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      The frequency, trajectories and predictors of adolescent recurrent pain: A population-based approach

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      Pain
      Elsevier BV

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          Abstract

          Recurrent pains are a complex set of conditions that cause great discomfort and impairment in children and adults. The objectives of this study were to (a) describe the frequency of headache, stomachache, and backache in a representative Canadian adolescent sample and (b) determine whether a set of psychosocial factors, including background factors (i.e., sex, pubertal status, parent chronic pain), external events (i.e., injury, illness/hospitalization, stressful-life events), and emotional factors (i.e., anxiety/depression, self-esteem) were predictive of these types of recurrent pain. Statistics Canada's National Longitudinal Survey of Children and Youth was used to assess a cohort of 2488 10- to 11-year-old adolescents up to five times, every 2 years. Results showed that, across 12-19 years of age, weekly or more frequent rates ranged from 26.1%-31.8% for headache, 13.5-22.2% for stomachache, and 17.6-25.8% for backache. Chi-square tests indicated that girls had higher rates of pain than boys for all types of pain, at all time points. Structural equation modeling using latent growth curves showed that sex and anxiety/depression at age 10-11 years was predictive of the start- and end-point intercepts (i.e., trajectories that indicated high levels of pain across time) and/or slopes (i.e., trajectories of pain that increased over time) for all three types of pain. Although there were also other factors that predicted only certain pain types or certain trajectory types, overall the results of this study suggest that adolescent recurrent pain is very common and that psychosocial factors can predict trajectories of recurrent pain over time across adolescence.

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          Most cited references41

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            The effects of socioeconomic status (SES) on health are well documented in adulthood, but far less is known about its effects in childhood. The authors reviewed the literature and found support for a childhood SES effect, whereby each decrease in SES was associated with an increased health risk. The authors explored how this relationship changed as children underwent normal developmental changes and proposed 3 models to describe the temporal patterns. The authors found that a model's capacity to explain SES-health relationships varied across health outcomes. Childhood injury showed stronger relationships with SES at younger ages, whereas smoking showed stronger relationships with SES in adolescence. Finally, the authors proposed a developmental approach to exploring mechanisms that link SES and child health.
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              The role of coding time in estimating and interpreting growth curve models.

              The coding of time in growth curve models has important implications for the interpretation of the resulting model that are sometimes not transparent. The authors develop a general framework that includes predictors of growth curve components to illustrate how parameter estimates and their standard errors are exactly determined as a function of receding time in growth curve models. Linear and quadratic growth model examples are provided, and the interpretation of estimates given a particular coding of time is illustrated. How and why the precision and statistical power of predictors of lower order growth curve components changes over time is illustrated and discussed. Recommendations include coding time to produce readily interpretable estimates and graphing lower order effects across time with appropriate confidence intervals to help illustrate and understand the growth process. (c) 2004 APA, all rights reserved
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                Author and article information

                Journal
                Pain
                Pain
                Elsevier BV
                0304-3959
                2008
                August 2008
                : 138
                : 1
                : 11-21
                Article
                10.1016/j.pain.2007.10.032
                18093737
                fd449c51-326b-4103-aa45-881003c89f7f
                © 2008
                History

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