Researchers have found a significant link between childhood behavioral problems and chronic pain in adulthood. Dr. Dong Pang of Aberdeen University, UK, and colleagues explain that chronic widespread pain affects about 12 percent of adults and can cause disability. It has previously been linked to major events in childhood such as hospitalization after a road accident and separation from mothers.
The team used a group of 19,478 participants who were born in a single week in 1958, and followed them through childhood and adulthood. Childhood behavior was recorded by parents and teachers at ages 7, 11, and 16, based on aspects such as restlessness, worrying, solitariness, ability to make friends, obedience, stealing, sucking thumbs and biting nails, lying, bullying, or displaying truant behavior. Pain in adulthood was measured at 45 years.
Children whose teachers reported “severe persistent behavior problems” at all ages had more than double the risk of chronic widespread pain by the age of 45 compared with children without behavior problems at all ages. A weaker link also existed for parent-reported behavior, possibly because teachers are more experienced and can be more objective, the researchers speculate.
In the journal Rheumatology, the authors conclude, “Maladjusted (social) behavior is associated with increased long-term chronic widespread pain beyond childhood and adolescence.”
Dr. Pang said, “Aspects of childhood behavior are strongly related to children reporting chronic widespread pain. However, until now, it was unknown whether maladjusted behavior in children was a long-term marker for chronic widespread pain in adulthood. Our study shows that it is.”
The association could not be explained by social class, says Dr. Pang, and was not thought to be due to the known link between psychological distress in adults and chronic widespread pain. He says that the underlying biological mechanism is not known, but suggested it may be “a long-term neuroendocrine dysfunction beginning in early life,” involving the hypothalamic-pituitary-adrenal axis which controls reactions to stress.
This dysfunction, possibly triggered by early trauma, could underlie both the childhood behavior and the adult chronic widespread pain, he believes. “Further research at molecular and genetic levels is needed to clarify this theory,” he states.
Psychological distress was measured at the age of 42, and this also showed a link with childhood behavioral problems. Long-term depression and anxiety, suicidal behavior, substance abuse and treatment for psychiatric illness were more common among those deemed to have early behavior problems.