Catastrophizing, pain, and social adjustment in scleroderma: Relationships with educational level
Catastrophizing, pain, and social adjustment in scleroderma: Relationships with educational level
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DOI：
10.1097/01.ajp.0000210918.26159.94
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发表时间：
2006-09-01
影响因子：
2.9
通讯作者：
Haythornthwaite, Jennifer
中科院分区：
文献类型：
--
作者：
Edwards, Robert R.;Goble, Layne;Haythornthwaite, Jennifer
目标：教育程度低与许多不良健康结果有关，一些证据表明心理社会变量可能会调节教育的影响。此外，心理社会功能和健康相关结果之间的关系可能会受到教育水平的调节，正规教育程度较低的个体更容易受到消极认知和情感状态的有害影响。本研究试图描述教育水平和与疼痛相关的灾难化之间的相互关系。方法：我们调查了自我报告的教育水平与疼痛和社交障碍之间的关系，我们评估了灾难化在这些关联中的潜在中介作用，我们还研究了教育作为灾难化对硬皮病患者样本中疼痛和社会残疾影响的调节因素，硬皮病是一种经常令人痛苦的疾病。 结果：首先，疼痛报告中与教育相关的差异是由灾难化和抑郁引起的。其次，在控制人口因素、疾病严重程度和抑郁症状后，教育调节了灾难化、疼痛影响和社会功能之间的关系。具体来说，在那些受过较少正规教育的人中，灾难化与更多地报告情感痛苦密切相关。此外，灾难化与受教育程度较低的个体的社会混乱呈负相关。 讨论：总的来说，研究结果支持教育与疼痛相关认知/情感功能之间相互作用的多种模型，尽管在中介和调节分析中，较低的正规教育水平是疼痛相关不良结果的风险因素。
Objectives: Low educational attainment is related to numerous adverse health outcomes, and some evidence suggests that psychosocial variables may mediate education's effects. Moreover, the relationship between psychosocial functioning and health-related outcomes may be moderated by educational level, with individuals lower in formal education being more susceptible to the deleterious effects of negative cognitive and affective states. The present study sought to characterize such interrelationships between educational level and pain-related catastrophizing.Methods: We investigated the association of self-reported educational level with pain and social disability, we evaluated catastrophizing's potential mediating role in those associations, and we also investigated education as a moderator of catastrophizing's effects on pain and social disability in a sample of patients with scleroderma, a frequently painful autoimmune disorder.Results: First, education-related differences in pain report were accounted for by catastrophizing and depression. Second, after controlling for demographic factors, disease severity, and depressive symptoms, education moderated the relationship between catastrophizing, pain affect, and social function. Specifically, catastrophizing was more highly associated with greater reporting of affective pain among those with less formal education. In addition, catastrophizing inversely correlated with social disruption among individuals with less formal education.Discussion: Collectively, study findings support multiple models of interaction between education and pain-related cognitive/ affective functioning, though in both mediational and moderational analyses, lower levels of formal education act as a risk factor for adverse pain-related outcomes.