Dataset Information

Allostatic load and chronic pain: a prospective finding from the national survey of midlife development in the United States, 2004-2014.

ABSTRACT:

Background

Previous research has demonstrated a correlation between chronic stress and chronic pain (CP). However, there have been few studies examining the prospective association of allostatic load (AL)-the biological processes related to stress-with CP.

Methods

We firstly conducted latent class analysis to identify phenotypes of AL using a community-dwelling sample, the Midlife in the United States. Multinomial logistic regression models were used to examine the prospective association between phenotypes of AL at MIDUS 2 biomarker project and the presence of CP, CP interference and the number of CP sites at MIDUS 3.

Results

Three phenotypes of AL, low biological dysregulation, parasympathetic dysregulation and metabolic dysregulation, were identified. Compared to low biological dysregulation group, participants experiencing metabolic dysregulation phenotype of AL at MIDUS 2 had higher risks of having high-interference CP (RRR = 2.00, 95% CI: 1.06, 3.79, P < 0.05) and 3 or more CP sites (RRR = 2.03, 95% CI: 1.08, 3.83, P < 0.05) at MIDUS 3.

Conclusion

The findings indicate that focusing on mitigating the metabolic dysfunction phenotype of AL has the potential to be an efficacious strategy for alleviating future CP bodily widespreadness and high CP interference.

SUBMITTER: Liang Y

PROVIDER: S-EPMC10854121 | biostudies-literature | 2024 Feb

REPOSITORIES: biostudies-literature

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Publications

Allostatic load and chronic pain: a prospective finding from the national survey of midlife development in the United States, 2004-2014.

Liang Yunlong Y Booker Cara C

BMC public health 20240209 1

<h4>Background</h4>Previous research has demonstrated a correlation between chronic stress and chronic pain (CP). However, there have been few studies examining the prospective association of allostatic load (AL)-the biological processes related to stress-with CP.<h4>Methods</h4>We firstly conducted latent class analysis to identify phenotypes of AL using a community-dwelling sample, the Midlife in the United States. Multinomial logistic regression models were used to examine the prospective ass ...[more]

PMID: 38336697

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Project description:BackgroundSocioeconomic disadvantages (SEDs) are associated with chronic pain (CP) and allostatic load (AL). Few prospective population-based studies have examined the relationship between life course SED, CP interference, and CP widespreadness, and there is no prospective population-based study on whether AL mediates the association between SED and CP.ObjectiveIn this study, we investigated whether the prospective effect of SED on CP at Midlife in the United States (MIDUS) 3 is consistent with the accumulation of risk model and social mobility model, using the National Survey of MIDUS (n = 593). To prepare for the mediation analysis, we tested (1) whether SED would be prospectively associated with AL in the MIDUS 2 biomarker project, (2) whether AL would be prospectively associated with CP, and (3) whether childhood, as a critical period, moderated the association between AL and CP. In addition, the mediating effect of AL on the association between SED and CP was examined.MethodSED was measured using cumulative scores and disadvantage trajectories derived from latent class trajectory modeling (LCTM). After multiple imputations, analyses were conducted using multinomial logistic regression for CP and negative binomial regression for AL, respectively. Finally, mediation analyses and moderated mediation analyses were performed.ResultsLCTM identified three SED trajectories, namely, constant low, high to low, and medium to high. The results showed that proximal cumulative SED was associated with high-interference CP. Furthermore, compared with the group with constant low SED, the group with medium-to-high SED was significantly associated with high-interference pain and experienced pain in at least three different sites. Cumulative SED and deteriorating SED trajectories were associated with higher AL, consistent with previous studies. Furthermore, childhood SED moderated the effect of AL on CP widespreadness and unexpectedly demonstrated a protective effect, while other associations between AL and CP were not significant. Subsequent mediation analysis did not yield statistically significant evidence.ConclusionsPeople who experienced more recent SED or increasing disadvantage throughout their lives were more likely to suffer from CP, and this association was not mediated by physiological system dysregulation caused by chronic stress. Therefore, measures to alleviate AL may not be effective in protecting socioeconomically disadvantaged populations from CP.

Project description:The contemporaneous association between higher socioeconomic position and better health is well established. Life course research has also demonstrated a lasting effect of childhood socioeconomic conditions on adult health and well-being. Yet, little is known about the separate health effects of intergenerational mobility-moving into a different socioeconomic position than one's parents-among early adults in the United States. Most studies on the health implications of mobility rely on cross-sectional datasets, which makes it impossible to differentiate between health selection and social causation effects. In addition, understanding the effects of social mobility on health at a relatively young age has been hampered by the paucity of health measures that reliably predict disease onset. Analysing 4,713 respondents aged 25 to 32 from the National Longitudinal Study of Adolescent Health's Waves I and IV, we use diagonal reference models to separately identify the effects of socioeconomic origin and destination, as well as social mobility on allostatic load among individuals in the United States. Using a combined measure of educational and occupational attainment, and accounting for individuals' initial health, we demonstrate that in addition to health gradient among the socially immobile, individuals' socioeconomic origin and destination are equally important for multi-system physiological dysregulation. Short-range upward mobility also has a positive and significant association with health. After mitigating health selection concerns in our observational data, this effect is observed only among those reporting poor health before experiencing social mobility. Our findings move towards the reconciliation of two theoretical perspectives, confirming the positive effect of upward mobility as predicted by the "rags to riches" perspective, while not contradicting potential costs associated with more extensive upward mobility experiences as predicted by the dissociative thesis.

Dataset Information

Allostatic load and chronic pain: a prospective finding from the national survey of midlife development in the United States, 2004-2014.

Background

Methods

Results

Conclusion

Publications

Allostatic load and chronic pain: a prospective finding from the national survey of midlife development in the United States, 2004-2014.

Similar Datasets

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