Anxiety and Depression Symptoms, Adverse Childhood Experiences, and Persistent/Recurrent Pain Across Early Adolescence.

IF 3 3区医学 Q1 PEDIATRICS

Academic Pediatrics Pub Date : 2024-08-26 DOI:10.1016/j.acap.2024.08.013

Thea Senger-Carpenter, Anao Zhang, Monica Ordway, Sarah A Stoddard, Terri Voepel-Lewis

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引用次数: 0

Abstract

Objective: To determine whether anxiety and depression symptoms are mechanisms through which adverse childhood experiences (ACEs) contribute toward persistent/recurrent pain (PRP) across early adolescence.

Methods: This study described the direct and indirect (i.e. mediated) effects of ACEs on PRP across early adolescence, using four years of Adolescent Brain Cognitive Development Study® data. Annual pain frequency, anxiety, and depression symptoms were measured using the Child Behavior Checklist, and youth with pain for ≥3 of the 4-year study period were classified with PRP. Early (up to age 9-10 years; reported at baseline) and recent (at age 10-11 years; reported at year 1) ACE exposures were derived from parent and youth completed surveys. Structural equation modeling estimated the direct and indirect associations among early and recent ACEs, pain outcomes, and anxiety/depression symptoms reported in the year(s) in between.

Results: Among 7,951 youth, 2,540 (31.9%) were classified with PRP. Higher levels of early ACE exposure were associated with an increased probability of having PRP (adj.β 0.65 (95% Confidence Interval [CI] 0.07, 1.22). Early ACEs also had indirect effects on PRP via higher interim anxiety (adj. β 5.36 [95% CI 3.45, 7.26]) and depression symptoms (adj. β 4.57 [95% CI 3.01, 6.13]). Early and recent ACE exposures predicted higher pain frequency scores in subsequent years, with mixed results regarding the role of anxiety and depression in the relationships between ACEs and pain frequency scores.

Conclusion: Anxiety and depression symptoms are potentially important interventional targets to lower the risk for PRP among youth exposed to ACEs.

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青春期早期的焦虑和抑郁症状、童年不良经历以及持续性/复发性疼痛。

摘要确定焦虑和抑郁症状是否是童年不良经历（ACE）导致青春期早期持续性/复发性疼痛（PRP）的机制：本研究利用四年的青少年大脑认知发展研究（Adolescent Brain Cognitive Development Study®）数据，描述了ACE对青春期早期持续性/复发性疼痛（PRP）的直接和间接（即中介）影响。使用儿童行为检查表测量每年的疼痛频率、焦虑和抑郁症状，并将在四年研究期间疼痛次数≥3 次的青少年归类为 PRP 患者。早期（9-10 岁前；基线时报告）和近期（10-11 岁；第 1 年时报告）ACE 暴露来自家长和青少年填写的调查问卷。结构方程模型估算了早期和近期 ACE、疼痛结果以及中间一年报告的焦虑/抑郁症状之间的直接和间接联系：在 7951 名青少年中，有 2540 人（31.9%）被归类为 PRP。早期 ACE 暴露水平越高，患 PRP 的概率越高（adj.β 0.65（95% 置信区间 [CI] 0.07，1.22））。早期 ACE 还通过较高的中期焦虑（adj. β 5.36 [95% CI 3.45, 7.26]）和抑郁症状（adj. β 4.57 [95% CI 3.01, 6.13]）对 PRP 产生间接影响。早期和近期的ACE暴露可预测随后几年中更高的疼痛频率得分，而焦虑和抑郁在ACE与疼痛频率得分之间关系中的作用结果不一：焦虑和抑郁症状可能是降低暴露于ACE的青少年PRP风险的重要干预目标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Academic Pediatrics PEDIATRICS-

CiteScore

4.60

自引率

12.90%

发文量

300

审稿时长

60 days

期刊介绍： Academic Pediatrics, the official journal of the Academic Pediatric Association, is a peer-reviewed publication whose purpose is to strengthen the research and educational base of academic general pediatrics. The journal provides leadership in pediatric education, research, patient care and advocacy. Content areas include pediatric education, emergency medicine, injury, abuse, behavioral pediatrics, holistic medicine, child health services and health policy,and the environment. The journal provides an active forum for the presentation of pediatric educational research in diverse settings, involving medical students, residents, fellows, and practicing professionals. The journal also emphasizes important research relating to the quality of child health care, health care policy, and the organization of child health services. It also includes systematic reviews of primary care interventions and important methodologic papers to aid research in child health and education.