Bullying, abuse and family conflict as risk factors for chronic pain among Dutch adolescents.
OBJECTIVE
Psychosocial stress seems to serve as an important risk factor for the occurrence of pain. The present study aims to examine if early adversities, e.g. bullying, abuse and family conflict are risk factors for chronic pain in adolescents. The secondary aim of the present study was to describe the pain characteristics of chronic pain in adolescents in a community sample of Dutch adolescents.


METHODS
Participants in the present study were 15,220 adolescents, attending schools (grade 7 and 8) in Rotterdam, the Netherlands. Chronic pain was measured with a newly developed questionnaire; the Pain Barometer. Early adversities were measured using single-item questions from the Rotterdam Youth Monitor, a longitudinal youth health surveillance system. Cross-sectional associations between early adversities and chronic pain were investigated using logistic multilevel analysis, adjusted for potential confounding.


RESULTS
In school year 2010-2011, 9.2% of the 15,220 adolescents reported chronic pain. Physical abuse by others (OR = 1.51, 95% CI =  1.07-2.14), sexual abuse (OR = 1.46, 95% CI = 1.05-2.05), family conflict (OR = 1.79, 95% C = 1.61-1.99) and being bullied (OR = 1.23, 95% CI = 1.17-1.29) are more common in adolescents with chronic pain. Physical abuse (OR = 1.28, 95% CI = 0.95-1.71) by parents and parental divorce (OR = 1.07, 95% CI = 0.93-1.22) were not significantly related to chronic pain.


CONCLUSIONS
The results of the present study suggest that bullying, abuse and family conflict may be risk factors for chronic pain in adolescents. Early signalling these stressors might prevent chronic pain.


CONCLUSIONS
Early adversities, i.e. physical and sexual abuse, being bullied and family conflict, might be risk factors for developing chronic pain. In addition, the present study suggests that chronic pain is common among Dutch adolescents and interferes with their daily activities. If future studies confirm our results, this knowledge can be used to improve the signalling and prevention of chronic pain in adolescents.
Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC University Medical Centre, Rotterdam, the Netherlands.
J S
JS
Voerman
Municipal Health Services Rotterdam-Rijnmond, the Netherlands.
I
I
Vogel
Municipal Health Services Rotterdam-Rijnmond, the Netherlands.
F
F
de Waart
Rijndam Rehabilitation Centre, Rotterdam, the Netherlands.
T
T
Westendorp
Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC University Medical Centre, Rotterdam, the Netherlands.
R
R
Timman
Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC University Medical Centre, Rotterdam, the Netherlands.
J J V
JJ
Busschbach
Municipal Health Services Rotterdam-Rijnmond, the Netherlands.
P
P
van de Looij-Jansen
Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC University Medical Centre, Rotterdam, the Netherlands.
C
C
de Klerk
D000293:Adolescent; D058445:Bullying / Q000706:statistics & numerical data; D002648:Child; D002649:Child Abuse / Q000706:statistics & numerical data; D059350:Chronic Pain / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D054541:Family Conflict; D005260:Female; D006801:Humans; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D012307:Risk Factors; D012574:Schools; D013315:Stress, Psychological / Q000150:complications* / Q000453:epidemiology