Disability in adolescents with chronic pain: Patterns and predictors across different domains of functioning

Many children and adolescents experience recurrent pain, but only a few become disabled by it. Research has established that higher pain intensity and worse depression seem to predict poorer functioning in this population. Parent and family variables have been minimally researched. This study investigated functional disability, social/adaptive functioning and school attendance in a population of highly disabled adolescents and their parents seeking help for chronic pain. Adolescents (N=110) were assessed using the Bath Adolescent Pain Questionnaire [BAPQ; Eccleston C, Jordan A, McCracken LM, Sleed M, Connell H, Clinch J. The Bath Adolescent Pain Questionnaire (BAPQ): Development and preliminary psychometric evaluation of an instrument to assess the impact of chronic pain on adolescents. Pain 2005;118:263-70], a multidimensional instrument designed for a pain population. Pain intensity and depression predicted functional disability. However, social/adaptive functioning was associated with different variables, including parent factors, and school attendance showed no association with pain intensity or anxiety. The results emphasise the need to measure multiple domains of functioning, and show that the connections between pain, physical disability and adaptive functioning are looser than might be predicted.