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Journal of Pediatric Psychology Advance Access published online on January 30, 2009
Journal of Pediatric Psychology, doi:10.1093/jpepsy/jsn143
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© The Author 2009. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

School Functioning in Adolescents With Chronic Pain: The Role of Depressive Symptoms in School Impairment

Deirdre E. Logan, PhD, Laura E. Simons, PhD and Karen J. Kaczynski, PhD

Children's Hospital Boston, Harvard University Medical School

All correspondence concerning this article should be addressed to Deirdre E. Logan, PhD, Pain Treatment Service, Children's Hospital Boston, 333 Longwood Avenue Suite 549, Boston, MA 02115. E-mail: Deirdre.logan{at}childrens.harvard.edu


  Abstract

Objective To explore associations between depressive symptoms and school functioning, including school attendance, academic performance, self-perceived academic competence, and teacher-rated school adjustment among predominantly Caucasian and female adolescent chronic pain patients. Methods A total of 217 clinically referred adolescents (aged 12–17 years) and their parents completed measures of pain characteristics, depression, and school functioning. Additional data were collected from school records and teacher reports. Results Depressive symptoms strongly correlated with school functioning indicators. In linear regression analyses, higher levels of depressive symptoms predicted more school impairment. A model testing whether depressive symptoms mediated the association between current pain intensity and parent perceptions of the interference of pain on school functioning was supported by the data. Conclusions Depressive symptoms play a key role in influencing the extent of school impairment in adolescents with chronic pain. Interventions to alleviate depressive symptoms may enhance treatments designed to improve school functioning in this population.

Key words: adolescents; depression; pain; school functioning.

Received May 28, 2008; revision received December 12, 2008; accepted December 14, 2008


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