# The Impact of Social Rejection: Investigating Pain-related Stigma in Adolescents with Chronic Widespread Musculoskeletal Pain

> **NIH NIH K23** · CONNECTICUT CHILDREN'S MEDICAL CENTER · 2020 · $54,000

## Abstract

ABSTRACT
Pain-related stigma is a significant and understudied psychosocial factor among adolescents with chronic
widespread musculoskeletal pain (CWMP) that has been implicated in impaired health outcomes. The
subjectivity of pain self-report increases the opportunity for an individual to experience symptom disbelief by
others. Pain-related stigma is a significant public-health priority due to its potential impact on delayed diagnosis
and impairment in recovery. Adolescents with CWMP are vulnerable to pain-related stigma from several
sources, including physicians, school staff, family, and peers, likely impacting their health. The objectives of
this proposal are to: 1) examine how pain-related stigma is a novel and necessary psychosocial component of
adolescent CWMP, and 2) develop and validate the Pain-Related Stigma Scale for Adolescents (PReSS-A) in
patients with CWMP. Not enough is known about pain-related stigma in this young population. This proposal
uses a mixed-methods design to develop a theoretical framework in new areas of psychosocial research for
adolescents with CWMP. This research will provide a foundation for understanding pain-related stigma and
developing interventions to target this social construct in adolescents with CWMP. The specific aims are: 1)
develop a pain-related stigma framework and PReSS-A items using separate focus groups of adolescents with
CWMP and juvenile idiopathic arthritis (JIA) and their parents; 2) refine PReSS-A items using classical item
analyses in a sample of adolescents with CWMP; 3) validate final PReSS-A items in a larger sample of
adolescents with CWMP, and test construct validity using a comparative sample of adolescents with JIA, who
are hypothesized to report less stigma due to the medical evidence supporting their JIA diagnosis; and 4)
leverage structural equation modeling to explore relationships between perceived pain-related stigma and
psychosocial and health outcomes. The use of multiple patient populations (i.e., CWMP and JIA) and their
parents to examine and validate a measure of this social construct is innovative. This career-development
award is designed to allow Dr. Emily Wakefield, a pediatric psychologist in the Division of Pain and Palliative
Medicine at Connecticut Children's Medical Center and Assistant Professor of Pediatrics at the University of
Connecticut School of Medicine, to draw upon ample resources of both institutions to become an independent
researcher dedicated to improving health outcomes for adolescents with chronic pain. Her short-term goal is to
understand mechanisms contributing to pain-related stigma and develop interventions focused on reducing this
stigma in adolescents with CWMP. To achieve this, the career-development plan includes formal and informal
training, mentorship and consultation in both qualitative and quantitative research design, and advanced
training on statistical analyses, pediatric pain, stigma, and randomized clinical trials. Her long-term ...

## Key facts

- **NIH application ID:** 10247216
- **Project number:** 3K23AR073934-01A1S1
- **Recipient organization:** CONNECTICUT CHILDREN'S MEDICAL CENTER
- **Principal Investigator:** Emily O Wakefield
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $54,000
- **Award type:** 3
- **Project period:** 2020-02-01 → 2025-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10247216

## Citation

> US National Institutes of Health, RePORTER application 10247216, The Impact of Social Rejection: Investigating Pain-related Stigma in Adolescents with Chronic Widespread Musculoskeletal Pain (3K23AR073934-01A1S1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10247216. Licensed CC0.

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