Pain is Associated With Poorer Grades, Reduced Emotional Well-Being, and Attention Problems in Adolescents

Objectives: The purpose of the present study was to determine whether pain is associated with specific aspects of academic performance, that is, poorer grades, and with factors critical to an adolescent's academic performance, that is, decreased emotional well-being and attention problems. We hypothesized that the association between pain and school grades is mediated by emotional well-being and attention problems. Methods: In a cross-sectional study, we collected data from 2215 pupils, ages 12 to 13 years. Pain (no, occasional, and frequent), emotional well-being, and attention problems were measured with self-rating scales. Dutch, English, and math grades were taken as an index of academic performance. Results: Frequent pain in adolescents was associated with poorer grades (Dutch P=0.02 and math P=0.01). Both occasional and frequent pain were associated with reduced emotional well-being (P<0.001) and reduced self-reported attention (P<0.001). However, the association between pain and lower grades disappeared when controlling for emotional well-being and attention. Discussion: The present study shows that the association between pain and Dutch adolescents grades is mediated by reduced emotional well-being and attention problems. The association between pain and math grades is mediated by emotional problems. The results suggest that an intervention targeted at pain in adolescents could have a positive effect on their emotional well-being, attention, and school performance.