Longitudinal course and risk factors for fatigue in adolescents: the mediating role of sleep disturbances

See Wan Tham, Amy Lewandowski Holley, Chuan Zhou, Gregory N. Clarke, Tonya M. Palermo

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


Objectives This study (1) examines fatigue over 1 year in adolescents with chronic pain (n=61) and depressive disorders (n=51) compared with healthy adolescents (n=60), (2) identifies longitudinal risk factors, and (3) tests sleep disturbances as a mediator between depression and fatigue. Methods Adolescents completed questionnaires at baseline, 6, and 12 months. Mixed effects models examined associations between risk factors and fatigue; structural equation modeling assessed contemporaneous and longitudinal mediation. Results Results revealed fatigue persisted at 1 year follow-up, with adolescents in the clinical samples experiencing greater fatigue than healthy youth at all time points (ps<.001). Age, baseline depression, and baseline sleep disturbances predicted longitudinal fatigue for the total sample (ps<.05), with variation in predictors by subgroup. Sleep quality mediated the contemporaneous effects of depression on fatigue in the clinical samples (ps<.05). Conclusions Findings underscore the longitudinal course of fatigue and suggest that improving sleep disturbances may reduce fatigue in clinical samples.

Original languageEnglish (US)
Pages (from-to)1070-1080
Number of pages11
JournalJournal of pediatric psychology
Issue number10
StatePublished - Nov 1 2013
Externally publishedYes


  • Adolescents
  • Depression
  • Fatigue
  • Recurrent and chronic pain
  • Sleep

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Developmental and Educational Psychology


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