Advisory Committee Chair
Burel R Goodin
Advisory Committee Members
Aaron Fobian
Matthew Stoll
Peter Weiser
David Schwebel
Document Type
Dissertation
Date of Award
2022
Degree Name by School
Doctor of Philosophy (PhD) College of Arts and Sciences
Abstract
Background: Chronic pain is a prominent feature of many pediatric rheumatic conditions. However, the diagnosis, experience, and treatment of musculoskeletal pain varies by condition. Therefore, the overall aim of the present study is to elucidate group differences and examine biopsychosocial correlates of pain in children with juvenile idiopathic arthritis (JIA), juvenile primary fibromyalgia syndrome (JPFS), non-specific chronic pain (NSCP), and pain-free controls.Methods: We recruited 117 (66% female, 73% White) school-aged children from Children’s of Alabama Rheumatology and Allergy Clinics and the community. Participants self-reported their pain, physical function, sleep, pain-related stigma, and somatic symptoms and underwent experimental pain tasks. Caregivers reported demographic information for themselves and their child (e.g., age, race, sex) and information on their pain and somatization. Participants wore an Actiwatch and filled out a sleep diary for seven days following their research appointment. Results: Results suggest that children with medically unexplained musculoskeletal pain (i.e., JPFS) report greater pain (F[3,112] = 21.56, p <.001), poorer physical function (F[3,110] = 22.59, p <.001), greater pain interference (F[3,112] = 27.45, p <.001), poorer sleep (F[3,107] = 7.75, p < .001; F[3,74] = 7.04, p < .001), and greater pain-related stigma (F[3,112] = 15.45, p < .001) than their counterparts with medically explained pain. Interestingly, children with JIA were the most susceptible to the negative effects of sleep (z=1.77, p=.039) and stigma (z=1.93, p=.027) on pain. Finally, the present study demonstrated greater caregiver pain and somatization were related to greater child pain and somatization (all p’s<.05). Specifically, caregiver pain behavior and somatization was associated with child endogenous pain amplification in children with JIA (z=1.79, p=.037; z=1.92, p= 027) and pain-free controls (z=1.97, p=.025). Conclusions: Although children with medically unexplained pain report more pain, poorer sleep, and greater pain-related stigma, children with medically explained pain may be more susceptible to the deleterious effects of stigma and sleep on pain outcomes. Therefore, it is equally important for all children with rheumatic conditions to receive interventions focused on bolstering coping skills to combat stigma and poor sleep hygiene to improve pain related outcomes.
Recommended Citation
Thompson, Kathryn Ann, "Predictors And Disparities Associated With Pain (Pandda-P) Study: A Comparison Of Pediatric Rheumatology Patients" (2022). All ETDs from UAB. 941.
https://digitalcommons.library.uab.edu/etd-collection/941