Department of Family and Community Medicine, University of Texas Southwestern Medical Center, 5920 Forest Park Rd, Suite 651, Dallas, TX 75390, USA.
Department of Psychological and Quantitative Foundations, University of Iowa, N372 Lindquist Center, Iowa City, IA 52242, USA.
Soc Sci Med. 2019 Sep;237:112452. doi: 10.1016/j.socscimed.2019.112452. Epub 2019 Jul 30.
Chronic stress contributes to the pathogenesis of chronic pain. Yet, the role of close relationship stress in these pathways to pain is not fully understood.
To delineate specific psychosocial pathways associated with chronic pain, specifically emphasizing close relationships for midlife adults. We tested whether relationship strain, relationship support, social integration, depression, anxiety, and pain severity predict chronic pain etiology and persistence over 10 years, highlighting specific associations for acute versus chronic pain.
Using data from the National Survey of Midlife in the U.S. (MIDUS 2 and 3, collected in 2004-2006 and 2013-2014, respectively), we used logistic regression to test the etiology of new chronic pain (n = 1591) and persistence of pain for adults with acute (n = 352) and chronic pain (n = 367) conditions at baseline.
Of participants who reported they did not have chronic pain at baseline, the development of chronic pain 10 years later was significantly associated with baseline family strain (OR = 1.38, p < .01). For participants with acute pain at baseline, the transition of this pain to chronic a decade later was significantly associated with initial reports of pain interference (OR = 1.24, p < .001), family support (OR = 0.60, p < .05), and depression (OR = 1.20, p < .05). Persistent chronic pain was solely associated with baseline pain interference (OR = 1.21, p < .01).
Family strain is an important part of the chronic stress profile associated with chronic pain etiology, whereas family support is associated with a reduced risk of acute pain transitioning to chronic pain over time. Prioritizing family relationships in treatment approaches to pain may be an indicated, innovative approach to preventing pain development and escalation and requires systems training in healthcare.
慢性压力会导致慢性疼痛的发病。然而，亲密关系压力在这些通向疼痛的途径中的作用还没有被完全理解。
为了描绘与慢性疼痛相关的特定心理社会途径，特别是强调中年成年人的亲密关系。我们测试了关系紧张、关系支持、社会融合、抑郁、焦虑和疼痛严重程度是否可以预测 10 年内慢性疼痛的病因和持续性，并突出了急性疼痛与慢性疼痛的具体关联。
使用来自美国中年全国调查（MIDUS 2 和 3，分别于 2004-2006 年和 2013-2014 年收集）的数据，我们使用逻辑回归来测试新的慢性疼痛（n=1591）的病因和基线时患有急性（n=352）和慢性疼痛（n=367）的成年人的疼痛持续性。
在基线时报告没有慢性疼痛的参与者中，10 年后发展为慢性疼痛与基线时的家庭紧张（OR=1.38，p<0.01）显著相关。对于基线时患有急性疼痛的参与者，这种疼痛在十年后转变为慢性疼痛与最初的疼痛干扰报告（OR=1.24，p<0.001）、家庭支持（OR=0.60，p<0.05）和抑郁（OR=1.20，p<0.05）显著相关。持续的慢性疼痛仅与基线时的疼痛干扰（OR=1.21，p<0.01）相关。
家庭紧张是与慢性疼痛病因相关的慢性压力特征的重要组成部分，而家庭支持与急性疼痛随时间向慢性疼痛转变的风险降低相关。在疼痛治疗方法中优先考虑家庭关系可能是预防疼痛发展和升级的一种有针对性、创新的方法，这需要在医疗保健系统中进行系统培训。
