The Journal of Pain reports on research that shows disability from chronic pain in adolescents can be exacerbated by high levels of anxiety. The journal is the peer review publication of the American Pain Society.
The report says that pain severity and duration is a reliable predictor of impaired function and quality of life, but other research suggests that psychological variables are able to influence disability beyond the pain itself.
Previous studies identified that anxiety and depression can make functional disability worse for adolescents who suffer from chronic pain.
Georgia State University and University of Bath (UK) researchers collaborated to explore the interplay between pain and anxiety and its potential negative influence on physical and social functioning. The team hypothesized that for adolescents with high levels of anxiety, pain would not be the main cause of physical and social disability.
The research team gathered information from two hundred twenty-two adolescents being treated in British pain clinics, and their parents.
Each adolescent was assessed for pain intensity using the 10-cm visual analogue scale. To measure anxiety, participants completed the Spense Children’s Anxiety Scale. In addition, their parents reported on their own perceptions of their child’s disability.
Adolescents who were highly anxious reported poor physical functioning, high school absences and frequent doctor’s office visits.
Researchers concluded that pain severity was not related to functioning.
The authors explained that a reinforcing cycle of behaviors occurs in these adolescents in which stress drives avoidance of physical and social activities and further heightens anxiety.
Conversely, in study subjects with low anxiety, pain severity seemed to be the driving force of disability.
The authors noted that in the absence of high anxiety, the levels of engagement or avoidance of physical and social activity in adolescents might be governed by pain severity levels.