The Relationship Between Pain Severity and Alcohol Use Among School-Aged Children and Adolescents: The Moderating Role of Drinking Motives

• Published in: Pain medicine (Malden, Mass.) Mass.), 2018-02, Vol.19 (2), p.284-296
• Main Authors: Horn-Hofmann, Claudia, Trost, Zina, Hublet, Anne, Mrug, Sylvie, Van Damme, Joris, Vervoort, Tine
• Format: Article
• Language: English
• Subjects: Abuse; Adolescence; Adolescent; Adolescents; Alcohol abuse; Alcohol Drinking - psychology; Alcohol use; Alcoholic Intoxication - psychology; Alcoholism; Belgium; Child; Child & adolescent psychiatry; Children; Childrens health; Chronic pain; Drinking (Alcoholic beverages); Drinking behavior; Drug abuse; Drunkenness; Elementary school students; Female; Future predictions; Health behavior; Humans; Juvenile drinking; Male; Motivation; Pain; Pediatric pain; Pediatrics; Public health; Surveys; Teenagers; Young Adult
• ISSN: 1526-2375; 1526-4637
• DOI: 10.1093/pm/pnx016

Abstract Objective Evidence from adult samples suggests a co-occurrence between pain and alcohol abuse. However, studies in adolescents are scarce and results are inconsistent, with some studies observing heightened and others observing reduced alcohol consumption in adolescents suffering from pain. We hypothesized that in adolescents the association between pain and alcohol use will be moderated by drinking motives. Methods Data from a large representative sample of Flemish school children and adolescents (N = 10,650, 50.8% boys, age range = 10–21 years, Mage = 14.33 years) were collected as part of the World Health Organization collaborative Health Behaviour in School-Aged Children (HBSC) survey. Pain severity was graded based on a pediatric pain classification system that accounts for both pain intensity and disability. Alcohol consumption was operationalized using two variables: frequency of drinking and drunkenness. The Drinking Motives Questionnaire–Revised was used to capture drinking motives; it assesses four motive categories (enhancement, coping, social, and conformity). Results Findings indicated that higher pain severity was associated with greater frequency of alcohol use and drunkenness. However, drinking motives moderated this association. The positive association between pain severity and drinking frequency was stronger in case of high conformity motives. Likewise, the association between pain severity and drunkenness frequency was stronger at high levels of conformity motives and reached significance only at high levels of coping motives. Conclusions Our findings suggest that specific drinking motives are linked to problematic alcohol use in adolescents with pain. Future studies using a longitudinal design are needed to draw conclusions about direction of effects.