TY - JOUR
T1 - Catastrophizing, pain, and social adjustment in scleroderma
T2 - Relationships with educational level
AU - Edwards, Robert R.
AU - Goble, Layne
AU - Kwan, Amy
AU - Kudel, Ian
AU - McGuire, Lynanne
AU - Heinberg, Leslie
AU - Wigley, Fred
AU - Haythornthwaite, Jennifer
PY - 2006/9
Y1 - 2006/9
N2 - 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.
AB - 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.
KW - Catastrophizing
KW - Coping
KW - Education
KW - Scleroderma
UR - http://www.scopus.com/inward/record.url?scp=33748154119&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33748154119&partnerID=8YFLogxK
U2 - 10.1097/01.ajp.0000210918.26159.94
DO - 10.1097/01.ajp.0000210918.26159.94
M3 - Article
C2 - 16926580
AN - SCOPUS:33748154119
SN - 0749-8047
VL - 22
SP - 639
EP - 646
JO - Clinical Journal of Pain
JF - Clinical Journal of Pain
IS - 7
ER -