Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Under Pressure to Perform

Impact of Academic Goal Orientation, School Motivational Climate, and School Engagement on Pain and Somatic Symptoms in Adolescents

Randall, Edin T. PhD*,†,‡; Shapiro, Jenna B. PhD§; Smith, Kelly R. BA; Jervis, Kelsey N. BS*; Logan, Deirdre E. PhD†,‡,¶

doi: 10.1097/AJP.0000000000000765
Original Articles

Objectives: Various academic factors are known to influence pain and somatic symptoms in adolescents, but the roles of academic goal orientation, school motivational climate, and school engagement are unknown. This study examined how these understudied academic factors are associated with adolescent pain and somatic symptoms and whether sex moderates the relations.

Materials and Methods: High school students (n=90) from a high-achieving community completed questionnaires assessing academic variables, various pain characteristics, and somatic symptoms.

Results: The majority of adolescents (67%) experienced pain and somatic symptoms in the past month, with 56% reporting multisite pain and 58% reporting at least 1 severe somatic symptom. Headache and abdominal pain were the most frequently reported “most bothersome” pains, and pain was rated, on average, as moderately severe, typically occurring several times per month, and was primarily chronic in nature (duration, ≥3 mo). Higher levels of ego goal orientation and perceived performance motivational climate were associated with more somatic symptoms, and ego goal orientation was also associated with more intense and frequent pain. Alternatively, greater school engagement was associated with fewer somatic symptoms. Task goal orientation and mastery motivational climate were unassociated with all pain and somatic symptom outcomes.

Discussion: This study demonstrates that adolescents from a high-achieving community report more somatic symptoms and pain when they are less engaged in school and when their academic focus is on grades and outperforming peers. Results suggest that de-emphasizing competition and performance outcomes may support physical well-being in adolescents.

*Pediatric Pain Rehabilitation Program

Department of Psychiatry

Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital

Department of Psychiatry, Harvard Medical School, Boston, MA

§Department of Psychiatry and Behavioral Medicine, Ann & Robert H. Lurie Children’s Hospital, Chicago, IL

Department of Psychology, West Virginia University, Morgantown, WV

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

The authors declare no conflict of interest.

Reprints: Edin T. Randall, PhD, 9 Hope Ave, Waltham, MA 02453 (e-mail:

Received February 28, 2019

Received in revised form July 11, 2019

Accepted August 27, 2019

Online date: September 10, 2019

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.