45[1.72,3.49]和调整后的 OR=1.63[1.20,2.23])。心理因素改善了多区域疼痛的分类,焦虑、躯体症状和嗜睡有显著影响。最后,与白人和非西班牙裔儿童相比,黑人和西班牙裔儿童报告疼痛的可能性较低(调整后的 OR=0.70[0.61,0.80];调整后的 OR=0.88[0.78,0.99]),但当疼痛存在时,疼痛干扰显著更高(调整后的 OR=1.49[1.29,1.73]和调整后的 OR=1.20[1.06,1.35])。

讨论

疼痛是一种生物心理社会现象,但与单区域疼痛相比,心理和社会文化特征在青春期早期可能与多区域疼痛更为相关。

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