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Trajectories of school absenteeism in adolescents with recurrent pain: Predictors and distal outcomes
University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health, Psychology and Sports Sciences, Occupational Health Science. Örebro universitet, Institutionen för beteende-, social- och rättsvetenskap.ORCID iD: 0000-0002-1630-4418
Örebro universitet, Institutionen för beteende-, social- och rättsvetenskap.ORCID iD: 0000-0002-5053-8373
Örebro universitet, Institutionen för beteende-, social- och rättsvetenskap.ORCID iD: 0000-0003-2718-7402
Örebro universitet, Institutionen för beteende-, social- och rättsvetenskap.ORCID iD: 0000-0001-9429-9012
2026 (English)In: Pain Reports, E-ISSN 2471-2531, Vol. 11, no 2, article id e1416Article in journal (Refereed) Published
Abstract [en]

Introduction: A sizeable number of adolescents with recurrent pain frequently miss school, yet the trajectories of absenteeism and their correlates remain unclear. We aimed to explore trajectories of school absenteeism due to pain among adolescents with recurrent pain, and predictors and correlates of the trajectories.

Methods: A prospective cohort design with 3 yearly measurement points between 2016 and 2018 was used. The sample included 873 Swedish upper secondary school adolescents (mean age = 16.5 years; 60.8% girls; 11.7% immigrants) with recurrent pain (headache, abdominal and/or musculoskeletal pain ≥1/wk for 6 months). Predictors were sociodemographic variables, pain characteristics, depressive symptoms, and stressors in the school context. Distal outcomes were perceived future work ability and overall future expectancy.

Results: We identified 3 trajectories of absenteeism through latent class growth analysis: persistently high absenteeism (18.1%), persistently low absenteeism (49.4%), and persistently no absenteeism (32.5%). Pain intensity and school-related stressors independently predicted absenteeism trajectories. Compared with the other trajectories, the persistently high absenteeism subgroup had more negative perceived future work ability and overall future expectancy.

Conclusion: A substantial subgroup of adolescents showed a stable pattern of high absenteeism across their upper secondary education, which was associated with overall negative expectancies for the future and specifically future work ability. Therefore, there is a need to identify this subgroup and intervene early in the life course to prevent long-term disadvantages in education, employment, and overall well-being.

Place, publisher, year, edition, pages
Wolters Kluwer , 2026. Vol. 11, no 2, article id e1416
Keywords [en]
Adolescents; Chronic pain; Future expectancy; Future work ability; Predictors; School absenteeism; Trajectories
National Category
Psychology (Excluding Applied Psychology)
Identifiers
URN: urn:nbn:se:hig:diva-46812DOI: 10.1097/pr9.0000000000001416ISI: 001712226900001PubMedID: 41822108Scopus ID: 2-s2.0-105035078928OAI: oai:DiVA.org:hig-46812DiVA, id: diva2:1953933
Funder
EU, Horizon 2020, 754285Available from: 2024-10-23 Created: 2025-04-23 Last updated: 2026-04-20Bibliographically approved
In thesis
1. Understanding Chronic Pain from a Life Course Perspective: An exploration of the psychosocial predictors, correlates, and consequences of pain onset early in Life
Open this publication in new window or tab >>Understanding Chronic Pain from a Life Course Perspective: An exploration of the psychosocial predictors, correlates, and consequences of pain onset early in Life
2024 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Chronic pain conditions can debut at any point in a person’s lifespan, although prevalence estimates peak in late adulthood. However, many adults report living with chronic pain for several decades, with some tracing this back to the early years of life. Given its impact, early life exposure to pain may be a risk factor for further health comorbid-ities and socioeconomic disadvantages. The studies in this dissertation examined differences in psychosocial outcomes between persons with early and later chronic pain onset. They also explored school absen-teeism due to pain in adolescents with recurrent pain as a pathway to accumulating risk over time. Data were gathered from a registry data-base and longitudinal surveys.

Study I (a retrospective design) found that those with an early life pain onset had a higher burden in terms of overall pain characteris-tics and psychosocial outcomes. Studies II and III (prospective longi-tudinal designs) showed that having at least one absenteeism due to pain was quite common (64%) among adolescents with recurrent pain, while about a quarter reported a more frequent rate. The risk factors for school absenteeism due to pain were sociodemographic factors, pain characteristics, stressors in the school context, and a his-tory of absenteeism due to pain at baseline (Study II). Further, about 1 in 5 adolescents with recurrent pain had persistently high absentee-ism due to pain throughout their high school education, and these in-dividuals perceived a poorer future work ability and overall future ex-pectancy compared to those with low to no absenteeism trajectory over time (Study III). These findings indicate that individuals with early life onset pain have a higher psychosocial burden of pain, with risk accumulation already noted in the early years of life.

Place, publisher, year, edition, pages
Örebro: Örebro University, 2024. p. 98
Keywords
chronic pain, adolescents, early onset pain, school absenteeism, work ability, future expectancy, Psychosocial outcomes, pain characteristics, aging, participation, life course, disadvantages
National Category
Psychology (Excluding Applied Psychology)
Identifiers
urn:nbn:se:hig:diva-46811 (URN)9789175295985 (ISBN)9789175295992 (ISBN)
Public defence
2024-11-22, Örebro universitet, Långhuset, Hörsal L2, 13:15 (English)
Opponent
Supervisors
Available from: 2025-04-23 Created: 2025-04-23 Last updated: 2025-10-02Bibliographically approved

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Owiredua, ChristianaEvans, BrittanyFlink, IdaBoersma, Katja

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