1. The authors would like to acknowledge the families at the Children’s Hospital of Wisconsin Jane P. Pettit Pain and Palliative Care Center. For more information, please contact Katherine Simon at simon@uwm.edu. Relationship between Pain Intensity and Frequency with Psychosocial Risk Factors Katherine Simon 1, Keri R. Hainsworth 2, Renee J. Ladwig 3, Kristen E. Jastrowski Mano 2, Kimberly Anderson Khan 2, W. Hobart Davies 1,3, and Steven J. Weisman 2,3 University of Wisconsin-Milwaukee 1, Medical College of Wisconsin 2, & Children’s Hospital of Wisconsin 3 Introduction It is estimated that one in five U.S. children are affected by chronic pain (Zeltzer & Schlank, 2005). Youth with chronic pain often have decreased social functioning, increased school absenteeism, and decreased quality of life (Eccleston, Wastell, Crombez, & Jordan, 2008). Research in adults has noted that daily stress is associated with headache severity (Cathcart & Pritchard, 2008); however, less is known about the relationship between daily stressors and pain in pediatric populations. Methods  This study involved patients presenting to a multidisciplinary pain clinic at a large Midwestern children’s hospital.  At intake, mothers, fathers, and youth completed a packet of questionnaires that assess clinical, behavioral, and psychosocial variables related to pain.  Based on an interview with the family, clinician’s also rate the occurrence of 23 psychosocial risk factors.  The current study includes youth 4 - 19 years old with chronic pain (e.g., headache, gastrointestinal pain, musculoskeletal pain). Table II: Correlations Hypothesis  The current study aimed to explore the association between pain (intensity and frequency) and common psychosocial risk factors reported by youth seen in a multidisciplinary pain clinic.  Hypothesis: Youth with fewer psychosocial risk factors will report lower pain intensity and frequency. Measures  Demographic and Medical Information, including age, gender, ethnicity, diagnosis, and pain intensity (worst, usual, best) and frequency, are collected upon arrival at the comprehensive pain center. The doctor or nurse asked the primary caregiver and the youth for this information.  Clinician Interviews were conducted during the initial visit with the family. The interviews include information regarding mental health history, current mental health symptoms, and coping attempts, among other factors. The number of risk factors were totaled and cumulative risk factors were used in subsequent analyses. Participant Demographics Results Conclusions  Pearson Correlations were used to explore the relationship between pain intensity, frequency and psychosocial risk factors.  Independent t-tests were conducted to further describe the relationship between pain intensity and frequency with psychosocial risk factors  See Table I for psychosocial risk factors, Table II for correlations, and Table III for t-tests.  The data highlight the importance of assessing potential risk factors in the treatment of chronic pain in youth, especially family and school factors.  These results suggest that there is a relationship between pain ratings and identified school (i.e. transition, academic problems) and family stressors (i.e. divorce, abuse, financial issues), which may indicate that youth identifying these stressors warrant more specific interventions directed at those problematic areas based on the fact that school and family are important components of development.  Future research should focus on determining if these psychosocial risk factors impact treatment strategies or the need for additional services. Table I: Top 10 Psychosocial Risk Factors *p <. 10. **p <.05. ***p <.01. Table III: T-tests *p <. 10. **p <.05. ***p <.01. Youth N = 351 Gender67.5% female Age13.65 yrs (2.39) Ethnicity77.9% Caucasian Best Pain Intensity2.15 (2.69) Worst Pain Intensity8.49 (1.75) Usual Pain Intensity5.59 (2.19) Psychosocial Risk Factors% Reported School Absenteeism31.3% Family Conflict28.5% Divorce19.9% School Transition19.7% Feeling Isolated/Not Fitting In19.4% Academic or Learning Difficulties18.8% Family Financial Problems16.2% Sibling Behavior Problems16.0% Youth as a High Achiever14.2% Peer Conflict9.7% Descriptive Statistics Pain Locations (Top 3) Headache35.1% Abdominal Pain24.7% Lower Extremity Pain17.1% Cumulative Risk Factors2.77 (SD = 2.39; R = 0-11) M of Pain if Factor Endorsed M of Pain if Factor Not Endorsed t(df)p Usual Pain Family Conflict6.33 N = 84 5.80 N = 222 1.91(304).057* Divorce6.40 N = 62 5.83 N = 244 1.85(304).066* Abuse6.89 N = 19 5.88 N = 287 1.96(304).051* Financial Problems7.11 N = 47 5.74 N = 259 4.05(304).000*** School Transition6.39 N = 64 5.83 N = 242 1.83(304).068* Academic Problems6.62 N = 58 5.79 N = 248 2.63(304).009** Best Pain School Absenteeism2.62 N = 95 1.94 N= 215 2.06(308).040** Athletic Achievement3.45 N = 22 2.04 N= 286 2.40(306).017** Worst Pain School Absenteeism8.80 N = 99 8.37 N = 217 2.02(314).044** Best Pain r p Worst Pain r p Usual Pain r p Cumulative Risk Factors.03 (NS).07 (NS).16 (.004)***  To Note: Best Pain was significantly correlated with Worst Pain (r =.14, p =.018) and Usual Pain (r =.30, p =.000). Worst and Usual pain were also significant related (r =.35, p =.000).