Social and Behavioral Science Department, Yale School of Public Health, USA; Psychology Department, Yale University, USA.
Social and Behavioral Science Department, Yale School of Public Health, USA; U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, USA; Department of Psychiatry, Yale School of Medicine, USA.
Soc Sci Med. 2023 Apr;323:115772. doi: 10.1016/j.socscimed.2023.115772. Epub 2023 Mar 10.
In view of the severity and prevalence of chronic pain, combined with the limited success of long-term treatments, there is the need for a more expansive understanding of its etiology. We therefore investigated over time three societal-based potential determinants of chronic pain that were previously unexamined in this connection: negative age stereotypes, age attribution, and age discrimination.
The cohort consisted of 1373 Americans aged 55 and older, who participated in four waves of the National Health and Resilience in Veterans Study, spanning seven years.
Consistent with the hypotheses, negative age stereotypes as well as age discrimination predicted chronic pain, and age attribution acted as a mediator between the negative age stereotypes and chronic pain. In a subset of participants who were free of chronic pain at baseline, those who had assimilated negative age stereotypes were 32% more likely to develop chronic pain in the next seven years than those who had assimilated positive age stereotypes.
Our finding that the three societal-based and modifiable predictors contributed to chronic pain refutes the widely held belief that chronic pain experienced in later life is entirely and inevitably a consequence of aging.
鉴于慢性疼痛的严重性和普遍性,以及长期治疗的效果有限,我们需要更广泛地了解其病因。因此,我们研究了三个以前在这方面未被研究过的基于社会的慢性疼痛潜在决定因素:负面的年龄刻板印象、年龄归因和年龄歧视。
该队列由 1373 名年龄在 55 岁及以上的美国人组成,他们参加了退伍军人健康与适应力研究的四个波次,历时七年。
与假设一致,负面的年龄刻板印象以及年龄歧视预测了慢性疼痛,而年龄归因则充当了负面年龄刻板印象和慢性疼痛之间的中介。在基线时没有慢性疼痛的参与者亚组中,那些同化了负面年龄刻板印象的人在接下来的七年中患上慢性疼痛的可能性比那些同化了正面年龄刻板印象的人高 32%。
我们发现这三个基于社会且可改变的预测因素导致了慢性疼痛,这驳斥了一种广泛持有的观点,即晚年经历的慢性疼痛完全且不可避免地是衰老的结果。