Resilience and social support are important for emerging adults and especially those with chronic health conditions (CHC). We examined associations among resilience, social support, and health in those with and without a CHC. 132 emerging adults with a CHC and matched healthy participants completed questionnaires. Two-group, measuredvariable path analysis and mediational models were conducted. Those with a CHC had poorer resilience and health but equivalent social support. Resilience significantly predicted general health and emotional well-being. Resilience mediated the relationships between coping and health for healthy participants and between coping and emotional wellbeing in those with a CHC. Satisfaction with social support was significantly correlated with health, mediating the influence of network size on emotional well-being for those without a CHC and both physical functioning and emotional well-being for healthy participants. These results indicate the importance of resilience and social support for emerging adults, especially those with a CHC.

Objective: Although insomnia symptoms and chronic pain are associated, less is known about the temporal nature of the associations between these variables or the impact of internalizing symptoms on the associations. Concurrent and longitudinal associations were examined among insomnia symptoms, internalizing symptoms, and pain in youth with chronic pain in this retrospective analysis of clinical records. We hypothesized the following: (a) pain, insomnia symptoms, and internalizing symptoms would be significantly interrelated at all waves, (b) insomnia symptoms would more strongly predict future pain than the reverse, and (c) internalizing symptoms would mediate the longitudinal association between insomnia symptoms and pain. Method: Youth (N = 132; age M = 15.34 years, SD = 1.86 years) were assessed at their initial and two subsequent appointments (time between appointments M = 6.48 months, SD = 4.43 months). At each appointment, youth reported their pain severity, insomnia symptoms, and internalizing symptoms. Confirmatory factor analyses (CFAs) and cross-lagged panel models using structural equation modeling were conducted. CFAs and the cross-lagged panel model with pain and insomnia symptoms as latent constructs converged. Results: Pain and insomnia symptoms were positively correlated within each wave. We found bidirectional longitudinal associations between insomnia symptoms and pain. Conclusions: Overall, these data demonstrate a bidirectional relationship between insomnia symptoms and pain, as well as weak support for internalizing symptoms mediating the association between pain and insomnia symptoms. Treatment of youth with chronic pain should prioritize concurrent or early treatment of comorbid insomnia symptoms to maximize response to pain treatment.

Objective Pain-related appraisals, including pain-related injustice, impact the development and maintenance of chronic pain. This cross-sectional study aimed to examine the relationship between the cognitive-emotional components of pain-related injustice—blame/unfairness and severity/irreparability of loss—and functioning in a mixed sample of adolescents with chronic pain. Methods Pediatric patients age 11–18 years (N = 408) completed forms assessing pain-related injustice, pain intensity, and physical and psychosocial functioning as part of their routine assessment in a pediatric chronic pain clinic between January 2014 and January 2019. A series of hierarchical regressions were used to evaluate the relationships among the separate components of pain-related injustice appraisals and functioning. Results Pain intensity and blame/unfairness appraisals were significantly associated with emotional functioning with blame/unfairness being the stronger association (β = −.27). Blame/unfairness appraisals, severity/irreparability appraisals, and pain intensity were significantly associated with physical functioning with pain intensity being the strongest association (β = .36). Pain intensity, blame/unfairness appraisals, and severity/irreparability appraisals were significantly associated with social functioning with blame/unfairness being the strongest association (β = −.34). Pain intensity and severity/irreparability appraisals were significantly associated with school functioning with severity/irreparability being the stronger association (β = −.19). Conclusions These results lend further support to incorporating pain-related injustice appraisals in standard clinical pain assessments. Treatment practices should target the specific injustice appraisals and domains of functioning impacted for each pediatric patient with chronic pain.

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