295: Longitudinal links among catastrophizing, interference and medication use in youth with chronic pain

Topic: Clinical Science
Subtopic: Non-specific to any diagnosis, Psychology, Epidemiology, Pain in Special Populations

Background and Aims: Cross-sectional studies have reported significant associations between pain catastrophizing and pain medication use in youth with chronic pain; however, longitudinal research is needed to clarify the processes underlying this association. Grounded in the pediatric Fear-Avoidance model, this one-year prospective cohort study examined whether pain interference contributes to the longitudinal association between pain catastrophizing and pain medication use.

Methods: Participants included 180 adolescents (mean age = 13.56 years old; 78% female) with chronic pain who completed self-reported measures of demographics (birth sex and age), pain characteristics (location, extent, and intensity), pain interference, pain catastrophizing, and pain medication use. Theory-driven confirmatory models and complementary sensitivity analyses, which evaluated model parsimony by testing simplified versions of the theoretical model, were conducted to examine whether the pattern of associations remained consistent across approaches.

Results: Structural equation models, accounting for the temporal stability of each outcome and adjusted for pain intensity, birth sex, and age, revealed moderate to high temporal stability in pain catastrophizing and pain medication use. No direct longitudinal association was found between pain catastrophizing and pain medication use. However, pain interference emerged as a potential indirect pathway through which pain catastrophizing may contribute to later pain medication use. The pattern of results was consistent across both confirmatory and sensitivity analyses.

Conclusions: These findings provide empirical evidence of the importance of assessing both pain interference and pain catastrophizing in clinical evaluations of adolescents with chronic pain and highlight the potential value of psychological interventions that address functional impairments and pain-related cognitions.

References: Könning A, Rosenthal N, Friese M, Hirschfeld G, Brown D, Wager J. Factors associated with physician consultation and medication use in children and adolescents with chronic pain: A scoping review and original data. European Journal of Pain (United Kingdom). 2021;25(1):88-106.

Miró J, Roman-Juan J, Sánchez-Rodríguez E, Solé E, Castarlenas E, Jensen MP. Chronic Pain and High Impact Chronic Pain in Children and Adolescents: A Cross-Sectional Study. Journal of Pain. 2023;24(5):812-823.

Roman-Juan J, Sánchez-Rodríguez E, SolCrossed D Sign© E, Castarlenas E, Jensen MP, Miró J. Psychological factors and pain medication use in adolescents with chronic pain. Pain Medicine (United States). 2023;24(10):1183-1188.

Presenting Author: Juan P. Sanabria-Mazo
Submitting Author: Juan P. Sanabria-Mazo

Senior Author: Jordi Miró

IASP 2026 Global Year theme of Neuropathic Pain: No

• Juan P. Sanabria-Mazo: PhD - Universitat Rovira i Virgili
• Josep Roman-Juan: PhD - University of Calgary
• Mark P. Jensen: PhD - University of Washington
• Jordi Miró: PhD - Universitat Rovira i Virgili