Linking family and intimate partner relationships to chronic pain: An application of the biobehavioral family model.

Abstract

Introduction:Research is needed to determine mechanisms of effect linking family relationships and chronic pain for adults. Guided by the Biobehavioral Family Model (BBFM), the present study examined indirect effects between a negative family emotional climate and chronic pain disease activity, as mediated by biobehavioral reactivity. Method: Data for this study are from the Midlife Development in the United States; specifically, a subsample of participants who reported experiencing chronic pain (n ϭ 1,461, ages 32-84). Participants self-reported family strain, biobehavioral reactivity (i.e., anxiety, depression), and chronic pain disease activity (i.e., pain interference, global health). A subsample of participants (n ϭ 1,070) completed an intimate partner strain measure, indicating they were married/in a committed relationship. Structural equation models were tested with maximum likelihood estimation and bootstrapping. Results: Family strain was indirectly associated with chronic pain disease activity via biobehavioral reactivity-Model 1; 2 (10) ϭ 40.75, p Ͻ .000, root mean square error of approximation [RMSEA] ϭ .07, comparative fit index [CFI] ϭ .96, standardized root-mean-square residual [SRMR] ϭ .04; partial mediation occurred for partnered participants. This finding was replicated when modeling family strain simultaneously with intimate partner strain, though intimate partner strain was not associated with chronic pain disease activity-Model 2; 2 (5) ϭ 8.29, p ϭ .14, RMSEA ϭ .03, CFI ϭ .99, SRMR ϭ .01. Discussion: These findings add to the growing literature that emphasizes the role of family relationships in chronic pain. Future research is needed to replicate our use of the BBFM to specify pathways of effect, incorporating relational and observational data, with diverse samples.

In-depth analysis of life values and their corresponding inhibitors and facilitators in chronic low back pain patients: A mixed-method approach

“…For instance, experiences of loss were mentioned for the values: "family", "intimate relations", and "friends", thus reflecting a high impact on individuals' lives; caring for a loved one was mentioned within the values "family" and "intimate relations"; and, dissatisfaction both with "friends" and "intimate relations" was reported. These results are consistent with other studies reported in the literature, where both family and social life related stressors [45][46][47] were repeatedly observed in chronic back pain patients as was family-related negative strain [46,48,49]. The association between family strain and back pain has also been found to be mediated by depression [50].…”

The Biobehavioral Family Model: An Evidence-Based Approach to Biopsychosocial Research, Residency Training, and Patient Care

“…Many studies have now substantiated the role of both intimate partner relationships as well as non-intimate family relationships in understanding the impact of family on health for adults [e.g., ( 33 , 34 )]. Though both operationalizations of family emotional climate—the positivity or negativity, and intensity, of intimate partnerships and of non-intimate family relationships—have been significantly linked to disease activity in tests of the BBFM, studies have tended to support more powerful links for non-intimate family relationships, especially when negative and intense [e.g., ( 29 , 35 , 36 )].…”

Family Structure and Family Climate in Relation to Health and Socioeconomic Status for Older Adults: A Longitudinal Moderated Mediation Analysis

“…We created a latent construct to represent emotion dysregulation by employing two validated indexes on depression (EURO-D) and anxiety (reduced Beck’s Anxiety Inventory, BAI) measured at T2 (Cronbach’s α = 0.764), similar to previous studies using the BBFM [ 30 , 61 ]. In our model, biobehavioral reactivity was conceptualized as a second mediator.…”