title: Examining the role of positive and negative affect in recovery from spine surgery.
abstract: Consistent evidence supports a significant association between lower positive affect and higher negative affect and increased pain and disability in adults with chronic pain. However, examining this relation in surgical populations has received little empirical consideration. The primary purpose of this study was to determine whether preoperative and postoperative positive and negative affect predict pain, disability, and functional status after spine surgery. A secondary objective was to assess the relation of depression to postoperative outcomes compared with positive and negative affect. Participants were 141 patients treated by spine surgery for lumbar or cervical degeneration. Data collection occurred at baseline and 6 weeks and 3 months postoperatively. Affect was measured with the Positive and Negative Affect Schedule. Multivariable mixed-model linear regression analyses found that preoperative variables were not predictive of postoperative pain, disability and functional status. However, multivariable postoperative analysis found that 6-week positive affect predicted functional status, and 6-week negative affect predicted pain interference and pain-related disability at 3 months following surgery. Postoperative depression demonstrated statistically significant and stronger associations with pain intensity, pain interference, and pain-related disability at 3-month follow-up, as compared with negative affect. Results suggest that positive affect and depression are important variables to target when seeking to improve postoperative outcomes in a spine surgery population. Recommendations include postoperative screening for positive affect and depression, and treating depression as well as focusing on rehabilitation strategies to bolster positive affect so as to improve functional outcomes after spine surgery.
authors: Department of Psychology, Washington DC Veterans Affairs Medical Center, Washington, DC, USA Department of Psychology, Loyola University Maryland, Baltimore, Maryland, USA Department of Physical Medicine and Rehabilitation, Johns Hopkins Medicine, Baltimore, Maryland, USA Department of Biostatistics, Vanderbilt University, School of Medicine, Nashville, Tennessee, USA Department of Orthopaedic Surgery, Johns Hopkins Medicine, Baltimore, Maryland, USA Department of Orthopaedic Surgery and Rehabilitation, Vanderbilt University, School of Medicine, Nashville, Tennessee, USA.
authors: Caryn L
authors: CL
authors: Seebach
authors: Matthew
authors: M
authors: Kirkhart
authors: Jeffrey M
authors: JM
authors: Lating
authors: Stephen T
authors: ST
authors: Wegener
authors: Yanna
authors: Y
authors: Song
authors: Lee H
authors: LH
authors: Riley
authors: Kristin R
authors: KR
authors: Archer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000503:physiopathology / Q000601:surgery; D003863:Depression / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000503:physiopathology / Q000523:psychology* / Q000534:rehabilitation; D011183:Postoperative Complications / Q000175:diagnosis* / Q000523:psychology*; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D020127:Recovery of Function; D012189:Retrospective Studies; D013122:Spinal Diseases / Q000523:psychology* / Q000601:surgery; D011795:Surveys and Questionnaires