Catastrophizing, pain, and social adjustment in scleroderma: relationships with educational level.

Full Abstract

OBJECTIVES:
Low educational attainment is related to numerous adverse health outcomes, and some evidence suggests that psychosocial variables may mediate education's effects. Moreover, the relationship between psychosocial functioning and health-related outcomes may be moderated by educational level, with individuals lower in formal education being more susceptible to the deleterious effects of negative cognitive and affective states. The present study sought to characterize such interrelationships between educational level and pain-related catastrophizing.

METHODS:
We investigated the association of self-reported educational level with pain and social disability, we evaluated catastrophizing's potential mediating role in those associations, and we also investigated education as a moderator of catastrophizing's effects on pain and social disability in a sample of patients with scleroderma, a frequently painful autoimmune disorder.

RESULTS:
First, education-related differences in pain report were accounted for by catastrophizing and depression. Second, after controlling for demographic factors, disease severity, and depressive symptoms, education moderated the relationship between catastrophizing, pain affect, and social function. Specifically, catastrophizing was more highly associated with greater reporting of affective pain among those with less formal education. In addition, catastrophizing inversely correlated with social disruption among individuals with less formal education.

DISCUSSION:
Collectively, study findings support multiple models of interaction between education and pain-related cognitive/affective functioning, though in both mediational and moderational analyses, lower levels of formal education act as a risk factor for adverse pain-related outcomes.

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Author information

Author/s: Edwards, Robert R (RR); Goble, Layne (L); Kwan, Amy (A); Kudel, Ian (I); McGuire, Lynanne (L); Heinberg, Leslie (L); Wigley, Fred (F); Haythornthwaite, Jennifer (J);

Affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA. redwar10(-atsign-)jhmi.edu

Grants: AR051315 (Agency:NIAMS NIH HHS) ; AR47219 (Agency:NIAMS NIH HHS)

Journal and publication information

Publication Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't

Journal: The Clinical journal of pain (Clin J Pain), published in United States. (Language: eng)

Reference: 2006-Sep; vol 22 (issue 7) : pp 639-46

Dates: Created 2006/08/23; Completed 2006/10/17; Revised 2007/11/15;

PMID: 16926580, status: MEDLINE (last retrieval date: 12/26/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adaptation, Psychological
Anxiety - epidemiology
Comorbidity
Educational Status
Female
Humans
Incidence
Male
Maryland - epidemiology

Middle Aged
Pain - epidemiology
Questionnaires
Risk Assessment - methods
Risk Factors
Scleroderma, Systemic - epidemiology
Social Adjustment
Social Behavior Disorders - epidemiology
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