Pain, Depressed Mood, and Academic Performance in Undergraduate Students with Chronic Pain

Open Access
Manetta, Sara Susan
Area of Honors:
Biobehavioral Health
Bachelor of Science
Document Type:
Thesis Supervisors:
  • Jennifer Elise Graham Engeland, Thesis Supervisor
  • Lori Anne Francis, Honors Advisor
  • chronic pain
  • depressed mood
  • MPQ
  • CES-D
  • academic performance
  • undergraduates
  • students
The high comorbidity rates of chronic pain and depression have been well documented. Chronic pain and depression are both complex phenomena that can have significant effects on physical and psychological health and which can be exacerbated by stress. However, little research has examined the relationship between chronic pain and depressed mood among undergraduate students, despite prevalence rates of depression in college students that are similar to other populations and relatively high rates of perceived stress among college students. The goal of this study was to examine the complex relationship between chronic pain experience and depressed mood among undergraduate students and to investigate how both affect academic performance. As a part of a larger study conducted at Penn State University, self-reported measures of pain, depressed mood, perceived stress, and academic performance were collected from 206 students with chronic pain. Chronic pain experience was measured by the McGill Pain Questionnaire (MPQ), providing ratings of sensory, affective, and evaluative, as well as other facets of pain. Depressed mood was measured by the Center for Epidemiologic Studies Depression (CES-D) Scale and its four factors—depressed affect, lack of positive affect, somatic, and interpersonal. MPQ subscales were compared to the CES-D subscales in college students with chronic pain in order to better understand the unique relationships between pain and psychological health. Lastly, the relationships between chronic pain, depressed mood and academic success was examined, with the expectation that depressed mood would mediate and account for any association between pain and performance. Academic performance was measured by grade point average (GPA) as well as a student’s happiness with their grades and the extent to which they believed their grades reflected their ability. Findings suggest a high prevalence of depression amongst college students with chronic pain. Total pain was most strongly associated with somatic and interpersonal depressed mood, while total depressed mood was most associated with affective and evaluative pain. Moreover, sensory and evaluative pain were more indicative of somatic and interpersonal depressed mood, while affective pain was linked to all aspects of depressed mood. Various measures of pain and depressed mood were negatively correlated with academic performance. Pain severity and lack of positive affect were significantly associated with a student’s happiness with their grades. Moreover, total depressed mood and somatic depressed mood were significantly related to both a student’s happiness and expectations of grades based on their abilities. Structural equation modeling suggested that chronic pain relates to academic performance via depressed mood, with a significant and well-fitted model. Results were significant with and without controlling for perceived stress. Overall, findings suggest an intricate relationship between chronic pain, depressed mood, and academic performance. It seems likely that pain contributes to depressed mood among undergraduate students with chronic pain and that their depressed mood contributes to poorer academic performance.