title: Happiness, Pain Intensity, Pain Interference, and Distress in Individuals with Physical Disabilities.
abstract: OBJECTIVE
  The aim of this study was to examine how the construct of happiness is related to pain intensity, pain interference, and distress in individuals with physical disabilities.
  
  
  METHODS
  This study involves cross-sectional analyses of 471 individuals with a variety of health conditions reporting at least mild pain.
  
  
  RESULTS
  The first hypothesis that happiness mediates the relationship between pain intensity and two outcomes, pain interference and distress, was not supported. The second hypothesis was supported by a good fitting model (χ2(10) = 12.83, P = 0.23, root-mean-square error of approximation = 0.025) and indicated that pain intensity significantly mediated the effect of happiness on pain interference (indirect effect: β = -0.13, P < 0.001) and on distress (indirect effect: β = 0.10, P = 0.01). Happiness showed a significant direct effect on pain intensity (β = -0.20, P < 0.001). A third model exploring the happiness components meaning, pleasure, and engagement fitted well (χ2(4) = 9.65, P = 0.05, root-mean-square error of approximation = 0.055). Pain intensity acted as a significant mediator but only mediated the effect of meaning on pain interference (indirect effect: β = -0.07, P = 0.05) and on distress (indirect effect via pain interference: β = -0.04, P = 0.05). Only meaning (β = -0.10, P = 0.05), but neither pleasure nor engagement, had a significant direct effect on pain intensity.
  
  
  CONCLUSIONS
  Participants who reported greater happiness reported lower pain interference and distress through happiness' effects on pain intensity. Experiencing meaning and purpose in life seems to be most closely (and negatively) associated with pain intensity, pain interference, and distress. Findings from this study can lay the groundwork for intervention studies to better understand how to more effectively decrease pain intensity, pain interference, and distress.
authors: From the Department of Rehabilitation Medicine, University of Washington, Seattle (RM, ALT, MPJ, IRM); Swiss Paraplegic Research, Nottwil, Switzerland (RM); and Rural Institute on Disabilities, University of Montana, Missoula (CR, CI).
authors: Rachel
authors: R
authors: Müller
authors: Alexandra L
authors: AL
authors: Terrill
authors: Mark P
authors: MP
authors: Jensen
authors: Ivan R
authors: IR
authors: Molton
authors: Craig
authors: C
authors: Ravesloot
authors: Catherine
authors: C
authors: Ipsen
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D006240:Happiness; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D010146:Pain / Q000523:psychology*; D058748:Pain Perception; D013315:Stress, Psychological / Q000523:psychology*