Pain Catastrophizing and Pain Resilience as Predictors of Patient-Reported Outcomes in Individuals with Chronic Musculoskeletal Pain

Abstract

Background. Extensive research has focused on vulnerability factors related to the maintenance and exacerbation of pain; however, less is known about how positive psychological factors influence pain and functioning. Moreover, the pain self-management strategies that individuals in Lebanon with chronic musculoskeletal engage in remain unknown, with little knowledge of how psychological factors relate to their use. Aims. This study aimed to examine whether pain catastrophizing and pain resilience predict pain interference and health-related quality of individuals with chronic musculoskeletal pain. Another aim is to explore their indirect effects through pain-related fear, pain-self efficacy, and pain self-management. Methods. Participants (N = 154) with chronic musculoskeletal pain were recruited from the rheumatology clinics of two tertiary medical centers in Beirut. Participants completed a battery of questionnaires measuring the psychological variables and outcomes of interest, as well as some demographic and clinical factors. Data were analyzed using descriptive statistics, correlational analysis, and multiple linear regression. Hayes’ process macro software was used to examine the indirect effects of pain catastrophizing and pain resilience on study outcomes. Results. Self-directed arthritis education (72.7%), rest/relaxation (70.8%), and warm baths (70.8%) were the most commonly used strategies. In the final model of multiple regression analyses, only pain resilience predicted better physical (β = 0.184, p = 0.048) and mental health functioning (β = 0.361, p = 0.000), and lower pain interference (β = - 0.093, p = 0.000). Results supported the indirect effects of pain catastrophizing and pain resilience on pain interference and physical health functioning through pain self-efficacy and use of medications as self-management strategies. Pain-related fear also mediated the relationship between pain catastrophizing and physical health functioning. No significant indirect effects were found between pain resilience and mental health functioning. Conclusion. This study supports the idea that targeting positive psychological factors may have a positive impact on pain outcomes of individuals with chronic musculoskeletal pain.