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

描述(申请人提供)：老年人慢性疼痛的患病率很高，并且患病率随着年龄的增长而增加。虽然疼痛对享乐幸福感(HWB)的不利影响已经被很好地记录下来，但很少有证据表明疼痛对幸福感(EWB)的各个方面有直接影响，如自主性和社会满足感。有证据表明，一些身体疼痛较高的老年人仍然保持高EWB，而其他身体疼痛较低的老年人EWB较低。本研究测试了一个模型，在该模型中，老年女性的目标导向和体力活动的质量决定了疼痛是否以及如何影响EWB。当活动受到内疚或控制的外部激励时，疼痛会抑制活动，而活动会对EWB产生负面影响；当活动是出于兴趣或自我定义的自主动机时，疼痛不会抑制活动，而活动会提高EWB。此外，当给予活动更多的时间时，这些影响将会更强。第二个目的是测试活动和EWB对生物标记物的影响，包括通过白细胞介素6及其可溶性受体测量的昼夜皮质醇和炎症。第三个目标将测试这些关系，以控制个性、基因、健康和疼痛敏感度的个体差异。有不同程度疼痛的Oldr妇女(N=300，年龄50-75岁)将从现有的登记中招募，每隔3个月在9个波中完成7天的日记，以测试日、波和人之间的关系。日常测量将包括目标导向和体力活动(包括活动的动机和花费的时间)、皮质醇斜率、主观健康、PAI、疼痛干扰、HWB和心理需求满意度，作为衡量日水平EWB的指标。波级测量将包括心理健康量表、HWB、白介素6和白介素6受体。个人层面的测量将包括乐观、COMT多态、最大摄氧量和感觉测试。多层次建模将测试人与人之间、人与人之间的关系以及滞后效应。联合PIs为这些目标带来了疼痛、目标、福祉和生理学方面的专业知识，并成功地完成了对老年人和疼痛患者的纵向研究，包括一项日记研究。这项研究将促进人们对一种常见的、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.