The Mediating Role of Pain Catastrophizing on the Association Between Depression and Pain Severity and Interference Among Elderly Asian Immigrants with Chronic Pain

Abstract

The association between depression and chronic pain is well established. However, few studies have examined the pathways from depression to chronic pain. The present cross-cultural study aimed to test the mediating effects of pain catastrophizing on associations between depression and chronic pain (eg, pain severity, pain intensity) among Korean American elderly. Patients and Methods: A total of 132 elderly Korean Americans with chronic pain were recruited from elderly daycare centers and Korean ethnic churches in the community. For mediation analyses, structural equation modeling with full information maximum likelihood estimation method was used. The bias-corrected bootstrap confidence interval (CI) method for inferential tests of the indirect effects was also conducted in mediation analysis. Results: The results indicated that the proportion of comorbid depression and chronic pain was 45.7%. Elderly Korean Americans with depression scored higher in pain severity, pain interference, and pain catastrophizing than those without depression. Pain catastrophizing was found to have a significant mediating effect on the relationship between depression and pain severity (indirect effect = 0.147, Bootstrap 95% CI = [0.079, 0.226]), controlling for demographic covariates, comorbidities and pain area. Pain catastrophizing also mediated the relationship between depression and pain interference (indirect effect =0.164, Bootstrap 95% CI = [0.097, 0.244]), controlling for the covariates. Conclusion: These findings add to the literature by providing evidence that pain catastrophizing plays a role in high levels of pain severity and pain interference comorbid chronic pain and depression in Asian elderly immigrants. Appropriate culturally tailored programs to redirect pain catastrophizing cognitive process should be developed and provided for elderly Asian Americans to reduce chronic pain disparity.

Psychosocial factors associated with pain and health‐related quality of life in Endometriosis: A systematic review

“…Fear-avoidance has been associated with pain in women with chronic pelvic pain and sexual pain (Gatchel et al, 2007;Thomtén et al, 2014). Previous studies have also found that catastrophising mediates the association between depression and pain (Kim et al, 2021;Wood et al, 2013). The mediating role of catastrophising may further explain the mixed findings earlier discussed regarding the association between depression and pain in Endometriosis.…”

The Mediating Role of Pain Catastrophizing: Understanding the Relationship Between Psychological Distress and Functional Disability in Mild Traumatic Brain Injury

“…Further correlation analyses were performed between demographic (i.e., gender, age), clinical characteristics (i.e., months elapsed from injury to assessment) and functional disability to assess suitability for inclusion as potential covariates in further analyses. Rationale for this process was derived from previous analogous research 24 Extending on this empirical rationale, three linear regressions were conducted to establish whether the demographic or clinical variables significantly predicted functional disability outcomes to further justify inclusion as covariates. Preliminary analyses were conducted to check the assumptions of normality, linearity, homoscedasticity, and multicollinearity.…”

“…Results did not support gender, b = -2.55, t(181) = -1.24, p = .216, 95% CI [-6.60, 1.50], β = -.09, R² < 0, age, b = .04, t(178) = 0.52, p = .604, 95% CI [-.10, .18], β = .04, R² < 0, or months to assessment, b = .12, t(169) = 1.22, p = .226, 95% CI [-.07, .31], β = .09, R² < 0, as significant predictors of functional disability outcomes. Based on the findings from both the regression and correlation analyses, and in line with previous research practices, 24 gender, age and months to assessment were not included in further analyses as confounding variables.…”

“…22 Further, the mediating role of pain catastrophizing has been demonstrated in the relationship between depression and pain severity among older adults with chronic pain. 24 Importantly however, the role of pain catastrophizing has received little attention in the context of mTBIs. Recognizing the large population affected by mTBI, and commonly experienced psychological distress by TBI sufferers, understanding the association among pain catastrophizing and psychological vulnerabilities represents a novel avenue of exploration.…”

Catastrophizing, Kinesiophobia, and Acceptance as Mediators of the Relationship Between Perceived Pain Severity, Self-Reported and Performance-Based Physical Function in Women with Fibromyalgia and Obesity

“…30,88 Also, it is important to note that most research did not include individuals with comorbid obesity and, importantly, did not account for the contribution of other significant additional mediators. 26,89,90 Finally, because psychosocial factors tend to be intercorrelated, predictive models in chronic pain should account for this shared variance between predictors to develop parsimonious models of pain and disability. 91 The fact that the present study included three important psychological predictors of disability might explain why not all of them contributed unique variance to physical performance.…”