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Publication
Social support for functional dependence, activity patterns, and chronic pain outcomes: A cross-lagged mediation panel study
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Advisor(s)
Abstract(s)
Objective: Received social support undermining engagement in life activities of individuals with chronic
pain (e.g., solicitousness, support for functional dependence) is consistently correlated with worse
physical functioning, pain severity and disability. Whether such responses lead to worse pain outcomes
(operant model of pain) or the latter lead to more supportive responses undermining activity
engagement (social communication and empathy models of pain) is unknown, given the lack of crosslagged panel studies. Furthermore, the mediating role of activity patterns in such relationship over time
is entirely unclear. This study aimed to bridge these gaps. Methods: This was a three-month prospective
study with three waves of data collection (T1-T3; six-week lag in-between), including 130 older adults
(71% women; Mage=78.26) with musculoskeletal chronic pain attending day-care centers. At every time
point, participants filled out self-report measures of staff social support for functional dependence,
activity patterns, physical functioning, pain severity and interference. Scales showed good/very good
test-retest reliability (ICC=.74-.96) and internal consistency (all α>.90). Results: Parsimonious crosslagged panel mediation models showed the best fit (χ²/df<2.44; CFI>.96; GFI>.93; RMSEA<.09).
Bidirectional effects were found over time, but poorer pain outcomes at T1 (higher pain
severity/interference, lower physical functioning) more consistently predicted higher social support for
functional dependence than vice versa. Poorer pain outcomes (T1) predicted more avoidance/less
overdoing (T3), via increased received support for functional dependence (T2). Conclusion: Further
research on the cyclical relationships between the study variables across chronic pain trajectories is
needed to harness the power of interpersonal relationships in future self-management interventions.
Description
Keywords
Chronic pain Received social support Activity patterns Cross-lagged panel design Older adults
Citation
Bernardes, S. F., de Matos, M. O., Brandão, T., & Ferreira-Valente, A. (2024). Social support for functional dependence, activity patterns, and chronic pain outcomes: A cross-lagged mediation panel study. Health Psychology, 43(7), 488–499. https://doi.org/10.1037/hea0001370
Publisher
American Psychological Association