Meaning in Life and Pain: The Differential Effects of Coherence, Purpose, and Mattering on Pain Severity, Frequency, and the Development of Chronic Pain

Abstract

Objective Meaning in life is consistently associated with better health outcomes across a range of mental and physical domains. However, meaning in life is a complex construct involving three distinct facets: coherence, purpose, and mattering. While these facets have been studied individually in relation to pain, they have not been assessed concurrently to parse out their potential distinct contributions to pain outcomes. We sought to identify the unique relationships of these individual facets of meaning with pain experiences and specify the components associated with pain-related resilience. Methods The associations of coherence, purpose, and mattering with pain outcomes were examined across three studies. Study 1 used data from the Midlife in the United States National Survey to determine associations between facets and the frequency of various recently experienced pains, and the development of chronic pain nine years later. Study 2 cross-sectionally observed the association between facets and recent pain severity in young adults. Using a diary-type approach, Study 3 captured fluctuations of pain severity in relation to the facets across the span of four weeks. Results Coherence was uniquely associated with less headache, backache, joint, and extremities pain frequency in Study 1, over and above purpose and mattering, controlling for other health variables. Coherence was also associated with lower odds of developing chronic pain. In Study 2, coherence was associated with less pain severity and fully mediated the relationship between global meaning in life and pain. Study 3 found that coherence predicted the most unique variance in weekly pain fluctuations. Conclusion Across three studies and timescales, coherence was uniquely associated with fewer and less severe pain experiences over and above purpose and mattering. These findings provide support for the value of coherence as a resilience factor in the context of pain and suggest a potential benefit for coherence-specific interventions in clinical settings.

Pain and associated functional impairment in the Danish general population: the role of mental well-being

“…In line with prior literature (Furrer et al, 2019;Sta ˚lnacke, 2011;Larsson et al, 2019;Fisher et al, 2004;Achat et al, 2000;Boring et al, 2022), the current study extends previous findings by showing that higher levels of mental well-being predict lower odds for pain and functional impairment due to pain one year later. The results were significant after adjusting for a range of sociodemographic and health-related factors, as well as depression based on the PHQ-8.…”

“…Larsson et al (2019) conducted a prospective study on a population-based cohort in Sweden, and showed that higher levels of hedonic well-being and life satisfaction were associated with lower risk of severe pain two years after baseline. More recently, Boring et al (2022) analyzed a cohort of American adults, and found that sense of coherence – a component of meaning in life – was associated with lower odds of developing pain nine years after baseline.…”

Modeling psychological well‐being among abdominal and pelvic cancer patients: The roles of total pain, meaning in life, and coping

“…Our findings indicate that the pain dimensions were negatively related to presence of meaning, while positively related to search for meaning, which also verifies the hypothesis. While the former result seems quite reasonable, that is, patients in severe pain show difficulties in achieving life goals and discovering meaning and purpose, 14,34 the latter result is rather thought‐provoking. It may indicate that, despite experiencing a spectrum of pervasive pain symptoms, patients do not abandon their pursuit of goals and aspirations, but search for meaning and purpose in their lives.…”

Introducing the integrated model of co-occurring chronic pain and posttraumatic stress disorder: Adding meaning-making and existential concepts to current theory.

“…Evidence of the longitudinal relationships between chronic pain and PTSD relevant to existential anxiety is scant. In addition to Boring et al, (2022) mentioned above, in a sample of 273 patients with chronic pain, Dezutter et al (2015) found that meaning in life at Time 1 predicted depressive symptoms at Time 2 (but not pain intensity) and that pain medication at Time 2 (but not pain intensity) predicted the presence of meaning at Time 3 (Dezutter et al, 2015).…”