Academic achievement of adolescents with chronic pain: the mediating role of sleep

Student thesis: Doctoral ThesisDoctorate in Educational, Child and Adolescent Psychology


Objective: To explore academic achievement among adolescents with chronic pain (CP) compared to their peers and how this relationship may be mediated by secondary influencing factors such as difficulties with sleep.

Methods: A secondary analysis was conducted across a population of adolescents with CP (n = 856) and their peers without chronic pain (NCP; n = 3093) from the Avon Longitudinal Study of Parents and Children (ALSPAC) in the UK who attended a research clinic at 17 years. Chi-square, t-test, regression, and mediation analyses were performed to explore the relationship between CP and academic achievement measures, pathway to higher education and educational qualifications. Analyses also explored descriptive information about the CP group compared to peers which are contextually important to the school experience, including pain characteristics, mental health difficulties, bullying, and substance use.

Results: A logistic regression revealed a relationship between CP and reporting a pathway to higher education after key variables were accounted for, although its predictive power was marginal and sensitive to the measure of academic achievement. Further analyses identified a moderate indirect effect of CP on reporting a pathway to higher education when mediated by sleep. Adolescents with CP were also found to be at risk across a range of measures including mental health difficulties, bullying, and substance misuse.

Conclusions: The limited predictive relationship between CP and academic achievement potentially indicates enhanced skills that the CP group may utilise in maintaining a developmental trajectory at school, or external factors such as support from their caregivers or school. The complex inter-relationship between sleep and CP is also an important consideration for adolescents with CP to achieve academically. Recommendations are provided for professionals working with adolescents with CP in an educational context.

Thesis is embargoed until 31 December 2024.

Date of AwardDec 2023
Original languageEnglish
Awarding Institution
  • Queen's University Belfast
SponsorsDepartment of Education Northern Ireland
SupervisorAnthea Percy (Supervisor) & Agnieszka Graham (Supervisor)


  • Chronic pain
  • academic achievement
  • sleep
  • adolescents
  • school

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