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. 2024 May 23;19(5):e0303775.
doi: 10.1371/journal.pone.0303775. eCollection 2024.

The role of pain self-efficacy and pain catastrophising in the relationship between chronic pain and depression: A moderated mediation model

Affiliations

The role of pain self-efficacy and pain catastrophising in the relationship between chronic pain and depression: A moderated mediation model

Lauren Kardash et al. PLoS One. .

Abstract

Chronic pain is a substantial health problem with a high prevalence of comorbid depression. To understand the link between chronic pain and depression, cognitive factors including pain catastrophising and pain self-efficacy have been theorised as significant contributing variables. There is relatively strong evidence that pain catastrophising mediates the relationship between pain severity and depression symptoms. There is also emerging evidence that the mediation role of pain catastrophising may vary as a function of pain self-efficacy. However, it is unknown whether this model will apply in a tertiary pain clinic sample. Thus, this study aimed to examine the respective moderating and mediating roles of pain self-efficacy and pain catastrophising on the association between pain severity and depressive symptoms in a large clinical sample of Australian adults living with chronic pain. Participants (n = 1195) completed all questionnaire measures prior to their first appointments at one tertiary pain service. As expected, the PROCESS path analysis showed that pain catastrophising mediated the relationship between pain severity and depressive symptoms. Further, there was support for the moderating effect of pain self-efficacy; as pain self-efficacy decreased, the relationship strengthened between both pain severity and pain catastrophising, as well as pain catastrophising and depressive symptoms. These findings may have important clinical implications including how relationships between these factors may be considered in the provision of care for those with chronic pain. Notably, these measures could be used in triaging processes to inform treatment decisions.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Moderated mediation model controlling for covariates of age, sex, and pain duration.
Note. All coefficients are unstandardized (*p < .05, **p < .01). Covariates are omitted to enhance the clarity of the model.
Fig 2
Fig 2. The Conditional Effects of Pain Self-Efficacy on the Relationship Between Pain Severity and Pain Catastrophising.
Note. Variables are presented uncentred for illustrated purposes. Uncentred results did not significantly differ from centred results.
Fig 3
Fig 3. The conditional effects of pain self-efficacy on the relationship between pain catastrophising and depressive symptoms.
Note. Variables are presented uncentred for illustrated purposes. Uncentred results did not significantly differ from centred results.

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Grants and funding

The author(s) received no specific funding for this work.