Sarah B Woods1, Jacob B Priest2, Veronica Kuhn3, Tara Signs4. 1. Department of Family and Community Medicine, University of Texas Southwestern Medical Center, 5920 Forest Park Rd, Suite 651, Dallas, TX 75390, USA. Electronic address: Sarah.Woods@UTSouthwestern.edu. 2. Department of Psychological and Quantitative Foundations, University of Iowa, N372 Lindquist Center, Iowa City, IA 52242, USA. Electronic address: Jacob-B-Priest@UIowa.edu. 3. Graduate School of Education & Psychology, Pepperdine University, 6100 Center Dr., Los Angeles, CA 90045, USA. Electronic address: Veronica.P.Kuhn@gmail.com. 4. College of Humanities and Social Sciences, Oklahoma Baptist University, 500 West University, Shawnee, OK, 74804, USA. Electronic address: Tara.Signs@OKBU.edu.
Abstract
RATIONALE: Chronic stress contributes to the pathogenesis of chronic pain. Yet, the role of close relationship stress in these pathways to pain is not fully understood. OBJECTIVE: To delineate specific psychosocial pathways associated with chronic pain, specifically emphasizing close relationships for midlife adults. We tested whether relationship strain, relationship support, social integration, depression, anxiety, and pain severity predict chronic pain etiology and persistence over 10 years, highlighting specific associations for acute versus chronic pain. METHOD: Using data from the National Survey of Midlife in the U.S. (MIDUS 2 and 3, collected in 2004-2006 and 2013-2014, respectively), we used logistic regression to test the etiology of new chronic pain (n = 1591) and persistence of pain for adults with acute (n = 352) and chronic pain (n = 367) conditions at baseline. RESULTS: Of participants who reported they did not have chronic pain at baseline, the development of chronic pain 10 years later was significantly associated with baseline family strain (OR = 1.38, p < .01). For participants with acute pain at baseline, the transition of this pain to chronic a decade later was significantly associated with initial reports of pain interference (OR = 1.24, p < .001), family support (OR = 0.60, p < .05), and depression (OR = 1.20, p < .05). Persistent chronic pain was solely associated with baseline pain interference (OR = 1.21, p < .01). CONCLUSIONS: Family strain is an important part of the chronic stress profile associated with chronic pain etiology, whereas family support is associated with a reduced risk of acute pain transitioning to chronic pain over time. Prioritizing family relationships in treatment approaches to pain may be an indicated, innovative approach to preventing pain development and escalation and requires systems training in healthcare.
RATIONALE: Chronic stress contributes to the pathogenesis of chronic pain. Yet, the role of close relationship stress in these pathways to pain is not fully understood. OBJECTIVE: To delineate specific psychosocial pathways associated with chronic pain, specifically emphasizing close relationships for midlife adults. We tested whether relationship strain, relationship support, social integration, depression, anxiety, and pain severity predict chronic pain etiology and persistence over 10 years, highlighting specific associations for acute versus chronic pain. METHOD: Using data from the National Survey of Midlife in the U.S. (MIDUS 2 and 3, collected in 2004-2006 and 2013-2014, respectively), we used logistic regression to test the etiology of new chronic pain (n = 1591) and persistence of pain for adults with acute (n = 352) and chronic pain (n = 367) conditions at baseline. RESULTS: Of participants who reported they did not have chronic pain at baseline, the development of chronic pain 10 years later was significantly associated with baseline family strain (OR = 1.38, p < .01). For participants with acute pain at baseline, the transition of this pain to chronic a decade later was significantly associated with initial reports of pain interference (OR = 1.24, p < .001), family support (OR = 0.60, p < .05), and depression (OR = 1.20, p < .05). Persistent chronic pain was solely associated with baseline pain interference (OR = 1.21, p < .01). CONCLUSIONS: Family strain is an important part of the chronic stress profile associated with chronic pain etiology, whereas family support is associated with a reduced risk of acute pain transitioning to chronic pain over time. Prioritizing family relationships in treatment approaches to pain may be an indicated, innovative approach to preventing pain development and escalation and requires systems training in healthcare.
Authors: AliceAnn Crandall; Nomi S Weiss-Laxer; Eliza Broadbent; Erin Kramer Holmes; Brianna Michele Magnusson; Lauren Okano; Jerica M Berge; Michael D Barnes; Carl Lee Hanson; Blake L Jones; Len B Novilla Journal: Front Public Health Date: 2020-11-20