TY - JOUR
T1 - Optimism moderates the influence of pain catastrophizing on shoulder pain outcome
T2 - A longitudinal analysis
AU - Coronado, Rogelio A.
AU - Simon, Corey B.
AU - Lentz, Trevor A.
AU - Gay, Charles W.
AU - Mackie, Lauren N.
AU - George, Steven Z.
N1 - Funding Information:
This research study was supported by an American Physical Therapy Association Orthopaedic Section research grant. Dr Coronado was supported by the National Institutes of Health T32 Interdisciplinary Training in Rehabilitation and Neuromuscular Plasticity grant (5T32HD043730) during his time at the University of Florida. Dr George was supported by a National Institutes of Health grant (2AR05589) and Brooks Rehabilitation.
Publisher Copyright:
Copyright © 2017 Journal of Orthopaedic & Sports Physical Therapy®.All rights reserved.
PY - 2017/1
Y1 - 2017/1
N2 - STUDY DESIGN: Secondary analysis of prospectively collected data. BACKGROUND: An abundance of evidence has highlighted the influence of pain catastrophizing and fear avoidance on clinical outcomes. Less is known about the interaction of positive psychological resources with these pain- associated distress factors. OBJECTIVE: To assess whether optimism moderates the influence of pain catastrophizing and fear avoidance on 3-month clinical outcomes in patients with shoulder pain. METHODS: Data from 63 individuals with shoulder pain (mean ± SD age, 38.8 ± 14.9 years; 30 female) were examined. Demographic, psychological, and clinical characteristics were obtained at baseline. Validated measures were used to assess optimism (Life Orientation Test-Revised), pain catastrophizing (Pain Catastrophizing Scale), fear avoidance (Fear- Avoidance Beliefs Questionnaire physical activity subscale), shoulder pain intensity (Brief Pain Inventory), and shoulder function (Pennsylvania Shoulder Score function subscale). Shoulder pain and function were reassessed at 3 months. Regression models assessed the influence of (1) pain catastrophizing and optimism and (2) fear avoidance and optimism. The final multivariable models controlled for factors of age, sex, education, and baseline scores, and included 3-month pain intensity and function as separate dependent variables. T tRESULTS: Shoulder pain (mean difference, -1.6; 95% confidence interval [CI]: -2.1, -1.2) and function (mean difference, 2.4; 95% CI: 0.3, 4.4) improved over 3 months. In multivariable analyses, there was an interaction between pain catastrophizing and optimism (β = 0.19; 95% CI: 0.02, 0.35) for predicting 3-month shoulder function (F = 16.8, R2 = 0.69, P<001), but not pain (P = .213). Further examination of the interaction with the Johnson-Neyman technique showed that higher levels of optimism lessened the influence of pain catastrophizing on function. There was no evidence of significant moderation of fear-avoidance beliefs for 3-month shoulder pain (P = .090) or function (P = .092). T tCONCLUSION: Optimism decreased the negative influence of pain catastrophizing on shoulder function, but not pain intensity. Optimism did not alter the influence of fear-avoidance beliefs on these outcomes.
AB - STUDY DESIGN: Secondary analysis of prospectively collected data. BACKGROUND: An abundance of evidence has highlighted the influence of pain catastrophizing and fear avoidance on clinical outcomes. Less is known about the interaction of positive psychological resources with these pain- associated distress factors. OBJECTIVE: To assess whether optimism moderates the influence of pain catastrophizing and fear avoidance on 3-month clinical outcomes in patients with shoulder pain. METHODS: Data from 63 individuals with shoulder pain (mean ± SD age, 38.8 ± 14.9 years; 30 female) were examined. Demographic, psychological, and clinical characteristics were obtained at baseline. Validated measures were used to assess optimism (Life Orientation Test-Revised), pain catastrophizing (Pain Catastrophizing Scale), fear avoidance (Fear- Avoidance Beliefs Questionnaire physical activity subscale), shoulder pain intensity (Brief Pain Inventory), and shoulder function (Pennsylvania Shoulder Score function subscale). Shoulder pain and function were reassessed at 3 months. Regression models assessed the influence of (1) pain catastrophizing and optimism and (2) fear avoidance and optimism. The final multivariable models controlled for factors of age, sex, education, and baseline scores, and included 3-month pain intensity and function as separate dependent variables. T tRESULTS: Shoulder pain (mean difference, -1.6; 95% confidence interval [CI]: -2.1, -1.2) and function (mean difference, 2.4; 95% CI: 0.3, 4.4) improved over 3 months. In multivariable analyses, there was an interaction between pain catastrophizing and optimism (β = 0.19; 95% CI: 0.02, 0.35) for predicting 3-month shoulder function (F = 16.8, R2 = 0.69, P<001), but not pain (P = .213). Further examination of the interaction with the Johnson-Neyman technique showed that higher levels of optimism lessened the influence of pain catastrophizing on function. There was no evidence of significant moderation of fear-avoidance beliefs for 3-month shoulder pain (P = .090) or function (P = .092). T tCONCLUSION: Optimism decreased the negative influence of pain catastrophizing on shoulder function, but not pain intensity. Optimism did not alter the influence of fear-avoidance beliefs on these outcomes.
KW - Catastrophization
KW - Optimism
KW - Psychology
KW - Regression analysis
KW - Shoulder pain
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U2 - 10.2519/jospt.2017.7068
DO - 10.2519/jospt.2017.7068
M3 - Article
C2 - 27819191
AN - SCOPUS:85008970582
SN - 0190-6011
VL - 47
SP - 21
EP - 30
JO - Journal of Orthopaedic and Sports Physical Therapy
JF - Journal of Orthopaedic and Sports Physical Therapy
IS - 1
ER -