Predictors and Consequences of Pediatric Pain Symptom Trajectories: A 14-Year Longitudinal Study

Abstract

Objective: The present study had three primary objectives. First, pain trajectory from early childhood to early adolescence were modeled. Second, we examined how early childhood individual-, parental-, and family-level factors predict pain trajectories. Third, we evaluated consequences of pain trajectories in terms of anxiety and depressive symptoms, and substance use at age 16 years.

Design: The current paper is a secondary data analysis of a multisite longitudinal study. A total of 731 children and their families were followed from ages 2 to 16 years.

Methods: A growth mixture model (GMM) was used to identify pain trajectories from ages 2 to 14 years.

Results: The GMM revealed three distinct pain trajectories: (1) Low Pain Symptom (n = 572); (2) Increasing Pain Symptom (n = 106); and (3) U-shaped Pain Symptom (n = 53). Children who experienced greater harsh parenting and sleep disturbances in early childhood were more likely to belong to the Increasing Pain Symptom group, and those with greater anxious-depressed symptoms at age 2 years were more likely to belong to the U-shaped Pain Symptom group than the Low Pain Symptom group. Additionally, those youth in the Increasing Pain Symptom group, compared to the Low and U-shaped Pain Symptom groups, showed elevated anxiety symptoms at age 16 years.

Conclusions: Reducing harsh parenting and children's sleep disturbances could be important targets for preventing pediatric pain problems. Children with increasing pain symptoms may also benefit from learning adaptive pain management skills to lower the risk of developing anxiety problems in late adolescence.

Keywords: Adolescent; Anxiety; Children; Depression; Pain; Parenting; Sleep; Substance Use.