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Chronic pain and depression: toward a cognitive-behavioral mediation model
Thomas E Rudy1, Robert D Kerns, Dennis C Turk
1Department of Anesthesiology and Center for Pain Evaluation and Treatment, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, U.S.A. West Haven VA Medical Center and Yale University School of Medicine, West Haven, CT 06516, U.S.A. Department of Psychiatry and Center for Pain Evaluation and Treatment, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213 U.S.A.
Pain
|November 1, 1988
Summary
Chronic pain does not directly cause depression. Instead, reduced life activities and loss of control mediate the link between pain and depressive symptoms in patients.
Area of Science:
- Psychology
- Clinical Psychology
- Behavioral Medicine
Background:
- Depression frequently co-occurs with chronic pain, yet empirical testing of explanatory models is limited.
- Existing models often fail to adequately explain the relationship between chronic pain and depression.
Purpose of the Study:
- To test a cognitive-behavioral mediation model of pain and depression.
- To investigate the role of perceived life interference and self-control in the development of depression among chronic pain patients.
Main Methods:
- Structural modeling with latent variables was employed.
- The study examined the mediating roles of perceived reduction in instrumental activities and perceived loss of control.
Main Results:
- The direct relationship between chronic pain and depression was non-significant.
- Perceived life interference and self-control emerged as significant intervening variables.
- Psychological mediators were empirically demonstrated in the development of depression secondary to chronic pain.
Conclusions:
- The findings support a cognitive-behavioral mediation model where pain's impact on activities and control influences depression.
- This contrasts with single-factor models suggesting a common cause for pain and depression.