Related Experiment Video
Updated: Sep 3, 2025

Chronic Social Defeat Stress in Early Adolescent Male Mice
Published on: January 24, 2025
The overlap of medical child abuse and central sensitization in adolescents: An exploratory qualitative study
Katie L Johnson1, Stephanie N Wilkins2, Emily C B Brown1
1Seattle Children's Hospital, Safe Child and Adolescent Network (SCAN), 4800 Sand Point Way NE, Seattle, WA 98105, United States; University of Washington School of Medicine, Seattle, WA, United States.
Background:
Both medical child abuse (MCA) and central sensitization (CS) may present in adolescents with chronic pain, disability, high healthcare utilization, and unremarkable medical evaluations.
Objective:
This study aimed to identify themes in the clinical narratives of adolescents with chronic pain that may help differentiate MCA from CS.
Participants And Setting:
Participants were 28 adolescents (ages 13-18 years) with chronic pain referred to either the Child Abuse Pediatrics team or the Pediatric Pain Medicine team at a tertiary children's hospital between 2011 and 2019, and diagnosed with MCA or CS, respectively.
Methods:
This was a qualitative, retrospective study. Qualitative themes were derived through a process of inductive content analysis utilizing open coding, grouping, and secondary review by an interdisciplinary panel of experts. The relative prevalence of each code, theme, and overarching category was examined between groups to identify areas of convergence and divergence.
Results:
Several themes appeared to be more prevalent in the MCA group (n = 9) compared to the CS group (n = 19). These included sick identity, homeschooling, caregiver with mental health disorder, maternal catastrophizing, maternal misrepresentation, persistence in healthcare-seeking, mandated reports made, medical neglect, and unnecessary and harmful medical care.
Conclusions:
This exploratory work identified themes from the clinical narratives of adolescents with chronic pain that may help differentiate MCA from CS. A visual reference, two illness scripts, and management recommendations are presented to aid pediatric providers in facilitating appropriate referrals for adolescents with chronic pain and disability out of proportion to diagnostic workup.
Related Concept Videos
Bullying
Autism Spectrum Disorder
These core symptoms manifest differently among individuals, ranging from mild to severe. The disorder's complexity extends beyond its clinical presentation, encompassing a diverse range of biological, cognitive, and sociocultural influences.
Psychological and Sociocultural Causes of Schizophrenia
Desensitization and Tachyphylaxis
Cognitive Development During Adolescence
Attention-Deficit/Hyperactivity Disorder
Diagnostic Criteria and Symptoms
To diagnose ADHD, symptoms must manifest before age 12 and be evident across multiple settings....

