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Pain Resilience and Catastrophizing as Mediators of Pain Intensity and Outcomes
Melissa Makhoul1, Huda Abu-Saad Huijer2, Douglas J French3
1Rafic Hariri School of Nursing, American University of Beirut, Beirut, Lebanon; Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL.
Purpose:
Chronic musculoskeletal pain (CMP) is highly prevalent and disabling. In Lebanon, its burden is likely exacerbated by ongoing sociopolitical crises impacting healthcare services. While pain catastrophizing is a well-known predictor of poorer pain outcomes, less is known about how positive psychological factors, such as pain resilience, contribute to optimal pain-related functioning. Additionally, the dynamic interplay between pain intensity, pain catastrophizing, and pain resilience on pain outcomes has received little attention. This study aimed to examine the serial mediating effects of pain catastrophizing and pain resilience on the relationship between pain intensity and outcomes including pain interference, physical and mental health-related quality of life (HRQoL).
Design:
A cross-sectional observational design was used.
Methods:
A total of 154 Lebanese adults with CMP were recruited from two tertiary medical centers. Participants completed self-report measures of pain intensity and interference, pain catastrophizing, pain resilience, physical and mental HRQoL, and depression. Serial mediation analyses using Hayes Process macro were performed.
Results:
After controlling for depression, analyses revealed that pain catastrophizing and pain resilience sequentially mediated the association between pain intensity and both pain interference and mental HRQoL, but not physical HRQoL.
Conclusions:
Pain catastrophizing and pain resilience may be potential mechanistic pathways by which pain intensity impacts pain-related outcomes.
Clinical Implications:
Targeting pain catastrophizing and pain resilience may help mitigate the negative impact of pain intensity in adults with CMP.
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