Psychological Trauma Exposure and Pain-Related Outcomes Among People with Chronic Low Back Pain: Moderated Mediation by Thought Suppression and Social Constraints.
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ABSTRACT:
SUBMITTER: Pegram SE
PROVIDER: S-EPMC5373950 | biostudies-literature | 2017 Apr
REPOSITORIES: biostudies-literature
Publications
Psychological Trauma Exposure and Pain-Related Outcomes Among People with Chronic Low Back Pain: Moderated Mediation by Thought Suppression and Social Constraints.
Pegram Sheri E SE Lumley Mark A MA Jasinski Matthew J MJ Burns John W JW
Annals of behavioral medicine : a publication of the Society of Behavioral Medicine 20170401 2
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Project description:BackgroundChronic low back pain (cLBP) is the leading cause of disability, with a significant societal cost. It disproportionately affects non-Hispanic blacks and individuals of lower socioeconomic status. The biopsychosocial framework has been used to study and manage cLBP, yet disparities persist.ObjectiveThe objective of this study was to assess whether self-identified race moderated the relationship between perceived social status and cLBP outcomes (pain interference and pain severity) and investigate whether race moderated the indirect relationship between perceived social status and pain outcomes via depressive symptoms.MethodsFifty-seven blacks and 48 whites with cLBP were recruited as part of a large ongoing study. Depressive symptoms, objective and subjective measures of socioeconomic status, and pain outcomes were measured. Hayes' moderated mediation model was used to estimate conditional direct and indirect relationship between these variables.ResultOn average black participants reported significantly more pain interference (4.12 [SD=2.65] vs. 2.95 [SD=2.13]) and severity (5.57 [SD=2.27] vs. 3.99 [SD=1.99]) than white participants, (P<0.05). Race moderated the association between perceived social status and pain interference: higher social status decreases pain interference for white participants, but that trend was not observed in black participants. Moreover, race moderated association of perceived social status with depressive symptoms (P<0.001); which mediates the effects of perceived social status on pain outcomes.ConclusionHigher perceived social status is associated with less severe depressive symptoms, which in turn is associated with less pain severity and less pain interference for whites but not for blacks with cLBP.
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Project description:BackgroundChildhood trauma is a potential threat to depression and can have a lifelong impact on the mental health of university students. Our study aimed to construct a moderated mediation model to explore the relationship between childhood trauma, psychache, ambivalence over emotional expression, physical activity, and depression in university students.MethodsA cross-sectional study was conducted in three universities in China, recruiting 476 university students using self-report questionnaires. The moderated mediation model was examined using the SPSS PROCESS model 21.ResultsAmbivalence over emotional expression (F=12.843), childhood trauma (F=117.639), and psychache (F=581.594) all had a significant positive effect on depression (p<0.001), explaining 2.9%, 21.7%, and 56.8% of the variance, respectively. On the chain of influence between childhood trauma and depression, the mediating effect of psychache, the moderating effect of ambivalence over emotional expression, and the moderating effect of physical activity are all significant the overall indirect effect value of the three is 0.287, accounting for 61.59% of the total effect.ConclusionThis study investigated the relationship between childhood trauma, ambivalence over emotional expression, psychache, physical activity, and depression in university students. Future interventions should focus on developing good emotional expression among university students, increasing opportunities for physical activity, and reducing psychache to reduce depression.
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Project description:BackgroundPsychological resilience is considered to protect against detrimental effects of perceived stress on cardiovascular and metabolic health, but few studies have tested biological mechanisms underlying these relationships.PurposeThis study examined whether psychological resilience moderated the indirect association of perceived stress with Metabolic Syndrome (MetS) severity via hair cortisol concentration (HCC), a retrospective index of hypothalamic pituitary adrenal (HPA) axis activity.MethodParticipants included 228 adults (73 White, 86 Hispanic, 69 African American; mean age 45.29 years; 68% females). Participants completed questionnaires assessing perceived stress (Perceived Stress Scale) and resilience (Brief Resilience Scale). The first 3 cm of scalp-near hair were analyzed for cortisol concentration using enzyme-linked immunoassay analysis. Cardiometabolic risk factors including blood glucose, lipids, blood pressure, and waist circumference were assessed, from which a sex- and race/ethnicity-specific continuous MetS severity score was calculated. A moderated mediation model was tested using path analysis.ResultsPsychological resilience moderated the association of perceived stress with HCC (R2 change for interaction = 0.014, p = 0.043), such that the association of perceived stress and HCC decreased as resilience scores increased. Resilience also moderated the indirect association of perceived stress with MetS severity via HCC (b = -0.039, 95% CI [-0.001; -0.100]), such that HCC mediated the association of greater perceived stress with greater MetS severity only for individuals reporting Brief Resilience Scale scores 3 or below (range: 1.17-5.00). Psychological resilience was also associated with lower MetS severity (β = -0.227, p = 0.014) independent of perceived stress and HCC.ConclusionFindings suggest that psychological resilience may serve as both a stress buffer and as a direct determinant of cardiometabolic health. These results extend literature on psychological resilience to measures of retrospective HPA axis function and MetS severity in a diverse sample.
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