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A Network Analysis of the Links Between Chronic Pain Symptoms and Affective Disorder Symptoms

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Abstract

Background

A range of psychological constructs, including perceived pain, self-efficacy, and pain avoidance, have been proposed to account for the comorbidity of chronic pain and affective disorder symptoms. Despite the likely inter-relation among these constructs, few studies have explored these predictors simultaneously. As such, the relative contributions of these psychological influences remain an open question.

Purpose

The present study uses a novel, network model approach to help to identify the key psychological contributors to the pain-affective disorder link.

Method

A cross-sectional design was implemented. The sample comprised 169 individuals with chronic pain (Mage 49.82; range 22–80 years; 58% female) admitted to a metropolitan chronic pain clinic in Victoria, Australia. Participants completed self-report measures of anxiety, depressive, and pain symptoms, pain self-efficacy, fear avoidance beliefs, perceived control, and pain-related disability.

Results

Network analysis identified self-efficacy, fear avoidance, and perceived disability as key constructs in the relationship between pain and affective disorder symptoms, albeit in different ways. While self-efficacy appeared to have direct links to other constructs in the network model, fear avoidance and perceived disability seemed to function more as mediators, linking other constructs in the model. Perceived control and anxiety were found to be less influential in the model.

Conclusions

Present findings identify self-efficacy, fear avoidance, and perceived disability as plausible candidate variables to target to disrupt the link between pain experience and affective disorder symptoms. However, further testing with longitudinal designs is needed to confirm this.

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Authors and Affiliations

  1. Geelong, School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, Victoria, 3220, Australia

    Emma L. Thompson, Jaclyn Broadbent, Matthew Fuller-Tyszkiewicz, Melanie D. Bertino & Petra K. Staiger

  2. The Victorian Rehabilitation Centre, Glen Waverley, Victoria, Australia

    Melanie D. Bertino

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  1. Emma L. Thompson
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  2. Jaclyn Broadbent
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  3. Matthew Fuller-Tyszkiewicz
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Correspondence to Jaclyn Broadbent.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Thompson, E.L., Broadbent, J., Fuller-Tyszkiewicz, M. et al. A Network Analysis of the Links Between Chronic Pain Symptoms and Affective Disorder Symptoms. Int.J. Behav. Med. 26, 59–68 (2019). https://doi.org/10.1007/s12529-018-9754-8

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