Battle of the Appraisals: Pain-Related Injustice Versus Catastrophizing as Mediators in the Relationship Between Pain Intensity and 3-Month Outcomes in Adolescents with Chronic Pain

JOURNAL OF PAIN

卷:23

Article

Miller, Megan M.¹  Williams, Amy E.²  Scott, Eric L.³  Trost, Zina⁴  Hirsh, Adam T.¹ 

[1] Indiana Univ Purdue Univ, Dept Psychol, LD124,402 N Blackford St, Indianapolis, IN 46202 USA

[2] Indiana Univ Sch Med, Riley Hosp Children, Dept Psychiat, Indianapolis, IN 46202 USA

[3] Univ Michigan, CS Mott Childrens Hosp, Dept Pediat & Anesthesiol, Ann Arbor, MI 48109 USA

[4] Virginia Commonwealth Univ, Dept Phys Med & Rehabil, Richmond, VA USA

关键词: Injustice;    catastrophizing;    chronic pain;    quality of life;    functioning;    youth;    adolescents;   

DOI  :  10.1016/j.jpain.2021.07.006

来源: Elsevier

【 摘 要 】

Pain appraisals are closely tied to pain and functional outcomes. Pain-related injus-tice and pain catastrophizing appraisals have both been identified as important cognitive-emo-tional factors in the pain experience of youth. Although pain-related injustice and catastrophizing have been linked to worse pain outcomes - as primary predictors and interme-diary variables - little is known about whether they operate as independent or parallel media -tors of the relationship between pain and functioning in youth. We tested pain-related injustice and catastrophizing appraisals as candidate mediators of the relationship between baseline pain intensity and 3-month functional outcomes in adolescents. Youth with chronic pain (N = 89, 76% female, 89% White, average age = 15 years) completed measures assessing pain intensity, pain-related injustice, and catastrophizing at baseline, as well as measures assessing functional disability and overall quality of life 3 months later. Multiple mediation analyses indicated that injustice mediated the relationship between pain intensity and 3 month quality of life. Explor-atory analyses of specific quality of life domains indicated that injustice mediated the relation-ship between pain intensity and 3 month emotional functioning, whereas catastrophizing mediated the relationship between pain intensity and 3 month social functioning. The findings suggest these pain-related appraisals play different intermediary roles in the relationships among pain and future psychosocial outcomes. Perspective: Pain-related injustice and catastrophizing appraisals play different intermediary roles in the relationships among pain and future psychosocial outcomes in youth with chronic pain. Treat-ments targeting pain-related injustice appraisals in pediatric populations are needed to complement existing treatments for catastrophizing. (c) 2021 by United States Association for the Study of Pain, Inc.

【 授权许可】

Free