title: Psychosocial mechanisms of the pain and quality of life relationship for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).
abstract: BACKGROUND
  Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a prevalent, chronic pelvic pain condition largely unresponsive to medical interventions. Psychosocial risk factors are associated with poor outcomes in CP/CPPS, but have not been examined for their intervening roles between pain and reduced quality of life (QoL). This study aimed to determine if psychosocial risk factors (i.e., patient coping and catastrophizing) mediate the association between pain and QoL.
  
  
  METHODS
  Using a cross sectional design, 175 men with CP/CPPS (mean age 46.83; SD 10.86) were recruited from tertiary care urology clinics and completed questionnaires on demographics, pain, QoL, pain coping, depression, and catastrophizing. An exploratory factor analysis was conducted and aggregate factor scores were examined to improve the amount of meaningful measurement to be used in multiple mediations. The models specified multiple risk factors as mechanisms between pain and both physical and mental QoL as the primary outcome measurements.
  
  
  RESULTS
  Four aggregate psychosocial factor scores were produced from the psychosocial measures (i.e., illness and wellness-focused behavioural coping, depression and catastrophizing). Illness-focused coping partially mediated the relationship between pain and physical QoL. However, catastrophizing and illness-focused coping fully mediated the relation between pain and mental QoL, showing the association between pain and mental QoL was no longer significant when catastrophizing and illness-focused coping were in the model.
  
  
  CONCLUSIONS
  Psychosocial factors function as mechanisms between higher pain and they are associated diminished mental QoL. These results introduce illness-focused coping as an important biopsychosocial target in CP/CPPS management.
authors.affiliation: Psychology, Queen's University, Kingston, ON;
authors.forename: Adrijana
authors.initials: A
authors.lastname: Krsmanovic
authors.affiliation: Psychology, Anesthesiology and Urology, Queen's University, Kingston, ON;
authors.forename: Dean A
authors.initials: DA
authors.lastname: Tripp
authors.affiliation: Urology, Queen's University, Kingston, ON;
authors.forename: J Curtis
authors.initials: JC
authors.lastname: Nickel
authors.affiliation: Urology, Glickman Urological and Kidney Institute, Cleveland, Ohio;
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Shoskes
authors.affiliation: Urology, Temple University, Philadelphia, PA;
authors.forename: Michel
authors.initials: M
authors.lastname: Pontari
authors.affiliation: Urology, David Geffen School of Medicine at UCLA, Los Angeles, California and Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, California;
authors.forename: Mark S
authors.initials: MS
authors.lastname: Litwin
authors.affiliation: Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Mary F
authors.initials: MF
authors.lastname: McNaughton-Collins