Pain-Specific Resilience in People Living With HIV and Chronic Pain: Beneficial Associations With Coping Strategies and Catastrophizing

Abstract

ObjectiveChronic pain is increasingly recognized as a common and disabling problem for people living with HIV (PLWH). In a recent systematic review of psychosocial factors associated with chronic pain in PLWH, it was reported that very few studies to date have examined protective psychological factors that might help mitigate chronic pain for PLWH. The current study examined pain-specific resilience in relation to clinical and experimental pain, as well as pain coping in PLWH and chronic pain. Pain-specific resilience specifically refers to the ability to maintain relatively stable, healthy levels of psychological and physical functioning in the face of ongoing and persistent pain.MethodsA total of 85 PLWH (mean CD4 = 643; 13% detectable viral load ≥200; 99% on antiretroviral therapy) who met criteria for chronic pain (>3 consecutive month’s duration) were enrolled. Medical records were reviewed to confirm clinical data. All participants provided sociodemographic information prior to completing the following validated measures: Pain Resilience Scale (PRS), Coping Strategies Questionnaire-Revised (CSQ-R), Center for Epidemiologic Studies – Depression Scale (CES-D), and the Brief Pain Inventory – Short Form (BPI-SF). They then completed a quantitative sensory testing battery designed to assess tolerance for painful heat and cold stimuli.ResultsIn adjusted multiple regression models controlling for covariates, greater pain-specific resilience was significantly associated with less pain interference (p = 0.022) on the BPI-SF, less pain catastrophizing (p = 0.002), greater use of distraction (p = 0.027) and coping self-statements (p = 0.039) on the CSQ-R, as well as significantly greater heat pain tolerance (p = 0.009). Finally, results of a parallel multiple mediation model demonstrated that the effect of pain-specific resilience on heat pain tolerance was indirectly transmitted through less pain catastrophizing (95% confidence interval:0.0042 to 0.0354), but not use of distraction (95% confidence interval: −0.0140 to 0.0137) or coping self-statements (95% confidence interval: −0.0075 to 0.0255).ConclusionThe findings suggest that pain-specific resilience may promote adaptation and positive coping in PLWH and chronic pain.

Brain system segregation and pain catastrophizing in chronic pain progression

“…This is consistent with previous studies focused on cognitive-affective processes of pain ( Gentili et al, 2019 ; Gonzalez et al, 2019 ; You et al, 2021 ). You et al (2021) demonstrated the existence of pain-specific resilience, referring to the ability to maintain relatively stable and healthy levels of psychological functioning in face of ongoing and persistent pain ( You et al, 2021 ).…”

Intersectional HIV and Chronic Pain Stigma: Implications for Mood, Sleep, and Pain Severity

“…A portion of the data generated from CHIPS has previously been published by our group. 26,27 While some of the data (eg, mood, sleep) published by Cody and colleagues does overlap with the data presented here, this study is unique in that the primary focus is on HIV and chronic pain stigma. The participants and measures described below are limited to those involved in the current study.…”

Determination of Health Anxiety and Resilience Levels in Patients with Fibromyalgia Syndrome and Rheumatoid Arthritis During SARS-CoV-2 Pandemic: A Case–Control Study

“… 29 , 30 Another study reported that high pain-specific resilience was associated with lower pain barrier and pain destruction, better distraction, higher pain coping, and pain tolerance. 31 In a study conducted with healthy adults, resilience reduced the effect of pain. 32 Therefore, there is a relationship between resilience and pain intensity, and resilience is an important factor in coping with pain intensity.…”