Perceived stigma, illness invalidation, sleep difficulties, and psychological distress in emerging adults in college with persistent pain

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Persistent pain is traditionally associated with middle-aged to older adults and most of the pain literature is focused on this age group. However, recent research indicates a high prevalence of pain in children and adolescents as well. These studies have indicated significant differences in the variables affecting pain experience of children and adolescents as compared to older adults. One of the least studied groups of individuals with pain is emerging adults, individuals between the ages of 18-29 years. The limited number of epidemiological surveys focused on this age group has suggested a surprisingly high prevalence of pain in this age group. A lack of understanding and acknowledgement of pain experience in emerging adults may lead to problems of inadequate pain relief and delay in treatment, potentially worsening long-term health outcomes. Preliminary analyses of a qualitative study of college students with chronic or recurrent pain (Kapoor, Thorn, & Eyer, forthcoming) suggest a perception of stigmatization because of their pain as well as perceived invalidation of their pain experience. These factors seemed to be additionally influenced by college students' perception of experiencing persistent pain as an off-time life event. The current study aimed to examine pain experience of college students with chronic or recurrent pain and compare them to peers who do not experience pain on a regular basis. It was hypothesized that participants with pain, apart from endorsing higher depressive symptomatology, would report lower satisfaction with life as well as lower physical quality of health. In addition, the association of sociocultural contextual factors such as perceived pain-related stigma and illness invalidation with pain-related variables and psychological variables was analyzed. The results revealed that greater perceived invalidation of pain was associated with a higher perceived pain-related stigma, lower satisfaction with life, heightened pain perception and catastrophizing, impaired quality of life, as well as greater self-reported depression. Finally, sleep difficulties of the participants with pain as compared to their same age peers were investigated. The results indicated that those with pain reported poorer quality as well as quantity of sleep. Furthermore, for participants with pain, higher self-reported depression was associated with a lower quality of sleep. Clinical implications are discussed.

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