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- All Subjects: Chronic Pain
- Creators: Karoly, Paul
- Creators: Lemery-Chalfant, Kathryn
- Creators: Infurna, Frank
Description
The present study examined the association of pain intensity and goal progress in a community sample of 132 adults with chronic pain who participated in a 21 day diary study. Multilevel modeling was employed to investigate the effect of morning pain intensity on evening goal progress as mediated by pain's interference with afternoon goal pursuit. Moderation effects of pain acceptance and pain catastrophizing on the associations between pain and interference with both work and lifestyle goal pursuit were also tested. The results showed that the relationship between morning pain and pain's interference with work goal pursuit in the afternoon was significantly moderated by a pain acceptance. In addition, it was found that the mediated effect differed across levels of pain acceptance; that is: (1) there was a significant mediation effect when pain acceptance was at its mean and one standard deviation below the mean; but (2) there was no mediation effect when pain acceptance was one standard deviation above the mean. It appears that high pain acceptance significantly attenuates the power of nociception in disrupting one's work goal pursuit. However, in the lifestyle goal model, none of the moderators were significant nor was there a significant association between pain interference with goal pursuit and goal progress. Only morning pain intensity significantly predicted afternoon interference with lifestyle goal pursuit. Further interpretation of the present findings and potential explanations of those inconsistencies are elaborated on discussion. Limitations and the clinical implication of the current study were considered, along with suggestions for future studies.
ContributorsMun, Chung Jung (Author) / Karoly, Paul (Thesis advisor) / Okun, Morris A. (Committee member) / Enders, Craig K. (Committee member) / Arizona State University (Publisher)
Created2014
Description
Chronic pain is among the most prevalent health issues experienced by older adults and negatively impacts daily functioning and psychosocial well-being through mechanisms that include energy depletion, pain interference, and pain-related changes in negative affect. The capacities to be aware of and regulate negative emotions play a critical role in the successful management of chronic pain. One dimension of negative emotion awareness, termed negative emotion differentiation (NED), is the ability to discriminate between negative affective experiences and recognize them as discrete categories. The ability to identify and distinguish between the various emotions that accompany pain flares and other stressors may enhance the precision of the individual’s regulatory efforts. In doing so, NED may be one possible resilience resource that can facilitate adaptive functioning in the context of chronic pain by buffering the effects of chronic pain flares on daily interpersonal stress. However, this has not yet been investigated. The current study aimed to examine the moderating effect of trait NED on the relationship between daily pain and same-day stress in 259 patients diagnosed with osteoarthritis (OA) or fibromyalgia syndrome (FMS). Individuals completed daily diaries each evening for 30 days reporting on average daily pain, negative emotions, interpersonal stress, and depressive symptoms. It was hypothesized that higher levels of NED would buffer the effects of daily pain on same-day stress. In exploratory analyses, it was evaluated whether the buffering effects were larger for individuals with FMS versus OA. Results of multilevel models revealed that, as expected, higher levels of trait NED predicted lower levels of same-day negative interpersonal events and perceived interpersonal stress. Trait NED also moderated the relationship between pain-related increases in same-day perceived interpersonal stress. Additionally, findings indicated that NED was similarly important for those with FMS and OA. Taken together, the current findings suggest that NED is an important resilience trait that can attenuate chronic pain-related increases in daily experiences of interpersonal stress.
ContributorsOlah, Meryl (Author) / Davis, Mary C (Thesis advisor) / Lemery-Chalfant, Kathryn (Committee member) / Infurna, Frank (Committee member) / Arizona State University (Publisher)
Created2022
Description
Pediatric chronic pain is common and costly to children, their families, and society. Importantly, pediatric pain often persists into adulthood. Prior research suggests that parent chronic pain, particularly maternal pain, is a risk factor for the development of chronic pain in children. Existing evidence also suggests that parenting, including parental pain-related pain catastrophizing and general parenting style, are all associated with greater levels of chronic pain in children. The present study examined whether the prospective relations between parent and child pain differed between mothers and fathers, and whether parenting mediated or moderated the parent pain--child pain relations. It was hypothesized that 1a) both maternal and paternal chronic pain prospectively predicts child chronic pain, but that maternal pain would be a stronger predictor; 1b) having 0, 1, or 2 parents will increase the child’s risk of developing chronic pain; 2) maternal pain catastrophizing about their own (a) and their children’ pain (b) would mediate the relations between maternal and child pain; and 3) authoritarian parenting style (a) and negative parenting behaviors (b) would mediate the relationship between parent and child pain. Exploratory analyses tested the whether parental warmth predicted child pain, independent of mom pain. Regression models that account for twin dependency used longitudinal data collected from a sample of 895 twin children showed that maternal pain but not paternal pain predicted child pain. Maternal catastrophizing of her own pain, but not her child’s pain, significantly mediated the relation between maternal and child pain. However, maternal catastrophizing of her child’s pain predicted child pain at age 9, when controlling for child pain at age 8. All proposed relations between general parenting styles as well as warm parenting and child pain were not significant.
ContributorsLagergren, Abigail (Author) / Davis, Mary (Thesis director) / Lemery-Chalfant, Kathryn (Committee member) / Barrett, The Honors College (Contributor) / Department of Psychology (Contributor)
Created2021-12
Description
Pediatric chronic pain is pervasive and associated with myriad adverse consequences, yet due consideration has not been given to the mental health disturbances that often present alongside chronic pain and the etiological mechanisms that potentially underlie both. The current study examined the etiology underlying chronic pain and internalizing symptomology in middle childhood, considering both independent and co-occurring symptom presentations. Phenotypic parent-offspring associations across chronic pain and internalizing symptomology were also examined. Lastly, nuclear twin family models were tested to determine the extent to which genetic and environmental factors underlie parent-offspring transmission. The sample comprised 795 children (399 families; Mage= 9.7 years; SD = 0.92) and their parents drawn from the Arizona Twin Project. Results indicated that chronic pain was highly heritable (78%), whereas internalizing symptomology was modestly heritable (32%) and further subject to moderate shared environmental influence (50%). Moreover, 9% of the variance in chronic pain was explained by additive genetic factors shared with internalizing symptomology. Maternal chronic pain and internalizing symptomology were positively associated with both child chronic pain and internalizing symptomology. The association between maternal chronic pain and child chronic pain was more pronounced for girls than boys, whereas the association between maternal internalizing symptomology and child internalizing symptomology was more pronounced for boys than girls. Paternal chronic pain was not significantly associated with child chronic pain but was unexpectedly associated with lower child internalizing symptomology. The negative association between paternal chronic pain and child internalizing symptomology was more pronounced for boys than girls. Paternal internalizing symptomology was not significantly associated with child chronic pain but was positively associated with child internalizing symptomology. Lastly, the best fitting reduced nuclear twin family models for both chronic pain and internalizing symptomology retained additive genetic, sibling-specific shared environmental, and nonshared environmental parameters, where parent-offspring transmission was solely explained by shared genetics and sibling-specific shared environmental factors further accounted for co-twin resemblance. Results provide novel insight into common liabilities underlying chronic pain and internalizing symptomology in middle childhood, parent-offspring associations across chronic pain and internalizing symptomology, and the etiological mechanisms that explain symptom aggregation across generations.
ContributorsOro, Veronica (Author) / Lemery-Chalfant, Kathryn (Thesis advisor) / Chassin, Laurie (Committee member) / Davis, Mary (Committee member) / Su, Jinni (Committee member) / Arizona State University (Publisher)
Created2021
Description
Chronic pain is common during childhood and has negative immediate and long-term implications for physical and mental health. Prior research points to physical activity and sleep as protective health-promoting behaviors predicting lower chronic pain intensity and disability during adulthood. No study has yet examined the interaction of physical activity and sleep parameters in prediction of chronic pain in a community sample of children. Guided by the biopsychosocial model of pediatric chronic pain, this study explored objectively assessed physical activity and sleep patterns at age 8 as predictors of childhood chronic pain at age 9 in a racially/ethnically and socioeconomically diverse sample of 896 twins participating in the longitudinal Arizona Twin Project. It was hypothesized that parameters of physical activity levels and sleep health would independently predict chronic pain one year later, and that sleep parameters would moderate the association between physical activity and chronic pain. Monthly chronic pain was common, with 57.1% of participants reporting at least one pain location. Headaches, stomachaches, and backaches were the most frequent chronic pain presentations. Participants exceeded physical activity guidelines but did not meet sleep recommendations for their age group. Multilevel modeling analyses revealed that physical activity and sleep parameters at age 8 did not predict chronic pain one year later, and that sleep parameters did not moderate the associations between physical activity and chronic pain. The present study provides evidence that the associations between objectively assessed physical activity and sleep and chronic pain are not yet evident during middle childhood in this community sample compared to patient samples who have existing pain, suggesting that these health behaviors may play distinct roles in pain development versus pain management. They also point to the need to pinpoint the time frame during which these health behaviors become relevant and potentially interact to predict chronic pain development and maintenance. Longitudinal research tracking these health behaviors and pain using both subjective and objective methods as children transition into and through adolescence can help to identify optimal developmental stages at which to target prevention and intervention efforts to promote long term health.
ContributorsBartsch, Eva Marie (Author) / Davis, Mary C (Thesis advisor) / Doane, Leah D (Committee member) / Lemery-Chalfant, Kathryn (Committee member) / Arizona State University (Publisher)
Created2023
Description
Current models of pain coping typically focus on how pain contributes to poor physical and psychological functioning. Researchers have argued that this focus on the negative consequences is too narrow and does not account for times when individuals are able to maintain meaningful functioning despite their pain. Thus, the current study sought to investigate the day-to-day processes that both help and hinder recovery from pain and persistence towards daily goals. Specifically, the present study tested: a) a two-factor model of risk and resilience “factors” that capture key processes across affective, cognitive and social dimensions of functioning, and b) whether the relation between morning pain and end-of-day physical disability is mediated by increases in these afternoon risk and resilience factors. Within-day study measures were collected for 21 days via an automated phone system from 220 participants with Fibromyalgia. The results of multi-level confirmatory factor analysis indicated that, consistent with prediction, risk and resilience do constitute two factors. Findings from multilevel structural equation models also showed resilience factor mediated the link between late morning increases in pain and end-of-day disability, in line with hypotheses. Although the vulnerability factor as a whole did not mediate the within-day link between pain and disability, pain-catastrophizing individually did serve as a significant mediator of this relation. This study was the first to empirically test a within-day latent factor model of resilience and vulnerability and the first to capture the multidimensional nature of the pain experience by examining mechanisms across affective, cognitive and social domains of functioning. The findings of the current study suggest that in addition to studying the processes by which pain has a negative influence on the lives of pain sufferers, our understanding of the pain adaptation process can be further improved by concurrently examining mechanisms that motivate individuals to overcome the urge to avoid pain and to function meaningfully despite it.
ContributorsThummala, Kirti (Author) / Davis, Mary C. (Thesis advisor) / Doane, Leah (Committee member) / Karoly, Paul (Committee member) / Barrera, Manuel (Committee member) / Arizona State University (Publisher)
Created2018
Description
Experiencing poor, unrefreshing sleep is a common occurrence for individuals with chronic pain. Sleep disturbance predicts not only greater pain and disability, but also heightened negative affect and reduced positive affect in individuals with chronic pain. Such fluctuations in affect have been linked with more negative and fewer positive social events. For those with chronic pain, negative social relations can exacerbate pain, whereas positive social interactions can help decrease disability. Thus, exploring the sleep‒social functioning process in chronic pain may be one way to improve daily functioning and quality of life. The current study examined positive and negative affect as two parallel mediators of the within-day relations between sleep quality and positive and negative social events in individuals with chronic pain. For 21 days, electronic daily diary reports were collected from 220 individuals with fibromyalgia, a condition characterized by widespread chronic pain. Within-person relations among reports of last night’s sleep quality, afternoon affects and pain, and evening social events were estimated via multilevel structural equation modeling. Findings showed that positive affect mediated both the sleep quality‒positive social events and sleep quality‒negative social events relations. That is, greater than usual sleep disturbance last night predicted afternoon reports of lower than usual positive affect. Low positive affect, in turn, predicted evening reports of fewer than usual positive social events and more than usual negative social events that day, controlling for the effects of afternoon pain. In addition, negative affect mediated the sleep quality‒negative social events link. That is, greater than usual sleep disturbance last night predicted afternoon reports of higher than usual negative affect, which, in turn, predicted evening reports of more than usual negative social events that day, controlling for the effects of afternoon pain. Of the three significant mediated paths, the sleep quality‒positive affect‒positive social events path was the strongest in magnitude. Thus, a night of poor sleep can have an impact on social events the next day in those with chronic pain by dysregulating affect. Further, findings highlight the key role of positive affect in the sleep‒social functioning process and potential socio-affective benefits of sleep interventions in chronic pain.
ContributorsKothari, Dhwani J. (Author) / Davis, Mary (Thesis advisor) / Luecken, Linda (Committee member) / Karoly, Paul (Committee member) / Infurna, Frank (Committee member) / Arizona State University (Publisher)
Created2019
Description
There is a robust association between psychosis and cannabis use, but the mechanisms underlying this relation are poorly understood. Because both psychosis and cannabis use have been linked to cardiovascular problems, it is possible that cannabis use exacerbates an underlying vascular vulnerability in individuals prone to psychosis. To investigate microvascular differences in individuals with psychotic symptoms and cannabis use, the current study tested associations between psychotic-like experiences, cannabis use, and retinal vessel diameter in 101 young adults (mean age=19.37 years [SD=1.93]). Retinal venular diameter did not differ between participants with (M=218.08, SD=15.09) and without psychotic-like experiences (M=216.61, SD=16.18) (F(1, 97)=0.01, p=.93) or between cannabis users (M=218.41, SD=14.31) and non-users (M=216.95, SD=16.26) (F(1, 97)=0.37, p=.54). Likewise, mean retinal arteriolar diameter did not differ between participants with (M=157.07, SD=10.96) and without psychotic-like experiences (M=154.88, SD=9.03) (F(1, 97)=0.00, p=.97). However, cannabis users had statistically significantly wider retinal arterioles (M=159.10, SD=9.94) than did non-users (M=154.29, SD=10.20) (F(1, 97)=5.99, p=.016), and this effect was robust to control for covariates. There was no evidence of an interaction between psychotic-like experiences and cannabis use in predicting retinal vessel diameter. These results indicate that cannabis use is associated with microvascular differences in young adulthood. Given current trends toward legalization of recreational cannabis use, future research should explore these differences and their potential consequences for cardiovascular health.
ContributorsHill, Melanie (Author) / Meier, Madeline H (Thesis advisor) / Karoly, Paul (Committee member) / Brewer, Gene (Committee member) / Arizona State University (Publisher)
Created2016
Description
Despite the strong link between pain and depressive symptoms, the mechanisms by which they are connected in the everyday lives of individuals with chronic pain are not well understood. In addition, previous investigations have tended to ignore biopsychosocial individual difference factors, assuming that all individuals respond to pain-related experiences and affect in the same manner. The present study tried to address these gaps in the existing literature. Two hundred twenty individuals with Fibromyalgia completed daily diaries during the morning, afternoon, and evening for 21 days. Findings were generally consistent with the hypotheses. Multilevel structural equation modeling revealed that morning pain and positive and negative affect are uniquely associated with morning negative pain appraisal, which in turn, is positively related to pain’s activity interference in the afternoon. Pain’s activity interference was the strongest predictor of evening depressive symptoms. Latent profile analysis using biopsychosocial measures identified three theoretically and clinically important subgroups (i.e., Low Functioning, Normative, and High Functioning groups). Although the daily pain-depressive symptoms link was not significantly moderated by these subgroups, individuals in the High Functioning group reported the lowest levels of average morning pain, negative affect, negative pain appraisal, afternoon pain’s activity interference, and evening depressive symptoms, and the highest levels of average morning positive affect across 21 days relative to the other two groups. The Normative group fared better on all measures than did the Low Functioning group. The findings of the present study suggest the importance of promoting morning positive affect and decreasing negative affect in disconnecting the within-day pain-depressive symptoms link, as well as the potential value of tailoring chronic pain interventions to those individuals who are in the greatest need.
ContributorsMun, Chung Jung (Author) / Karoly, Paul (Thesis advisor) / Davis, Mary C. (Thesis advisor) / Suk, Hye Won (Committee member) / Dishion, Thomas J (Committee member) / Arizona State University (Publisher)
Created2017
Description
Interpersonal strain is linked with depressive symptoms in middle-aged adults. Self-compassion is an emerging resilience construct that may be advantageous in navigating relationship strain by helping individuals respond to emotions in a kind and nonjudgmental way. Although theory and empirical evidence suggests that self-compassion is protective against the impact of stress on mental health outcomes, many studies have not investigated how self-compassion operates in the context of relationship strain. In addition, few studies have examined psychological or physiological mechanisms by which self-compassion protects against mental health outcomes, depression in particular. Thus, this study examined 1) the extent to which trait self-compassion buffers the relation between family strain and depressive symptoms, and 2) whether these buffering effects are mediated by hope and inflammatory processes (IL-6) in a sample of 762 middle-aged, community-dwelling adults. Results from structural equation models indicated that family strain was unrelated to depressive symptoms and the relation was not moderated by self-compassion. Hope, but not IL-6, mediated the relation between family strain and depressive symptoms and the indirect effect was not conditional on levels of self-compassion. Taken together, the findings suggest that family strain may lead individuals to experience less hope and subsequent increases in depressive symptoms, and further, that a self-compassionate attitude does not affect this relation. Implications for future self-compassion interventions are discussed.
ContributorsMistretta, Erin (Author) / Davis, Mary C. (Thesis advisor) / Karoly, Paul (Committee member) / Infurna, Frank (Committee member) / Arizona State University (Publisher)
Created2019