An investigation of the pain experience of college and university students: a mixed-method approach
Embargo Date
2025-02-22
OA Version
Citation
Abstract
Chronic pain's impact on social and school functioning in university students is widely understudied. However, some studies have shown that chronic pain negatively impacts school performance in adolescents by increasing the rate of absences and impacting students' ability to concentrate and retain information. Further, chronic pain in emerging adults has been shown to increase rates of anxiety and depression and decrease self-esteem and social functioning. This current study aims to investigate chronic pain's effect on students' anxiety, depression, self-efficacy, pain behavior, pain interference, and the school and social supports they receive for their pain. Participants were recruited from colleges/universities across the US and Royal Holloway University in the UK. Participation involved answering a series of questionnaires, of which this study examines demographic questions, PROMIS measures, and qualitative questions. Participants were also asked to fill out a pain scale and the Michigan Body Map to determine the location, intensity, and duration of their pain. These measures were used to determine whether a participant experienced chronic pain. In total, 115 participants, aged 18-25 years reported at least one area of chronic pain and completed the qualitative questions and at least one PROMIS measure. PROMIS measures were scored against a known population average to determine clinical significance. Of the 115 chronic pain participants, 60% reported clinically significant anxiety symptoms, 49% reported clinically significant symptoms of depression, 31% of participants reported moderate to severe rates of pain behavior, and 40% reported the same of pain interference. In addition, 38% of participants reported low or very low self-efficacy. All measures had higher rates of clinical significance compared to the non-pain participants except pain behavior. Further, an inductive approach to thematic analysis was used to determine themes in participant responses, including (1) chronic pain impacting academics, (2) feelings of isolation due to lack of communication by students, (3) a desire for easier access to health care resources, and (4) more understanding and flexibility from faculty. This study confirmed the impact of chronic pain on students' mental health and daily lives. It highlighted the underutilization of school support and the lack of support received by chronic pain students from their peers and school staff. Future studies are needed to examine social determinants of how emerging adults express pain and how universities can tailor appropriate interventions for this population.