The relationship of demographic and psychosocial variables to pain-related outcomes in a rural chronic pain population.
Rural residency and low socioeconomic status (SES) are associated with increased likelihood of chronic pain. Other demographics are also differentially associated with the experience of pain. This study examines the relations between demographic and pain-related variables in a virtually unstudied population of rural Alabama chronic pain patients. One hundred and fifteen patients completed validated measures of pain catastrophizing, depression, pain intensity, pain interference, perceived disability, and life satisfaction. Average age of study participants was 52-years, 79% were female, 74% were African-American, 72% reported annual income between 00,000-12,999, and 61% were unemployed. Although average years of reported education was 12.26, reading level percentile (primary literacy indicant) was 17.33. Cross-sectional multivariate and univariate analyses were conducted to examine associations among demographic and psychosocial variables in relation to various pre-treatment pain-related variables. The mediating role of pain catastrophizing and depression was investigated. Results indicate that race was significantly associated with pain intensity and pain interference, such that African-Americans reported higher scores than White-Americans. Pain catastrophizing was uniquely associated with pain intensity, pain interference, and perceived disability; depression was uniquely associated with pain interference and life satisfaction. Pain catastrophizing mediated the relation between primary literacy and pain intensity; age effects were differentially mediated by either pain catastrophizing or depression. These analyses provide an insight into the specific demographic and psychosocial factors associated with chronic pain in a low-literacy, low-SES rural population.
Day
Melissa A
MA
The Department of Psychology, The University of Alabama, Tuscaloosa, AL, USA.
Thorn
Beverly E
BE
D000328:Adult; D000367:Age Factors; D000368:Aged; D000407:Alabama / Q000453:epidemiology; D058443:Catastrophization / Q000209:etiology; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003710:Demography; D003863:Depression / Q000453:epidemiology / Q000209:etiology; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010146:Pain / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology*; D059408:Pain Management; D010147:Pain Measurement / Q000379:methods; D058748:Pain Perception / Q000502:physiology; D011584:Psychology; D011788:Quality of Life; D012424:Rural Population; D013223:Statistics as Topic; D018709:Statistics, Nonparametric
Pain. 2004 Jul;110(1-2):103-11
15275757
J Pain. 2005 Apr;6(4):228-36
15820910
Spine (Phila Pa 1976). 1995 Dec 15;20(24):2721-30
8747251
Arch Intern Med. 1998 Jan 26;158(2):166-72
9448555
Am J Phys Med Rehabil. 1989 Feb;68(1):6-11
2917058
West J Med. 2000 Nov;173(5):348-51
11069878
J Pain. 2005 May;6(5):301-14
15890632
Behav Res Ther. 1994 Jan;32(1):9-16
8135727
J Gerontol A Biol Sci Med Sci. 2007 Sep;62(9):989-96
17895437
Arthritis Care Res. 1996 Dec;9(6):257-62
9136289
Behav Res Methods. 2008 Aug;40(3):879-91
18697684
Spine (Phila Pa 1976). 1991 Jun;16(6):605-7
1830688
Med Care Res Rev. 2000;57 Suppl 1:108-45
11092160
Arthritis Rheum. 2001 Feb;45(1):48-55
11308061
J Int Neuropsychol Soc. 2007 May;13(3):462-70
17445295
Pain. 2003 Aug;104(3):597-608
12927632
Pain Med. 2005 Jan-Feb;6(1):88-98
15669954
Spine (Phila Pa 1976). 1999 Aug 15;24(16):1693-9; discussion 1699-700
10472104
Psychosom Med. 2001 Mar-Apr;63(2):316-23
11292281
Pain Manag Nurs. 2001 Sep;2(3):98-109
11710091
J Clin Invest. 1944 Jan;23(1):81-91
16695086
J Pain. 2006 Jul;7(7):459-68
16814685
Pain. 1998 Sep;77(3):231-239
9808348
J Pain. 2004 Apr;5(3):171-82
15106130
South Med J. 1991 Oct;84(10):1172-5
1925713
Pain. 2002 Jul;98(1-2):127-34
12098624
J Psychosom Res. 1994 Nov;38(8):849-58
7722964
Pain. 1989 May;37(2):215-222
2748195
Spine (Phila Pa 1976). 2001 Jun 15;26(12):1364-9
11426153
Clin J Pain. 1993 Sep;9(3):174-82
8219517
Soc Sci Med. 2005 Jan;60(1):191-204
15482878
BMJ. 1996 Apr 20;312(7037):1004-7
8616345
J Gen Intern Med. 1995 Oct;10(10):577-86
8576775
Milbank Q. 1993;71(2):279-322
8510603
Pain. 1998 Feb;74(2-3):181-7
9520232
Pain. 1996 May-Jun;65(2-3):123-67
8826503
Int J Geriatr Psychiatry. 2000 Nov;15(11):1021-7
11113982
Pain Med. 2005 Jan-Feb;6(1):61-71
15669951
Pain. 1985 Dec;23(4):337-343
4088696
Pain. 2005 Apr;114(3):462-472
15777871
Am J Med Sci. 1994 Aug;308(2):79-82
8042658
J Pain. 2004 Aug;5(6):317-28
15336636
Psychol Bull. 2003 Jan;129(1):10-51
12555793
JAMA. 1999 Feb 10;281(6):552-7
10022112
J Pers Soc Psychol. 1986 Dec;51(6):1173-82
3806354
Clin J Pain. 1997 Mar;13(1):9-21
9084948
Pain. 1996 Dec;68(2-3):315-21
9121820
Pain. 2004 Oct;111(3):335-341
15363877
J Gerontol. 1990 Mar;45(2):P64-8
2313050
Am J Public Health. 1997 May;87(5):805-10
9184510
J Pain. 2004 May;5(4):195-211
15162342
Int Psychogeriatr. 2001 Mar;13(1):63-73
11352336
Psychol Med. 2000 Jan;30(1):11-22
10722172
Clin J Pain. 2001 Mar;17(1):52-64
11289089
J Rheumatol. 1999 Aug;26(8):1785-92
10451078
Pain. 2000 Sep;87(3):325-334
10963912
Am J Cardiol. 1999 Jan 1;83(1):106-8, A8
10073794
Pain. 1996 Nov;68(1):45-53
9251997
Pain. 1998 Jan;74(1):21-27
9514556
Psychol Med. 2005 Sep;35(9):1253-63
16168148
CA Cancer J Clin. 2002 May-Jun;52(3):134-49
12018928
Curr Opin Rheumatol. 2003 Mar;15(2):110-5
12598796
J Pain. 2002 Aug;3(4):284-91
14622752
Pain. 2001 Nov;94(2):133-137
11690726
Pain. 1995 Apr;61(1):93-101
7644253
J Nurs Meas. 1999 Winter;7(2):135-52
10710858
Pain. 2004 Oct;111(3):245-252
15363867
Pain. 1983 Oct;17(2):197-210
6646795
Clin J Pain. 2002 Sep-Oct;18(5):286-96
12218499
Pain Med. 2005 Jan-Feb;6(1):49-60
15669950
Vital Health Stat 10. 2009 Dec;(242):1-157
20821903
Soc Psychiatry Psychiatr Epidemiol. 2004 Jan;39(1):33-8
15022044
Clin J Pain. 2005 Nov-Dec;21(6):513-23
16215337
Aging Ment Health. 2007 Sep;11(5):556-69
17882594
Am J Public Health. 2002 Aug;92(8):1278-83
12144984
BMJ. 1996 Apr 20;312(7037):999-1003
8616393
Psychosom Med. 2000 May-Jun;62(3):309-17
10845344
Clin J Pain. 1997 Sep;13(3):207-14
9303252
Pain. 2004 Nov;112(1-2):188-96
15494200
Clin J Pain. 1993 Jun;9(2):104-14
8358133
Pain. 2002 Apr;96(3):319-324
11973004
J Behav Med. 1997 Dec;20(6):589-605
9429990
Soc Sci Med. 1994 Jan;38(1):1-14
8146699
Pain Res Manag. 2001 Fall;6(3):142-51
11854777
Ophthalmology. 1998 Mar;105(3):561-6
9499791
Int J Geriatr Psychiatry. 2001 May;16(5):477-83
11376463
J Community Health Nurs. 2002 Winter;19(4):213-24
12494742
J Pain. 2004 Jun;5(5):257-63
15219257