Pain and Well-being in Older Women: The Roles of Activity and Motivation

描述（由申请人提供）：慢性疼痛在老年人中的患病率很高，患病率随着年龄的增长而增加。尽管疼痛对快乐幸福感（hedonic well-being， HWB）的不利影响已被充分记录，但很少有证据表明疼痛对幸福感（eudaemonic well-being， EWB）如自主性和社会满意度有直接影响。有证据表明，一些身体疼痛程度高的老年人仍然保持高EWB，而其他身体疼痛程度低的老年人EWB则较低。目前的研究测试了一个模型，在这个模型中，老年妇女的目标导向和身体活动的质量决定了疼痛是否以及如何影响EWB。当活动的外部动机是内疚或控制时，疼痛会抑制活动，活动会对EWB产生不利影响；当活动是由兴趣或自我定义自主驱动时，疼痛不会抑制活动，而活动会增强EWB。此外，如果给予活动更多的时间，这些影响将会更强。第二个目标是测试活动和EWB对生物标志物的影响，包括通过白细胞介素-6及其可溶性受体测量的日皮质醇和炎症。第三个目标是测试这些关系，控制个性、基因型、适应性和疼痛敏感性的个体差异。老年妇女（N = 300，年龄50-75岁），疼痛程度不同，将从现有的登记处招募，以3个月为间隔，分9波完成7天的日记期，以测试日、波和个人水平的关系。日常测量将包括目标导向和身体活动（包括活动的动机和时间），皮质醇斜率，主观健康，pai，疼痛干扰，HWB和心理需求满意度作为一天水平EWB的测量。波级测量将包括心理健康量表，HWB，白细胞介素-6和白细胞介素-6受体。个人水平的测量将包括乐观、COMT多态性、最大摄氧量和感觉测试。多层次建模将测试人与人之间和人与人之间的关系和滞后效应。联合pi将疼痛、目标、幸福感和生理学方面的专业知识带到这些目标中，并成功地完成了老年人和疼痛患者的纵向研究，包括日记研究。这项研究将促进对一种常见的、与年龄相关的经历——身体疼痛——如何影响EWB和身体健康的理解。

DESCRIPTION (provided by applicant): The prevalence of chronic pain in older adults is high, and prevalence increases with increasing age. Although adverse effects of pain on hedonic well-being (HWB) are well documented, there is less evidence that pain has a direct effect on aspects of eudaemonic well-being (EWB) such as autonomy and social satisfaction. Evidence suggests that some older adults with high physical pain nonetheless maintain high EWB, whereas others with low physical pain have low EWB. The present study tests a model in which qualities of the goal-directed and physical activities of older women determine whether and how pain affects EWB. When activity is externally motivated by guilt or control, pain will inhibit activity and activity will adversely affect EWB; when activity is autonomously motivated by interest or self-definition, pain will not inhibit activity and activity will enhance EWB. Furthermore, when activities are accorded more time, these effects will be stronger. A second aim tests effects of activity and EWB on biomarkers, including diurnal cortisol and inflammation as measured by interleukin-6 and its soluble receptor. A third aim will test these relationships controlling for individual differences in personality, genotype, fitness, and pain sensitivity. Oldr women (N = 300, aged 50-75) with varying levels of pain will be recruited from an existing registry to complete 7-day diary periods at 3-month intervals over 9 waves to test day-, wave-, and person-level relationships. Daily measures will include goal-directed and physical activities (including motivation for and time spent in the activities), cortisol slope, subjective health, pai, pain interference, HWB, and psychological need satisfaction as a measure of day-level EWB. Wave-level measures will include the Scales of Psychological Well-Being, HWB, interleukin-6, and interleukin-6 receptor. Person-level measures will include optimism, COMT polymorphism, VO2max, and sensory testing. Multi-level modeling will test for between-person and within-person relationships and lagged effects. The co-PIs bring expertise in pain, goals, well-being, and physiology to these aims and have successfully completed longitudinal studies of older adults and pain patients, including a diary study. The study will advance understanding of how a common, age-relevant experience - physical pain - affects EWB and physical health.