Pain-Specific Resilience in People Living With HIV and Chronic Pain: Beneficial Associations With Coping Strategies and Catastrophizing

Cesar E Gonzalez, Jennifer I Okunbor, Romy Parker, Michael A Owens, Dyan M White, Jessica S Merlin, Burel R Goodin, Cesar E Gonzalez, Jennifer I Okunbor, Romy Parker, Michael A Owens, Dyan M White, Jessica S Merlin, Burel R Goodin

Abstract

Objective: Chronic pain is increasingly recognized as a common and disabling problem for people living with HIV (PLWH). In a recent systematic review of psychosocial factors associated with chronic pain in PLWH, it was reported that very few studies to date have examined protective psychological factors that might help mitigate chronic pain for PLWH. The current study examined pain-specific resilience in relation to clinical and experimental pain, as well as pain coping in PLWH and chronic pain. Pain-specific resilience specifically refers to the ability to maintain relatively stable, healthy levels of psychological and physical functioning in the face of ongoing and persistent pain.

Methods: A total of 85 PLWH (mean CD4 = 643; 13% detectable viral load ≥200; 99% on antiretroviral therapy) who met criteria for chronic pain (>3 consecutive month's duration) were enrolled. Medical records were reviewed to confirm clinical data. All participants provided sociodemographic information prior to completing the following validated measures: Pain Resilience Scale (PRS), Coping Strategies Questionnaire-Revised (CSQ-R), Center for Epidemiologic Studies - Depression Scale (CES-D), and the Brief Pain Inventory - Short Form (BPI-SF). They then completed a quantitative sensory testing battery designed to assess tolerance for painful heat and cold stimuli.

Results: In adjusted multiple regression models controlling for covariates, greater pain-specific resilience was significantly associated with less pain interference (p = 0.022) on the BPI-SF, less pain catastrophizing (p = 0.002), greater use of distraction (p = 0.027) and coping self-statements (p = 0.039) on the CSQ-R, as well as significantly greater heat pain tolerance (p = 0.009). Finally, results of a parallel multiple mediation model demonstrated that the effect of pain-specific resilience on heat pain tolerance was indirectly transmitted through less pain catastrophizing (95% confidence interval:0.0042 to 0.0354), but not use of distraction (95% confidence interval: -0.0140 to 0.0137) or coping self-statements (95% confidence interval: -0.0075 to 0.0255).

Conclusion: The findings suggest that pain-specific resilience may promote adaptation and positive coping in PLWH and chronic pain.

Keywords: HIV-human immunodeficiency virus; catastrophizing; chronic pain; coping; resilience (psychological).

Figures

FIGURE 1
FIGURE 1
Parallel mediation model depicting the indirect effects of pain-specific resilience on heat pain tolerance (HPTo) through pain catastrophizing, distraction, and coping self-statements.

References

    1. Ankawi B., Slepian P. M., Himawan L. K., France C. R. (2017). Validation of the pain resilience scale in a chronic pain sample. J. Pain 18 984–993. 10.1016/j.jpain.2017.03.013
    1. Berg K. M., Cooperman N. A., Newville H., Arnsten J. H. (2009). Self-efficacy and depression as mediators of the relationship between pain and antiretroviral adherence. AIDS Care 21 244–248. 10.1080/09540120802001697
    1. Bruce R. D., Merlin J., Lum P. J., Ahmed E., Alexander C., Corbett A. H., et al. (2017). 2017 HIVMA of IDSA clinical practice guideline for the management of chronic pain in patients living With HIV. Clin. Infect. Dis. 65 e1–e37. 10.1093/cid/cix636
    1. Dale S. K., Cohen M. H., Kelso G. A., Cruise R. C., Weber K. M., Watson C., et al. (2014). Resilience among women with HIV: impact of silencing the self and socioeconomic factors. Sex. Roles 70 221–231. 10.1007/s11199-014-0348-x
    1. Emlet C. A., Shiu C., Kim H. J., Fredriksen-Goldsen K. (2017). Bouncing back: resilience and mastery among hiv-positive older gay and bisexual men. Gerontologist 57(Suppl. 1), S40–S49. 10.1093/geront/gnw171
    1. Geisser M. E., Roth R. S., Robinson M. E. (1997). Assessing depression among persons with chronic pain using the center for epidemiological studies-depression scale and the beck depression inventory: a comparative analysis. Clin. J. Pain 13 163–170. 10.1097/00002508-199706000-00011
    1. Goodin B. R., Glover T. L., Sotolongo A., King C. D., Sibille K. T., Herbert M. S., et al. (2013). The association of greater dispositional optimism with less endogenous pain facilitation is indirectly transmitted through lower levels of pain catastrophizing. J. Pain 14 126–135. 10.1016/j.jpain.2012.10.007
    1. Hayes A. F. (2013). Introduction to Mediation, Moderation, and Conditional Process Analysis: a Regression-Based Approach, 2nd Edn New York, NY: Guilford Press.
    1. Joyce S., Shand F., Tighe J., Laurent S. J., Bryant R. A., Harvey S. B. (2018). Road to resilience: a systematic review and meta-analysis of resilience training programmes and interventions. BMJ Open 8:e017858. 10.1136/bmjopen-2017-017858
    1. Karoly P., Ruehlman L. S. (2006). Psychological “resilience” and its correlates in chronic pain: findings from a national community sample. Pain 123 90–97. 10.1016/j.pain.2006.02.014
    1. Malloy K. M., Milling L. S. (2010). The effectiveness of virtual reality distraction for pain reduction: a systematic review. Clin. Psychol. Rev. 30 1011–1018. 10.1016/j.cpr.2010.07.001
    1. Mao J. (2006). Opioid-induced abnormal pain sensitivity. Curr. Pain Headache Rep. 10 67–70. 10.1007/s11916-006-0011-5
    1. Merlin J. S., Cen L., Praestgaard A., Turner M., Obando A., Alpert C., et al. (2012). Pain and physical and psychological symptoms in ambulatory HIV patients in the current treatment era. J. Pain Symptom. Manage. 43 638–645. 10.1016/j.jpainsymman.2011.04.019
    1. Merlin J. S., Westfall A. O., Chamot E., Overton E. T., Willig J. H., Ritchie C., et al. (2013). Pain is independently associated with impaired physical function in HIV-infected patients. Pain Med. 14 1985–1993. 10.1111/pme.12255
    1. Merlin J. S., Westfall A. O., Long D., Davies S., Saag M., Demonte W., et al. (2018). A randomized pilot trial of a novel behavioral intervention for chronic pain tailored to individuals with HIV. AIDS Behav. 22 2733–2742. 10.1007/s10461-018-2028-2
    1. Merlin J. S., Zinski A., Norton W. E., Ritchie C. S., Saag M. S., Mugavero M. J., et al. (2014). A conceptual framework for understanding chronic pain in patients with HIV. Pain Pract. 14 207–216. 10.1111/papr.12052
    1. Miller T. R., Halkitis P. N., Durvasula R. (2019). A biopsychosocial approach to managing HIV-related pain and associated substance abuse in older adults: a review. Ageing Int. 44 74–116. 10.1007/s12126-018-9333-y
    1. Myers T. A. (2011). Goodbye, listwise deletion: presenting hot deck imputation as an easy and effective tool for handling missing data. Commun. Methods Meas. 5 297–310. 10.1080/19312458.2011.624490
    1. Natamba B. K., Achan J., Arbach A., Oyok T. O., Ghosh S., Mehta S., et al. (2014). Reliability and validity of the center for epidemiologic studies-depression scale in screening for depression among HIV-infected and -uninfected pregnant women attending antenatal services in northern Uganda: a cross-sectional study. BMC Psychiatr. 14:303. 10.1186/s12888-014-0303-y
    1. Negin J., Barnighausen T., Lundgren J. D., Mills E. J. (2012). Aging with HIV in Africa: the challenges of living longer. AIDS 26(Suppl. 1), S1–S5. 10.1097/QAD.0b013e3283560f54
    1. Niesters M., Aarts L., Sarton E., Dahan A. (2013). Influence of ketamine and morphine on descending pain modulation in chronic pain patients: a randomized placebo-controlled cross-over proof-of-concept study. Br. J. Anaesth. 110 1010–1016. 10.1093/bja/aes578
    1. O’Keefe K. J., Scheer S., Chen M. J., Hughes A. J., Pipkin S. (2013). People fifty years or older now account for the majority of AIDS cases in San Francisco. California, 2010. AIDS Care 25 1145–1148. 10.1080/09540121.2012.752565
    1. Ong A. D., Zautra A. J., Reid M. C. (2010). Psychological resilience predicts decreases in pain catastrophizing through positive emotions. Psychol. Aging 25 516–523. 10.1037/a0019384
    1. Padesky C. A., Mooney K. A. (2012). Strengths-based cognitive-behavioural therapy: a four-step model to build resilience. Clin. Psychol. Psychother. 19 283–290. 10.1002/cpp.1795
    1. Parker R., Jelsma J., Stein D. J. (2017). Pain in amaXhosa women living with HIV/AIDS: a cross-sectional study of ambulant outpatients. BMC Womens Health 17:31. 10.1186/s12905-017-0388-9
    1. Parker R., Stein D. J., Jelsma J. (2014). Pain in people living with HIV/AIDS: a systematic review. J. Int. AIDS Soc. 17:18719. 10.7448/IAS.17.1.18719
    1. Penn T. M., Trost Z., Parker R., Wagner W. P., Owens M. A., Gonzalez C. E., et al. (2019). Social support buffers the negative influence of perceived injustice on pain interference in people living with HIV and chronic pain. Pain Rep. 4:e710. 10.1097/PR9.0000000000000710
    1. Pitts M., Grierson J., Misson S. (2005). Growing older with HIV: a study of health, social and economic circumstances for people living with HIV in Australia over the age of 50 years. AIDS Patient Care STDS 19 460–465. 10.1089/apc.2005.19.460
    1. Pulvers K., Hood A. (2013). The role of positive traits and pain catastrophizing in pain perception. Curr. Pain Headache Rep. 17:330. 10.1007/s11916-013-0330-2
    1. Radloff L. S. (1977). A self-report depression scale for research in the general population. Appl. Psychol. Meas. 1 385–401. 10.1177/014662167700100306
    1. Ramírez-Maestre C., Esteve R., López A. E. (2012). The path to capacity: resilience and spinal chronic pain. Spine 37 E251–E258. 10.1097/BRS.0b013e31822e93ab
    1. Roditi D., Robinson M. E., Litwins N. (2009). Effects of coping statements on experimental pain in chronic pain patients. J. Pain Res. 2 109–116.
    1. Rosenstiel A. K., Keefe F. J. (1983). The use of coping strategies in chronic low back pain patients: relationship to patient characteristics and current adjustment. Pain 17 33–44. 10.1016/0304-3959(83)90125-2
    1. Scott W., Arkuter C., Kioskli K., Kemp H., McCracken L. M., Rice A. S. C., et al. (2018). Psychosocial factors associated with persistent pain in people with HIV: a systematic review with meta-analysis. Pain 159 2461–2476. 10.1097/j.pain.0000000000001369
    1. Simmonds M. J., Novy D., Sandoval R. (2005). The differential influence of pain and fatigue on physical performance and health status in ambulatory patients with human immunodeficiency virus. Clin. J. Pain 21 200–206. 10.1097/00002508-200505000-00002
    1. Slepian P. M., Ankawi B., France C. R. (2018). Pain resilience and catastrophizing combine to predict adaptation to back pain over three months. J. Pain 19 S59–S60.
    1. Slepian P. M., Ankawi B., Himawan L. K., France C. R. (2016). Development and initial validation of the pain resilience scale. J. Pain 17 462–472. 10.1016/j.jpain.2015.12.010
    1. Sturgeon J. A., Zautra A. J. (2010). Resilience: a new paradigm for adaptation to chronic pain. Curr. Pain Headache Rep. 14 105–112. 10.1007/s11916-010-0095-9
    1. Sturgeon J. A., Zautra A. J. (2013). Psychological resilience, pain catastrophizing, and positive emotions: perspectives on comprehensive modeling of individual pain adaptation. Curr. Pain Headache Rep. 17:317. 10.1007/s11916-012-0317-4
    1. Tan G., Jensen M. P., Thornby J. I., Shanti B. F. (2004). Validation of the Brief Pain Inventory for chronic nonmalignant pain. J. Pain 5 133–137. 10.1016/j.jpain.2003.12.005
    1. Treede R. D., Rief W., Barke A., Aziz Q., Bennett M. I., Benoliel R., et al. (2015). A classification of chronic pain for ICD-11. Pain 156 1003–1007. 10.1097/j.pain.0000000000000160
    1. Tsao J. C., Soto T. (2009). Pain in persons living with HIV and comorbid psychologic and substance use disorders. Clin. J. Pain 25 307–312. 10.1097/AJP.0b013e31819294b7
    1. U. S. Federal Poverty Guidelines (2017). U. S. Federal Poverty Guidelines. U.S. Department of Health and Human Services; Washington, DC:
    1. Verhoeven K., Van Damme S., Eccleston C., Van Ryckeghem D. M., Legrain V., Crombez G. (2011). Distraction from pain and executive functioning: an experimental investigation of the role of inhibition, task switching and working memory. Eur. J. Pain 15 866–873. 10.1016/j.ejpain.2011.01.009
    1. Wadley A. L., Mitchell D., Kamerman P. R. (2016). Resilience does not explain the dissociation between chronic pain and physical activity in South Africans living with HIV. PeerJ 4:e2464. 10.7717/peerj.2464
    1. Wright L. J., Zautra A. J., Going S. (2008). Adaptation to early knee osteoarthritis: the role of risk, resilience, and disease severity on pain and physical functioning. Ann. Behav. Med. 36 70–80. 10.1007/s12160-008-9048-5

Source: PubMed

스폰서 및 공동 작업자

건강 상태

약물 개입

3
구독하다