title: Concurrent and longitudinal bidirectional relationships between toddlers' chronic pain and mental health: the generation R study.
abstract: OBJECTIVE
  The aim was to investigate the concurrent and longitudinal associations of chronic pain with behavioral and emotional problems in toddlers, as it is not known which comes first in life.
  
  
  METHODS
  The study was embedded in the Generation R Study, a prospective population-based cohort study. Parents of 3,751 toddlers completed questionnaires of their child's health and development. Behavioral and emotional problems were measured at 1.5 and 3 years, chronic pain was measured at 2 and 3 years.
  
  
  RESULTS
  There were concurrent associations between chronic pain and internalizing problems, e.g. anxiety/depression symptoms. However, chronic pain did not precede the development of new behavioral and emotional problems. Also, behavioral and emotional problems did not precede new-onset chronic pain, except for somatic symptoms, which increased the likelihood of chronic pain.
  
  
  CONCLUSIONS
  Chronic pain was associated with concurrent internalizing problems. Somatic complaints were not only concurrently related to pain but also predicted new-onset pain.
authors.affiliation: Department of Medical Psychology and Psychotherapy, Erasmus University Medical Center, The Netherlands.
authors.forename: Noor J
authors.initials: NJ
authors.lastname: Wolff
authors.forename: Anne-Sophie E
authors.initials: AS
authors.lastname: Darlington
authors.forename: Joke A M
authors.initials: JA
authors.lastname: Hunfeld
authors.forename: Vincent W V
authors.initials: VW
authors.lastname: Jaddoe
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.forename: Hein
authors.initials: H
authors.lastname: Raat
authors.forename: Frank C
authors.initials: FC
authors.lastname: Verhulst
authors.forename: Jan
authors.initials: J
authors.lastname: Passchier
authors.forename: Henning
authors.initials: H
authors.lastname: Tiemeier
mesh_terms: D002652:Child Behavior / Q000523:psychology*; D002653:Child Behavior Disorders / Q000523:psychology*; D002657:Child Development; D002675:Child, Preschool; D059350:Chronic Pain / Q000523:psychology*; D004644:Emotions; D005260:Female; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health; D010290:Parents / Q000523:psychology; D011446:Prospective Studies; D011795:Surveys and Questionnaires