Pain Appraisals in Patients with Physical Injury: Assessing the Role of Distress Tolerance in the Relationship between Depression and Pain Catastrophizing

Valerie J. Hruschak; Yan Yuan; Whitney RingwaldCorinne BeaugardMelissa RepineMaria Pacella-LaBarbaraDaniel RosenGerald Cochran

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Pain Appraisals in Patients with Physical Injury: Assessing the Role of Distress Tolerance in the Relationship between Depression and Pain Catastrophizing

机译：Pain Appraisals in Patients with Physical Injury: Assessing the Role of Distress Tolerance in the Relationship between Depression and Pain Catastrophizing

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Pain is a complex construct contributing to significant impairment, particularly among physically injured patients seeking treatment in trauma and orthopedic surgery settings in which social workers are an integral component of care. The biopsychosocial theory, fear-avoidance, and cognitive mediation models of pain suggest that psychological factors (for example, depression) affect one’s ability to tolerate distress, leading to negative pain appraisals, such as catastrophizing. This study examined whether distress tolerance serves as a mechanism by which depression is associated with pain catastrophizing. We administered a health survey to outpatient trauma and orthopedic surgery clinic patients who were using opioid medications; 84 patients were included in the final analysis; 39.3 percent screened positive for depression. A multilevel mediation model using structural equation modeling revealed a significant direct effect from depression to pain catastrophizing (β = .31, z = 3.96, p < .001) and a significant indirect effect by distress tolerance (△β = .27, z = 3.84, p < .001). These results, which suggest that distress tolerance partially mediated the path from depression to pain catastrophizing, can inform social workers and other members of the multidisciplinary team about both the critical role of psychosocial factors after injury and interventions to improve postinjury recovery.

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来源
《Health and social work》 |2021年第3期|187-198|共12页
作者
Valerie J. Hruschak; Yan Yuan; Whitney RingwaldCorinne BeaugardMelissa RepineMaria Pacella-LaBarbaraDaniel RosenGerald Cochran;
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作者单位

Brigham and Women’s Hospital, Harvard Medical, Anesthesiology, Perioperative, and Pain Medicine, 75 Francis Street, Boston, MA;

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原文格式 PDF
正文语种英语
中图分类保健组织与事业（卫生事业管理）;
关键词
depression; distress tolerance; injury; opioids; pain management;

Pain Appraisals in Patients with Physical Injury: Assessing the Role of Distress Tolerance in the Relationship between Depression and Pain Catastrophizing

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