395 School functioning in youth with disorders of gut–brain interaction: Implications for pain-related stigma from school personnel

Objectives/Goals: Youth with painful disorders of gut–brain interaction (DGBIs) report school-related challenges: stigma from school staff and poorer performance. The present study explored how stigma from school staff correlates with poorer school functioning through internal locus of control and pain interference. Methods/Study Population: Participants included 133 youth aged 8–18 years (Mage= 13.8). Youth completed a series of validated self-report questionnaires assessing pain-related stigma from school personnel, pain interference (i.e., the degree to which pain prevents engagement in daily activities), health-related locus of control (LOC – the belief that one’s health is determined by their own actions), and school functioning. A sequential mediation analysis was conducted using 95% bootstrapped confidence intervals to ascertain the indirect effect of school-based stigma on school functioning through internal LOC and pain interference. An alpha level of 0.05 was determined a priori. Results/Anticipated Results: School-based stigma was significantly correlated with poorer school functioning, even after controlling for internal LOC and pain interference, β = -0.22, p = .003. Evidence suggests a partial mediation model, such that school-based stigma is indirectly associated with poorer school functioning via internal LOC and pain interference (β = -0.028, 95% CI [-0.069, -0.002]). More specifically, greater school-based stigma correlates with a greater internal LOC (β = 0.19, p= .03). In turn, a greater internal LOC correlates with greater pain interference (β = 0.32, p<.001). Finally, greater pain interference correlates with poorer school functioning (β = -0.46, p< .001). Discussion/Significance of Impact: Stigma from teachers and nurses may cause youth with DGBIs to feel more responsible for their pain. Consequently, as they internalize this stigma, their pain may present a greater barrier to engagement in daily activities, including participation in school activities.