Psychological Predictors of Perceived Age and Chronic Pain Impact in Individuals With and Without Knee Osteoarthritis
Psychological Predictors of Perceived Age and Chronic Pain Impact in Individuals With and Without Knee Osteoarthritis
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DOI：
10.1097/ajp.0000000000000842
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发表时间：
2020-08-01
影响因子：
2.9
通讯作者：
Bartley, Emily J.
中科院分区：
文献类型：
--
作者：
Booker, Staja Q.;Sibille, Kimberly T.;Bartley, Emily J.
目的：实际年龄是慢性疼痛的危险因素；然而，衰老研究支持这样一个前提：身体和心理健康可以更好地预测感知年龄。鉴于缺乏慢性疼痛背景下感知年龄的证据，当前的研究提出了关于患有或不患有膝骨关节炎的成年人的感知年龄、慢性疼痛影响和心理功能之间关系的新发现。方法：这项二次分析是一项正在进行的多中心观察队列研究的一部分，旨在了解膝盖疼痛和残疾的进展情况。 45 岁以上的社区居住成年人 (N=227) 完成了特质复原力、特质积极和消极影响、疼痛灾难化、年龄主观感知和分级慢性疼痛量表的测量。结果：平均而言，参与者感觉自己比实际年龄年轻 10 岁；然而，这种效应在报告高强度疼痛的个体中减弱。较低的感知年龄与较低的疼痛影响（低疼痛/低残疾）相关，而较高的感知年龄与较高的疼痛影响（高疼痛/高残疾）和更不利的心理影响相关。使用分层线性回归，高影响力的疼痛和积极情绪成为感知年龄的统计显着预测因素，而特质恢复力、消极情绪或疼痛灾难化之间没有观察到差异。讨论：这些发现强调了生物心理社会方法在理解与慢性疼痛相关的心理和身体因素之间的交叉方面的重要性。通过心理治疗解决对衰老的负面自我认知，同时增强积极影响，可以减轻疼痛和残疾。
Objective: Chronological age is a risk factor in chronic pain; however, aging research supports the premise that physical and psychological health may better predict perceived age. Given the lack of evidence on perceived age in the context of chronic pain, the current study presents novel findings about the relationship between perceived age, chronic pain impact, and psychological function in adults with and without knee osteoarthritis. Methods: This secondary analysis was part of an ongoing multisite observational cohort study to understand the progression of knee pain and disability. Community-dwelling adults (N=227) ages 45+ completed measures of trait resilience, trait positive and negative affect, pain catastrophizing, subjective perceptions of age, and the Graded Chronic Pain Scale. Results: On average, participants reported feeling 10 years younger than their chronological age; however, this effect was attenuated in individuals reporting high-impact pain. Lower perceived age was associated with lower pain impact (low pain/low disability), while higher perceived age correlated with higher pain impact (high pain/high disability) and more adverse psychological effects. Using hierarchical linear regression, high-impact pain and positive affect emerged as statistically significant predictors of perceived age, whereas no differences were observed among trait resilience, negative affect, or pain catastrophizing. Discussion: These findings highlight the importance of a biopsychosocial approach in understanding the intersection between psychological and physical factors associated with chronic pain. Addressing negative self-perceptions of aging, while simultaneously augmenting positive affect, through psychological therapies may mitigate pain and disability.