Department of Sociology, University of Calgary, Calgary, AB Canada T2N 1N4.
J Gerontol B Psychol Sci Soc Sci. 2011 Sep;66(5):595-604. doi: 10.1093/geronb/gbr070. Epub 2011 Aug 1.
This study examines how mastery mediates and moderates the relationship between pain and depression among older adults, as well as the extent to which these processes differ by the timing of pain in late life, while utilizing statistical methods that comprehensively control for time-stable confounds.
Data are derived from multiple observations of adults aged 65 years and older in the Washington, DC, metropolitan area over a 4-year period. Fixed effects models are used to control for time-stable influences.
With all time-stable influences controlled, pain is positively related to symptoms of depression, although this relationship is substantially reduced in comparison with a model in which all time-stable confounds are not held constant. Mastery does not mediate this relationship because pain is not significantly related to mastery once time-stable factors are taken into account. Mastery buffers the relationship between pain and depression, but only for elders later in late life.
This study suggests that a synthesis of stress process and life course perspectives is critical for understanding how pain influences depression in late life. However, research that does not comprehensively control for time-stable factors may overestimate the consequences of pain for older adults.
本研究通过综合控制时间稳定的混杂因素，检验掌握感在老年人疼痛与抑郁之间的关系中起到的中介作用和调节作用，以及这些过程在生命后期疼痛出现时间上的差异。
数据来自于华盛顿特区大都市区 65 岁及以上成年人的多次观察，在 4 年的时间内进行。固定效应模型用于控制时间稳定的影响。
在控制所有时间稳定影响的情况下，疼痛与抑郁症状呈正相关，尽管与不固定所有时间稳定混杂因素的模型相比，这种关系有明显减弱。掌握感并不能调解这种关系，因为一旦考虑到时间稳定因素，疼痛与掌握感之间就没有显著关联。掌握感缓冲了疼痛与抑郁之间的关系，但仅适用于生命后期较晚的老年人。
本研究表明，压力过程和生命历程观点的综合对于理解疼痛如何影响老年人的抑郁至关重要。然而，如果研究没有综合控制时间稳定的因素，可能会高估疼痛对老年人的影响。
