{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T08:55:36Z","timestamp":1787820936751,"version":"build-2784847793"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T00:00:00Z","timestamp":1678320000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K23AR073934"],"award-info":[{"award-number":["K23AR073934"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,4,20]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Childhood chronic pain conditions are common and vulnerable to stigma. Adolescents with chronic primary pain experience diagnostic uncertainty and describe pain-related stigma experiences across multiple social contexts. Juvenile idiopathic arthritis (JIA) is a childhood autoimmune, inflammatory condition with associated chronic pain, but with well-defined diagnostic criteria. The current study examined pain-related stigma experiences in adolescents with JIA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Four focus groups of 3\u20137 adolescents with JIA (N\u2009=\u200916), ages 12\u201317 (Mage\u2009=\u200915.42, SD\u2009=\u20091.82), and parents (N\u2009=\u200913) were conducted to examine experiences of, and reaction to, pain-related stigma. Patients were recruited from an outpatient pediatric rheumatology clinic. Focus group length ranged from 28 to 99\u2009minutes long. Two coders used directed content analysis resulting in 82.17% inter-rater level of agreement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Adolescents with JIA described pain-related stigma experiences predominantly from school teachers and peers, and less from medical providers (e.g., school nurses), and family members after a diagnosis. The primary categories that emerged were (1) Felt Stigma, (2) Internalized Stigma, (3) Anticipatory Stigma\/Concealment, and (4) Contributions to Pain-Related Stigma. A common experience of pain-related stigma was the perception by others that the adolescent was too young to have arthritis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In common with adolescents with unexplained chronic pain, our findings indicate that adolescents with JIA experience pain-related stigma in certain social contexts. Diagnostic certainty may contribute to greater support among medical providers and within families. Future research should investigate the impact of pain-related stigma across childhood pain conditions.<\/jats:p><\/jats:sec>","DOI":"10.1093\/jpepsy\/jsac092","type":"journal-article","created":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T17:25:08Z","timestamp":1678382708000},"page":"341-351","source":"Crossref","is-referenced-by-count":9,"title":["Does Diagnostic Certainty Matter?: Pain-Related Stigma in Adolescents with Juvenile Idiopathic Arthritis"],"prefix":"10.1093","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9308-6557","authenticated-orcid":false,"given":"Emily O","family":"Wakefield","sequence":"first","affiliation":[{"name":"Divisions of Pain and Palliative Medicine and Pediatric Psychology, Connecticut Children\u2019s Medical Center , Hartford, CT"},{"name":"Department of Pediatrics, University of Connecticut School of Medicine , Farmington, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaishali","family":"Belamkar","sequence":"additional","affiliation":[{"name":"Department of Research, Connecticut Children\u2019s Medical Center , Hartford, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Sandoval","sequence":"additional","affiliation":[{"name":"Department of Psychological Science, Central Connecticut State University , New Britain, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca M","family":"Puhl","sequence":"additional","affiliation":[{"name":"Rudd Center for Food Policy & Obesity, University of Connecticut , Hartford, CT"},{"name":"Department of Human Development and Family Sciences, University of Connecticut , Storrs, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Edelheit","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Connecticut School of Medicine , Farmington, CT"},{"name":"Division of Rheumatology, Connecticut Children\u2019s Medical Center , Hartford, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William T","family":"Zempsky","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Connecticut School of Medicine , Farmington, CT"},{"name":"Division of Pain and Palliative Medicine, Connecticut Children\u2019s Medical Center , Hartford, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah A","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Department of Psychological Science, Central Connecticut State University , New Britain, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8319-6090","authenticated-orcid":false,"given":"Mark D","family":"Litt","sequence":"additional","affiliation":[{"name":"Division of Behavioral Sciences and Community Health, University of Connecticut Health Center , Farmington, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,3,9]]},"reference":[{"issue":"4","key":"2023042023005817400_jsac092-B1","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1016\/j.yebeh.2004.04.008","article-title":"Measuring stigma in children with epilepsy and their parents: Instrument development and testing","volume":"5","author":"Austin","year":"2004","journal-title":"Epilepsy & Behavior: E&B"},{"issue":"1","key":"2023042023005817400_jsac092-B2","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1093\/jpepsy\/jsaa083","article-title":"Stigma by association: Parent stigma and youth adjustment in inflammatory bowel disease","volume":"46","author":"Baudino","year":"2021","journal-title":"Journal of Pediatric Psychology"},{"issue":"1","key":"2023042023005817400_jsac092-B3","doi-asserted-by":"crossref","DOI":"10.1186\/s42358-020-00138-4","article-title":"Adolescents\u2019 social needs living with juvenile idiopathic arthritis and their views about digital resources","volume":"60","author":"Beneitez","year":"2020","journal-title":"Advances in Rheumatology"},{"issue":"8","key":"2023042023005817400_jsac092-B4","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1097\/AJP.0000000000000454","article-title":"What\u2019s in a name? 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