Medical and psychological factors related to pain in adults with pediatric-onset spinal cord injury: a biopsychosocial model.
METHODS
A cross-sectional study.


OBJECTIVE
The aim of this study is to determine medical and psychological correlates of pain in individuals with pediatric-onset spinal cord injury (SCI).


METHODS
Shriners Hospitals for Children-Chicago, Philadelphia and Northern California (USA).


METHODS
A total of 187 adults who had sustained an injury before 19 years of age completed interviews that included medical information, standardized measures of psychological functioning (Beck Anxiety Inventory and Patient Health Questionnaire) and a comprehensive pain questionnaire to assess the location, frequency, intensity and duration of pain and distress and disability related to pain.


RESULTS
The findings identified the medical and psychological correlates of pain. Greater symptoms of depression and anxiety were strong and consistent predictors of several aspects of pain, above and beyond the impact of gender, injury-related characteristics and secondary medical complications.


CONCLUSIONS
The findings support a biopsychosocial model of the development and persistence of pain in individuals with pediatric-onset SCI. Interdisciplinary rehabilitation may incorporate psychological treatment such as cognitive-behavioral therapy to reduce the pain and improve functioning. The assessment and treatment of pain in pediatric-onset SCI is a clinical and research priority.


BACKGROUND
This study is supported by funding from Shriners Hospitals for Children and the Craig H. Neilsen Foundation, grant #324671.
Department of Psychology, Loyola University, Chicago, IL, USA.
C B
CB
Murray
Department of Psychology, Shriners Hospitals for Children, Chicago, IL, USA.|Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
K
K
Zebracki
Department of Clinical Research, Shriners Hospitals for Children, Chicago, IL, USA.
K M
KM
Chlan
Department of Psychology, Marquette University, Milwaukee, WI, USA.
A C
AC
Moss
Department of Pediatrics, Shriners Hospitals for Children, Chicago, IL, USA.|Department of Pediatrics, Rush Medical College, Chicago, IL, USA.
L C
LC
Vogel
D000328:Adult; D017668:Age of Onset; D001007:Anxiety / Q000209:etiology / Q000503:physiopathology; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D008297:Male; D008875:Middle Aged; D008959:Models, Neurological; D008960:Models, Psychological; D010146:Pain / Q000209:etiology / Q000503:physiopathology* / Q000523:psychology*; D012737:Sex Factors; D012959:Socioeconomic Factors; D013119:Spinal Cord Injuries / Q000150:complications / Q000503:physiopathology* / Q000523:psychology*; D014481:United States; D055815:Young Adult
Spinal Cord. 2005 Dec;43(12):704-12
15968299
Clin J Pain. 1996 Dec;12(4):291-300
8969874
Eur J Pain. 2009 Nov;13(10):1005-7
19766028
Rehabil Psychol. 2015 Nov;60(4):328-34
26618213
J Spinal Cord Med. 2011;34(1):60-6
21528628
Cochrane Database Syst Rev. 2014 Nov 28;(11):CD009177
25432061
Arch Dis Child. 2004 Oct;89(10):938-42
15383438
JAMA. 1999 Nov 10;282(18):1737-44
10568646
Arch Phys Med Rehabil. 2001 Apr;82(4):501-9
11295011
Spinal Cord. 2008 Jun;46(6):451-5
18283293
J Consult Clin Psychol. 1988 Dec;56(6):893-7
3204199
J Consult Clin Psychol. 2002 Feb;70(1):6-20
11860057
Pain. 2003 Jun;103(3):249-57
12791431
Pain. 2002 Sep;99(1-2):157-65
12237193
J Spinal Cord Med. 2011 Nov;34(6):535-46
22330108
Pain. 2004 Feb;107(3):213-9
14736583
Eur J Pain. 2015 Jan;19(1):5-14
24824334
Arthritis Care Res. 1999 Feb;12(1):52-60
10513491
J Pain. 2009 May;10(5):447-85
19411059
Cochrane Database Syst Rev. 2012 Nov 14;11:CD007407
23152245
J Rehabil Res Dev. 2009;46(1):1-12
19533516
Spinal Cord. 2009 Feb;47(2):108-14
18779835
Top Spinal Cord Inj Rehabil. 2014 Winter;20(1):1-12
24574817
Dev Med Child Neurol. 2015 Dec;57(12):1143-9
26095798
Sleep Med Rev. 2010 Feb;14(1):35-46
19939713
Spinal Cord. 2005 Feb;43(2):85-95
15570322
J Spinal Cord Med. 2016 Feb 17;:1-5
26869240
Rehabil Psychol. 2013 May;58(2):158-65
23713727
Sleep. 2008 May;31(5):619-26
18517032