一项对在跨学科儿科疼痛诊所接受评估的顺性别、跨性别和性别多样化青少年慢性疼痛的社会心理相关因素的回顾性研究。
A retrospective review of psychosocial correlates of chronic pain in cisgender, transgender, and gender-diverse youth receiving evaluation in interdisciplinary pediatric pain clinics.
作者信息
Tracy Crystal, Lynch Milder Mary, Vater Lindsey, Lagges Ann, Lemanek Kathleen, Wrona Sharon, Gilbert Elaine, Hirsh Adam T, Miller Megan M, Donahue Kelly, Streicher Morgan, Williams Amy E
机构信息
Department of Psychology, Indiana State University, Terre Haute, Indiana, USA.
Great Lakes Neurobehavioral Center, Eagan, Minnesota, USA.
出版信息
Can J Pain. 2025 Apr 15;8(2):2477466. doi: 10.1080/24740527.2025.2477466. eCollection 2024.
BACKGROUND
Individuals who experience social marginalization, such as transgender and gender-diverse (TGD) youth, have increased risk for poor health outcomes, including chronic pain. A better understanding of the impact of chronic pain in these populations would improve treatment and aid in reducing health care disparities. Our retrospective review of clinical data examined psychosocial correlates of pain in TGD and cisgender youth with chronic pain.
AIMS
The study aim was to explore differences in psychosocial variables between TGD and cisgender youth with chronic pain. In alignment with the minority stress model, we hypothesized worse pain and pain-related disability, poorer quality of life, and more internalizing symptoms in TGD patients. The secondary aim was to explore associations among psychosocial variables in TGD and cisgender youth.
METHODS
Data were collected from 140 youth (48 TGD, 92 cisgender) evaluated in pediatric pain clinics. Independent samples -tests examined group differences in pain intensity, functional disability, quality of life, pain catastrophizing, and internalizing symptoms. Bivariate correlations were conducted for each group, and differences in the strength of correlations were evaluated using Fisher -to-. Institutional review board (IRB) approval was obtained for all study procedures at each participating institution prior to extraction of retrospective clinical data (Indiana 240 University IRB Protocol No. 12506, The Ohio State University College of Medicine IRB Protocol No. 16-00937). Informed consent was not required or obtained due to the retrospective nature of the study.
RESULTS
Cisgender patients reported worse pain intensity, whereas TGD patients reported lower quality of life and more internalizing symptoms. In the combined sample, pain intensity was correlated with worse functional disability, poorer quality of life, and more catastrophic thinking. No group differences in the strength of correlations were found.
CONCLUSIONS
Results suggest that for TGD youth with chronic pain, internalizing symptoms and quality of life are important targets for treatment and improvement.
背景
经历社会边缘化的个体，如跨性别和性别多样化（TGD）青年，健康状况不佳的风险增加，包括慢性疼痛。更好地了解慢性疼痛对这些人群的影响将改善治疗并有助于减少医疗保健差距。我们对临床数据的回顾性研究检查了患有慢性疼痛的TGD和顺性别青年疼痛的心理社会相关因素。
目的
本研究的目的是探讨患有慢性疼痛的TGD青年和顺性别青年在心理社会变量上的差异。根据少数群体压力模型，我们假设TGD患者的疼痛及与疼痛相关的残疾更严重，生活质量更差，内化症状更多。次要目的是探讨TGD青年和顺性别青年心理社会变量之间的关联。
方法
从儿科疼痛诊所评估的140名青年（48名TGD，92名顺性别）中收集数据。独立样本t检验检查了疼痛强度、功能残疾、生活质量、疼痛灾难化和内化症状方面的组间差异。对每组进行双变量相关性分析，并使用Fisher r-to-z评估相关性强度的差异。在提取回顾性临床数据之前，每个参与机构的所有研究程序均获得了机构审查委员会（IRB）的批准（印第安纳大学IRB协议号12506，俄亥俄州立大学医学院IRB协议号16-00937）。由于研究的回顾性性质，未要求或获得知情同意。
结果
顺性别患者报告的疼痛强度更差，而TGD患者报告的生活质量更低，内化症状更多。在合并样本中，疼痛强度与更差的功能残疾、更低的生活质量和更多的灾难性思维相关。未发现相关性强度的组间差异。
结论
结果表明，对于患有慢性疼痛的TGD青年，内化症状和生活质量是治疗和改善的重要目标。
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