Interactions among biopsychosocial predictors of somatic pain in Australian adolescents: a nationally representative survey

The prevalence of somatic pain (headache, stomach ache, backache) in late adolescence is similar to adulthood, positioning adolescent pain as a significant public health issue. Pain in adolescents is complex and multi-factorial in nature however, the predictors of somatic pain are not well understood. We conducted a secondary analysis of data collected via an online survey from The Australian Child Wellbeing Project (ACWP). Participants were Australian school children aged 8 - 14 years. Somatic pain items were measured using the Health Behaviour in School-Aged Children’s – Symptoms Checklist (HBSC-SCL). A somatic pain summary score was the aggregated headache, stomach ache and backache items (range 0 to15). Identification of the strongest predictors, moderation and direct and indirect paths were constructed to investigate the relationship between 16 different physical, psychological and social predictors and somatic pains stratified by gender. The sample was 4,572 adolescents (52% Girls). The average frequency score of somatic pain for adolescents was 6.0±2.9 (range0 to 15). Emotional state was identified as the most significant predictor associated with all somatic pain types, which is similar between both boys and girls. The current study also identified predictors relating to relationships with peers and school environment being moderately associated with somatic pains. We also identified that psychosocial factors such as bullying, support of friends and school satisfaction moderate the relationship between negative emotional state and somatic pains. Psychosocial factors largely operate through indirect pathways via emotional state in their association with somatic pain types. Conversely physical factors such as puberty were not associated with any somatic pain type. Overall somatic pain places a large burden on Australian boys and girls across Australia and appears to be predominantly associated with psychological and social predictors.