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Annals of General Psychiatry
Published in: Annals of General Psychiatry 1/2019

Open Access 01-12-2019 | Primary research

Positive psychological well-being predicts lower severe pain in the general population: a 2-year follow-up study of the SwePain cohort

Authors: Britt Larsson, Elena Dragioti, Björn Gerdle, Jonas Björk

Published in: Annals of General Psychiatry | Issue 1/2019

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Abstract

Background

Positive psychology indicators like well-being and life satisfaction may play a pivotal role in pain-related outcomes. In this study, we aimed to examine the prospective associations of positive well-being and life satisfaction with pain severity.

Methods and Subjects

This longitudinal study, with a follow-up of 2 years, included 9361 participants (4266 males, 5095 females; mean age: 52.5 years; SD: 17.5) without and with chronic pain (CP) at baseline. All analyses were stratified by the two sub-cohorts—participants without CP (sub-cohort 1) and participants with CP (sub-cohort 2) at baseline. The predictive associations, assessed using ordinal regression in a Generalized Linear Model, were adjusted for baseline potential confounders and reported as odds ratios (ORs) with corresponding 95% confidence intervals (CIs).

Results

After adjustments, in sub-cohort 1 positive well-being at baseline was associated with lower severe pain at follow-up compared to participants with severe distress (OR: 0.64; 95% CI 0.49–0.84; p < 0.001). In sub-cohort 2, both positive well-being and life satisfaction at baseline were associated with lower severe pain at follow-up compared to participants with severe distress and not satisfied with life (OR: 0.80; 95% CI 0.65–0.98; p = 0.031 and OR: 0.82; 95% CI 0.69–0.96; p = 0.014, respectively).

Conclusions

Positive well-being is predictive of lower pain severity both among participants without and with CP at baseline, whereas life satisfaction was found predictive of lower pain severity only for subjects with CP. Future research should emphasize implementing treatments associated with promoting and maintaining positive well-being and life satisfaction in patients who suffer from chronic pain and in risk populations.
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Literature
1.
Steptoe A, Deaton A, Stone AA. Subjective wellbeing, health, and ageing. Lancet. 2015;385(9968):640–8.PubMedCrossRef
2.
Gallagher MW, Lopez SJ, Preacher KJ. The hierarchical structure of well-being. J Pers. 2009;77(4):1025–50.PubMedCrossRef
3.
Lamers SM, Bolier L, Westerhof GJ, Smit F, Bohlmeijer ET. The impact of emotional well-being on long-term recovery and survival in physical illness: a meta-analysis. J Behav Med. 2012;35(5):538–47.PubMedCrossRef
4.
Seligman ME, Csikszentmihalyi M. Positive psychology. An introduction. Am Psychol. 2000;55(1):5–14.PubMedCrossRef
5.
Birket-Smith M, Hansen BH, Hanash JA, Hansen JF, Rasmussen A. Mental disorders and general well-being in cardiology outpatients—6-year survival. J Psychosom Res. 2009;67(1):5–10.PubMedCrossRef
6.
Moskowitz JT, Epel ES, Acree M. Positive affect uniquely predicts lower risk of mortality in people with diabetes. Health Psychol. 2008;27(1S):S73–82.PubMedCrossRef
7.
Ryff CD, Singer BH, Dienberg Love G. Positive health: connecting well-being with biology. Philos Trans R Soc Lond B Biol Sci. 2004;359(1449):1383–94.PubMedPubMedCentralCrossRef
8.
Steptoe A, Wardle J, Marmot M. Positive affect and health-related neuroendocrine, cardiovascular, and inflammatory processes. Proc Natl Acad Sci USA. 2005;102(18):6508–12.PubMedCrossRef
9.
Folkman S, Moskowitz JT. Positive affect and the other side of coping. Am Psychol. 2000;55(6):647–54.PubMedCrossRef
10.
Grant N, Wardle J, Steptoe A. The relationship between life satisfaction and health behavior: a cross-cultural analysis of young adults. Int J Behav Med. 2009;16(3):259–68.PubMedCrossRef
11.
Ostir GV, Markides KS, Peek MK, Goodwin JS. The association between emotional well-being and the incidence of stroke in older adults. Psychosom Med. 2001;63(2):210–5.PubMedCrossRef
12.
Davidson KW, Mostofsky E, Whang W. Don’t worry, be happy: positive affect and reduced 10-year incident coronary heart disease: the Canadian Nova Scotia Health Survey. Eur Heart J. 2010;31(9):1065–70.PubMedPubMedCentralCrossRef
13.
Okely JA, Cooper C, Gale CR. Wellbeing and arthritis incidence: the survey of health, ageing and retirement in Europe. Ann Behav Med. 2016;50(3):419–26.PubMedPubMedCentralCrossRef
14.
Fisher MN, Snih SA, Ostir GV, Goodwin JS. Positive affect and disability among older Mexican Americans with arthritis. Arthritis Rheum. 2004;51(1):34–9.PubMedCrossRef
15.
Brummett BH, Morey MC, Boyle SH, Mark DB. Prospective study of associations among positive emotion and functional status in older patients with coronary artery disease. J Gerontol B Psychol Sci Soc Sci. 2009;64(4):461–9.PubMedCrossRef
16.
Ong AD. Pathways Linking Positive Emotion and Health in Later Life. Curr Direct Psychol Sci. 2010;19(6):358–62.CrossRef
17.
18.
Chida Y, Steptoe A. Positive psychological well-being and mortality: a quantitative review of prospective observational studies. Psychosom Med. 2008;70(7):741–56.PubMedCrossRef
19.
Lyubomirsky S, King L, Diener E. The benefits of frequent positive affect: does happiness lead to success? Psychol Bull. 2005;131(6):803–55.PubMedCrossRef
20.
21.
Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, Shibuya K, Salomon JA, Abdalla S, Aboyans V, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2163–96.PubMedPubMedCentralCrossRef
22.
Bernfort L, Gerdle B, Rahmqvist M, Husberg M, Levin LA. Severity of chronic pain in an elderly population in Sweden–impact on costs and quality of life. Pain. 2015;156(3):521–7.PubMedCrossRef
23.
Furrer A, Michel G, Terrill AL, Jensen MP, Muller R. Modeling subjective well-being in individuals with chronic pain and a physical disability: the role of pain control and pain catastrophizing. Disabil Rehabil. 2019;41(5):498–507.PubMedCrossRef
24.
Stalnacke BM. Life satisfaction in patients with chronic pain—relation to pain intensity, disability, and psychological factors. Neuropsychiatr Dis Treat. 2011;7:683–9.PubMedPubMedCentralCrossRef
25.
Muller R, Gertz KJ, Molton IR, Terrill AL, Bombardier CH, Ehde DM, Jensen MP. Effects of a Tailored positive psychology intervention on well-being and pain in individuals with chronic pain and a physical disability: a feasibility trial. Clin J Pain. 2016;32(1):32–44.PubMedCrossRef
26.
Grimby-Ekman A, Gerdle B, Bjork J, Larsson B. Comorbidities, intensity, frequency and duration of pain, daily functioning and health care seeking in local, regional, and widespread pain—a descriptive population-based survey (SwePain). BMC Musculoskelet Disord. 2015;16:165.PubMedPubMedCentralCrossRef
27.
Larsson B, Gerdle B, Bjork J, Grimby-Ekman A. Pain sensitivity and its relation to spreading on the body, intensity, frequency, and duration of pain: a cross-sectional population-based study (SwePain). Clin J Pain. 2017;33(7):579–87.PubMedCrossRef
28.
von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP, Initiative S. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Prev Med. 2007;45(4):247–51.CrossRef
29.
Von Korff M, Ormel J, Keefe FJ, Dworkin SF. Grading the severity of chronic pain. Pain. 1992;50(2):133–49.CrossRef
30.
Von Korff M, Dworkin SF, Le Resche L. Graded chronic pain status: an epidemiologic evaluation. Pain. 1990;40(3):279–91.CrossRef
31.
Von Korff M. Studying the natural history of back pain. Spine (Phila Pa 1976). 1994;19(18 Suppl):2041S–6S.CrossRef
32.
Smith BH, Penny KI, Purves AM, Munro C, Wilson B, Grimshaw J, Chambers WA, Smith WC. The Chronic Pain Grade questionnaire: validation and reliability in postal research. Pain. 1997;71(2):141–7.PubMedCrossRef
33.
Underwood MR, Barnett AG, Vickers MR. Evaluation of two time-specific back pain outcome measures. Spine (Phila Pa 1976). 1999;24(11):1104–12.CrossRef
34.
Elliott AM, Smith BH, Smith WC, Chambers WA. Changes in chronic pain severity over time: the chronic pain grade as a valid measure. Pain. 2000;88(3):303–8.PubMedCrossRef
35.
Vingard E, Mortimer M, Wiktorin C, Pernold RPTG, Fredriksson K, Nemeth G, Alfredsson L, Musculoskeletal Intervention Center-Norrtalje Study G. Seeking care for low back pain in the general population: a two-year follow-up study: results from the MUSIC-Norrtalje Study. Spine (Phila Pa 1976). 2002;27(19):2159–65.CrossRef
36.
Fazio AF. A concurrent validational study of the NCHS General Well-Being Schedule. Vital Health Stat 2. 1977;73:1–53.
37.
McDowell I. Measuring health: a guide to rating scales and questionnaires. 3rd ed./McDowell I. editor. New York, Oxford: Oxford University Press; 2006.
38.
Fugel-Meyer AR, Fugl-Meyer KS. The coping process after traumatic brain injury. Scand J Rehabil Med Suppl. 1988;17:51–3.PubMedCrossRef
39.
Fugl-Meyer AR, Melin R, Fugl-Meyer KS. Life satisfaction in 18- to 64-year-old Swedes: in relation to gender, age, partner and immigrant status. J Rehabil Med. 2002;34(5):239–46.PubMedCrossRef
40.
Dragioti E, Larsson B, Bernfort L, Levin LA, Gerdle B. Prevalence of different pain categories based on pain spreading on the bodies of older adults in Sweden: a descriptive-level and multilevel association with demographics, comorbidities, medications, and certain lifestyle factors (PainS65+). J Pain Res. 2016;9:1131–41.PubMedPubMedCentralCrossRef
41.
Dragioti E, Bernfort L, Larsson B, Gerdle B, Levin LA. Association of insomnia severity with well-being, quality of life and health care costs: a cross-sectional study in older adults with chronic pain (PainS65+). Eur J Pain. 2018;22(2):414–25.PubMedCrossRef
42.
Wallace E, Salisbury C, Guthrie B, Lewis C, Fahey T, Smith SM. Managing patients with multimorbidity in primary care. BMJ. 2015;350:h176.PubMedCrossRef
43.
Nelder JA, Wedderburn RWM. Generalized Linear Models. J R Stat Soc Ser A (Gen). 1972;135(3):370.CrossRef
44.
McCullagh P, Nelder JA. Generalized Linear Models. 2nd ed. UK: Chapman and Hall; 1989.CrossRef
45.
O’brien R. A caution regarding rules of thumb for variance inflation factors. Qual Quant Int J Methodol. 2007;41(5):673–90.CrossRef
46.
Wikman A, Wardle J, Steptoe A. Quality of life and affective well-being in middle-aged and older people with chronic medical illnesses: a cross-sectional population based study. PLoS ONE. 2011;6(4):e18952.PubMedPubMedCentralCrossRef
47.
Boehm JK, Winning A, Segerstrom S, Kubzansky LD. Variability modifies life satisfaction’s association with mortality risk in older adults. Psychol Sci. 2015;26(7):1063–70.PubMedPubMedCentralCrossRef
48.
Sheldon KM, Lyubomirsky S. The challenge of staying happier: testing the Hedonic Adaptation Prevention model. Pers Soc Psychol Bull. 2012;38(5):670–80.PubMedCrossRef
49.
Nilsson KW, Leppert J, Simonsson B, Starrin B. Sense of coherence and psychological well-being: improvement with age. J Epidemiol Community Health. 2010;64(4):347–52.PubMedCrossRef
50.
George LK, Landerman R. Health and subjective well-being: a replicated secondary data analysis. Int J Aging Hum Dev. 1984;19(2):133–56.PubMedCrossRef
51.
Wang L, Zhang Z, McArdle JJ, Salthouse TA. Investigating ceiling effects in longitudinal data analysis. Multivar Behav Res. 2009;43(3):476–96.CrossRef
52.
53.
Sin NL. The protective role of positive well-being in cardiovascular disease: review of current evidence, mechanisms, and clinical implications. Curr Cardiol Rep. 2016;18(11):106.PubMedPubMedCentralCrossRef
54.
Cohen S, Alper CM, Doyle WJ, Treanor JJ, Turner RB. Positive emotional style predicts resistance to illness after experimental exposure to rhinovirus or influenza a virus. Psychosom Med. 2006;68(6):809–15.PubMedCrossRef
55.
Bower JE, Moskowitz JT, Epel E. Is benefit finding good for your health? Curr Direct Psychol Sci. 2009;18(6):337–41.CrossRef
Metadata
Title
Positive psychological well-being predicts lower severe pain in the general population: a 2-year follow-up study of the SwePain cohort
Authors
Britt Larsson
Elena Dragioti
Björn Gerdle
Jonas Björk
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Annals of General Psychiatry / Issue 1/2019
Electronic ISSN: 1744-859X
DOI
https://doi.org/10.1186/s12991-019-0231-9

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