title: Stressor, perceived stress and recurrent pain in Swedish schoolchildren.
abstract: OBJECTIVE
  Stress is an important etiological factor for pain. Little is known, however, about how this process is mediated. The aim of this study is to highlight how more stress corresponds with the amount of reported perceived stress, pain symptom, and the co-occurrence of two pain symptoms--headache and abdominal pain--and how these three phenomena are related. We have also studied possible gender differences.
  
  
  METHODS
  A cross-sectional study based on data from child supplements linked to national household surveys in Sweden during 2002-2003. Information concerning harassment, perceived stress, headache, and abdominal pain was gathered from a questionnaire. The study population consisted of a representative national sample of 2597 children aged 10-18 years.
  
  
  RESULTS
  Children's reports of exposure to the stressor harassment were associated with their subjective perception of stress and recurrent pain in a stepwise manner. Having both pain symptoms was more strongly associated with the stressor harassment and perceived stress than having only one pain symptom. This was especially true of girls, who reported higher levels of stress symptoms and who had a different profile of pain symptoms than boys.
  
  
  CONCLUSIONS
  The stressor harassment, perceived stress, and recurrent pain are associated with each other in a stepwise fashion. The co-occurrence of headache and abdominal pain is much more closely associated with harassment and perceived stress than any of these symptoms separately, especially in girls.
authors.affiliation: CLINTEC Departement, Karolinska Institute, Stockholm, Sweden. gosta.alfven@karolinska.se
authors.forename: Gösta
authors.initials: G
authors.lastname: Alfven
authors.forename: Viveca
authors.initials: V
authors.lastname: Ostberg
authors.forename: Anders
authors.initials: A
authors.lastname: Hjern
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology*; D011602:Psychophysiologic Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D012008:Recurrence; D012574:Schools; D013315:Stress, Psychological / Q000453:epidemiology* / Q000523:psychology*; D013334:Students / Q000523:psychology* / Q000706:statistics & numerical data*; D013548:Sweden / Q000453:epidemiology; D014944:World Health Organization