Pain Catastrophizing in Older Adults with Chronic Pain: The Mediator Effect of Mood Using a Path Analysis Approach

Abstract

<jats:p>Cognitive models of pain propose that catastrophic thinking is negatively associated with chronic pain. However, pain catastrophizing is a complex phenomenon requiring a multivariate examination. This study estimates the effects of mood variables (anxiety and depression) on pain catastrophizing in older adults with chronic pain. A postal survey addressing pain aspects was sent to 6611 people ≥ 65 years old living in south-eastern Sweden. Pain catastrophizing was measured using the pain catastrophizing scale. Anxiety and depression were assessed using two subscales of the general well-being schedule. Data were analysed using a path analysis approach. A total of 2790 respondents (76.2 ± 7.4 years old) reported chronic pain (≥three months). The mediation model accounted for 16.3% of anxiety, 17.1% of depression, and 30.9% of pain catastrophizing variances. Pain intensity, insomnia, number of comorbidities, and lifestyle factors (smoking, alcohol consumption, and weight) significantly affected both pain catastrophizing and mood. Anxiety (standardized path coefficient (bstd) = 0.324, p &lt; 0.001) in comparison to depression (bstd = 0.125, p &lt; 0.001) had a greater effect on pain catastrophizing. Mood mediated the relationship between pain catastrophizing and pain-related factors accounting for lifestyle and sociodemographic factors.</jats:p>

The Mediating Role of Pain Catastrophizing on the Association Between Depression and Pain Severity and Interference Among Elderly Asian Immigrants with Chronic Pain

“…For example, a previous report of depression mediating the association between pain catastrophizing and pain-related factors, including pain intensity among elderly. 15 Pain catastrophizing mediates the associations between pain intensity and depression. [16][17][18] The possible mechanisms for how depression influences the chronic pain experience have not been examined and need to be explored given the high prevalence of depression 13 and chronic pain severity 9 in this particular population.…”

“…For example, a previous report of depression mediating the association between pain catastrophizing and pain-related factors, including pain intensity among elderly. 15 Pain catastrophizing mediates the associations between pain intensity and depression. 16–18 …”

Association between Participation Activities, Pain Severity, and Psychological Distress in Old Age: A Population-Based Study of Swedish Older Adults

“…This is a large cross-sectional study based on the Swedish Total Population Register (STPR) for the two largest cities (Linköping and Norrköping) in one county (Östergötland) in south-eastern Sweden [ 33 , 34 , 35 , 36 , 37 ]. The STPR for this geographical area entails about 49,320 persons in the age group 65 years and older.…”

“…Here, we used the total PCS (PCS-total): the maximum score according to the original scale was 52 with a high score indicating a worse outcome. However, due to a printing malfunction, the most negative alternative (“all the time”) was not printed in the questionnaire, so the most negative alternative was “to a great degree” [ 35 , 37 ]. In this study, PCS-total had possible scores between 0 and 39 instead of 0 and 52.…”

Patient-Centered Care in Psoriatic Arthritis—A Perspective on Inflammation, Disease Activity, and Psychosocial Factors

“…Cognitive and behavioral aspects provide a potential link between chronic pain, disturbed sleep, and depression [ 20 ]. There is also a complex relationship of pain with mood disturbances [ 21 ] and disability [ 22 ] that we do not fully understand. It is beneficial to think of these factors as an interconnected network that can mutually interact and exacerbate each constituent.…”