Family strain, but not family support, is linked to worse pain interference among midlife adults reporting new chronic pain.

Abstract

Introduction: Although family relationship quality has been linked to later chronic pain incidence for aging adults, it is unclear whether the quality of these relationships is linked to the impact of pain. We estimated longitudinal associations between family relationship quality (i.e., family support and family strain) and pain interference for adults who develop novel chronic pain across 10 years of midlife. Method: We conducted a secondary analysis of data from the Midlife in the United States (MIDUS) study. Using path analysis, we tested whether family support and strain reported by participants (54% female, age M = 54.8 years) who denied having chronic pain at the study's second wave (MIDUS 2, 2004(MIDUS 2, -2006 but reported chronic pain 10 years later (MIDUS 3, 2014(MIDUS 3, -2016; N = 406) was associated with the interference of that pain with daily activities after accounting for key covariates, including sociodemographics, depression symptoms, global physical health, and MIDUS 3 reports of family support and strain. Results: The hypothesized model demonstrated good fit to the data based on multiple model fit indices. Greater family strain at baseline, but not family support, was significantly associated with greater pain interference 10 years later. Discussion: Findings build on prior studies to suggest that not only are stressful family relationships likely associated with the odds of developing chronic pain, but they are also linked to the interference of that chronic pain when it develops. We recommend biopsychosocial screening in primary care that captures family relationship quality and can inform best practices for nonpharmacological, family-based pain management. Public Significance StatementThough family relationship quality has been linked to later pain incidence for aging adults, it remains unclear whether family relationships are also linked to the impact of that pain once it develops, compromising our ability to develop effective nonpharmacological pain management interventions. This study leveraged data from an existing project on aging health to find that family strain, but not family support, was significantly associated with greater pain interference 10 years later, among aging adults who developed novel chronic pain during that time. The results imply the importance of biopsychosocial screening in primary care to capture family relationship quality and inform family-based pain self-management interventions to ameliorate aging adult pain.

Hidden family rules: perspective on a dysfunctional paternalistic system and the persistence of pain

“…Childhood adversity is associated with poorer health and the occurrence, severity, and impact of chronic pain in later life (3)(4)(5)(6)(7)(8)(9). Chronic pain negatively impacts family dynamics (10)(11)(12), and conversely, family strain negatively impacts pain experience (13)(14)(15)(16). Chronic pain in parents is associated with non-specific chronic pain in adolescents and young adults (3,(17)(18)(19)(20)(21).…”