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Biopsychosocial Typologies of Pain in a Cohort of Patients With Systemic Sclerosis
Author(s) -
Merz Erin L.,
Malcarne Vanessa L.,
Assassi Shervin,
Nair Deepthi K.,
Graham Tiffany A.,
Yellman Brayden P.,
EstradaYMartin Rosa M.,
Mayes Maureen D.
Publication year - 2014
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.22171
Subject(s) - biopsychosocial model , worry , medicine , psychosocial , physical therapy , psychoeducation , chronic pain , clinical psychology , cohort , psychiatry , anxiety , intervention (counseling)
Objective Despite being a common problem in systemic sclerosis (SSc; scleroderma), the extant literature on pain has primarily focused on biomedical correlates, or bivariate relationships with a few psychological characteristics. There is a need to investigate the more heuristic biopsychosocial model, which incorporates the simultaneous contributions of medical, psychological, and social variables in understanding pain. Methods Patients with SSc (n = 333) received clinical examinations and completed self‐report surveys at enrollment in the Genetics versus Environment in Scleroderma Outcome Study. Latent profile analysis was used to derive biopsychosocial profiles of patients using skin thickening, percent predicted forced vital lung capacity, perceived physical health, health worry, mental health, and social support. The profiles were examined in relation to pain and pain medication usage. Results A 3‐profile solution provided the best fit to the data. Based on the biopsychosocial indicators, the profiles were characterized as managing (n = 217), resilient (n = 86), and distressed (n = 30). Between‐group differences for pain emerged, with the distressed group, whose disease was less severe than the resilient group, reporting the highest pain and the greatest utilization of pain medication. Conclusion Clinicians should consider biopsychosocial characteristics as contributing factors to the experience of pain in patients with SSc. Patients who are similar to those in the distressed profile may be at an increased risk for pain and would likely benefit from a referral to a behavioral health or other ancillary service provider for pain management, rather than relying solely on pharmacologic therapies.