Department of Psychology & Neuroscience, Dalhousie University, Halifax.
Centre for Pediatric Pain Research, IWK Health, Halifax, Nova Scotia.
Clin J Pain. 2023 May 1;39(5):226-235. doi: 10.1097/AJP.0000000000001108.
Chronic pain in youth is often associated with social conflict, depression, and suicidality. The interpersonal theory of suicide posits that there are psychosocial factors, such as peer victimization and lack of fear of pain, that may also influence suicidality.
The objective of this study was to determine whether depressive symptoms, peer victimization, and lack of fear of pain predict suicidality in adolescents with chronic pain. It was hypothesized that higher levels of depressive symptoms and peer victimization, and lower levels of fear of pain, would predict a higher lifetime prevalence of suicidality.
Participants consisted of 184 youth with primary chronic pain conditions (10 to 18 y, M = 14.27 y). Measures included diagnostic clinical interviews assessing suicidality and self-report questionnaires assessing depressive symptoms, peer victimization, and fear of pain.
Forty-two (22.8%) participants reported suicidality. Regression analyses demonstrated that the occurrence of suicidality was associated with higher rates of depressive symptoms (β = 1.03, P = 0.020, 95% CI: 1.01, 1.06) and peer victimization (β = 2.23, P < 0.05, 95% CI: 1.07, 4.63), though there was no association between lower fear of pain and suicidality.
These results suggest that depressive symptoms and peer victimization are significant predictors of suicidality in adolescents with chronic pain; however, lower fear of pain was not shown to be a significant predictor. Given these findings, depression and peer victimization should be further explored and considered in the design and implementation of prevention and early intervention strategies that target chronic pain and suicidality in youth.
青少年慢性疼痛常与社会冲突、抑郁和自杀意念相关。自杀的人际关系理论认为，也存在一些心理社会因素，如同伴受欺凌和不怕疼痛，可能也会影响自杀意念。
本研究旨在确定抑郁症状、同伴受欺凌和不怕疼痛是否可预测患有慢性疼痛的青少年的自杀意念。假设更高水平的抑郁症状和同伴受欺凌，以及更低水平的不怕疼痛，会预测更高的终生自杀意念发生率。
参与者为 184 名患有原发性慢性疼痛疾病的青少年（10 至 18 岁，M = 14.27 岁）。研究采用诊断性临床访谈评估自杀意念，自我报告问卷评估抑郁症状、同伴受欺凌和不怕疼痛。
42（22.8%）名参与者报告有自杀意念。回归分析表明，自杀意念的发生与更高的抑郁症状发生率相关（β = 1.03，P = 0.020，95%CI：1.01，1.06）和同伴受欺凌（β = 2.23，P < 0.05，95%CI：1.07，4.63），尽管不怕疼痛与自杀意念之间没有关联。
这些结果表明，抑郁症状和同伴受欺凌是青少年慢性疼痛患者自杀意念的重要预测因素；然而，不怕疼痛程度较低并不是一个显著的预测因素。鉴于这些发现，应进一步探讨和考虑抑郁和同伴受欺凌，以设计和实施针对青少年慢性疼痛和自杀意念的预防和早期干预策略。
