title: Examining the Relationship Between Pain Catastrophizing and Suicide Risk in Patients with Rheumatic Disease: the Mediating Role of Depression, Perceived Social Support, and Perceived Burdensomeness.
abstract: Little research has examined the role of pain catastrophizing (PC) in predicting suicide among patients with rheumatic disease or the mechanisms through which it works. This study examines whether depression, perceived social support (PSS), and perceived burdensomeness (PB) mediate the relationship between PC and suicide risk. It also examines the relative importance of sociodemographic, clinical, and psychological factors in predicting suicide risk.
  
  
  
  Three hundred sixty patients from a rheumatology clinic in Korea completed measures of pain catastrophizing, social support, depression, and perceived burdensomeness.
  
  
  
  In hierarchical multiple regression analysis, the PC magnification, PB, physical disability, and PSS were significantly related to suicide risk. Results of the serial multiple mediation analysis indicated that the total indirect effect of PC magnification on suicide risk was significant while the direct effect was not. Four specific indirect effects of PC magnification were found to be statistically significant. First of all, PC magnification was associated with suicide risk through PB and through depression and PB. PC magnification was also associated with suicide risk through depression and PSS. Lastly, PC magnification was associated with suicide risk through depression, PSS, and PB.
  
  
  
  The identified pathways through which PC affects suicide risk suggest the importance of depression, PSS, and PB. Evaluation and intervention targeted at physical disability and the psychological factors of PC magnification, depression, PSS, and PB may be integrated into the management of suicide risk in patients with rheumatic disease.
authors.affiliation: Department of Psychology, Pusan National University, Busan, South Korea.
authors.forename: Eun -Jung
authors.initials: E-
authors.lastname: Shim
authors.affiliation: Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, and College of Medicine, Medical Research Center, Seoul National University, Seoul, South Korea.|Division of Rheumatology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: Yeong Wook
authors.initials: YW
authors.lastname: Song
authors.affiliation: Department of Psychology, Pusan National University, Busan, South Korea.
authors.forename: Seung-Hee
authors.initials: SH
authors.lastname: Park
authors.affiliation: Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, South Korea.|Department of Psychiatry, Gyeonggi provincial Medical Center Uijeongbu Hospital, Uijeongbusi, South Korea.
authors.forename: Kwang-Min
authors.initials: KM
authors.lastname: Lee
authors.affiliation: Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, and College of Medicine, Medical Research Center, Seoul National University, Seoul, South Korea.|Division of Rheumatology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: Dong Jin
authors.initials: DJ
authors.lastname: Go
authors.affiliation: Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, South Korea. hahmbj@gmail.com.|Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. hahmbj@gmail.com.|Integrated Cancer Care Center, Seoul National University Cancer Hospital, Seoul, South Korea. hahmbj@gmail.com.
authors.forename: Bong-Jin
authors.initials: BJ
authors.lastname: Hahm
mesh_terms: D000328:Adult; D000368:Aged; D058443:Catastrophization / Q000523:psychology*; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D010465:Perception; D056910:Republic of Korea; D012216:Rheumatic Diseases / Q000523:psychology*; D012944:Social Support; D013405:Suicide / Q000523:psychology*
keywords: Depression; Pain catastrophizing; Perceived burdensomeness; Rheumatic disease; Social support; Suicide