CoChat
Sign Up
Cited by 149Musculoskeletal pain and rehabilitationSpine and Intervertebral Disc PathologyPain Management and Treatment

Symptoms of depression and stress mediate the effect of pain on disability

Hall, Amanda M., Kamper, Steven J., Maher, Chris G., Latimer, Jane, Ferreira, Manuela L., Nicholas, Michael K.·2011·Pain
DOI 10.1016/j.pain.2011.01.014
Open this paper in CoChat — free account

Abstract

The mechanism or mechanisms involved in the development of pain-related disability in people with low back pain is unclear. Psychological distress has been identified as one potential pathway by which an episode of pain influences the development of persistent disabling symptoms; however, the relationship has not been formally investigated. This study investigated the causal relationship between pain and disability via psychological distress (and its components depression, stress, and anxiety) by using mediation path analysis. The study sample included 231 participants with subacute low back pain (6 to 12 weeks' pain duration) who had been recruited for an exercise-based randomised, controlled trial. All participants completed self-report assessments of pain (0-10 numerical rating scale), disability (Roland Morris Disability Questionnaire), and psychological distress (Depression Anxiety and Stress Scale) at baseline and again at 2 follow-up time points (6 and 12 weeks after baseline). The results of the mediation analysis suggest that approximately 30% of the relationship between subacute pain and later disability is dependent on the level of patients' psychological distress. The finding that psychological distress only partially (30%) mediated the pain-disability relationship indicates that other factors should also be explored. Further analysis into the components of psychological distress revealed that the symptoms of depression and stress, but not anxiety, are responsible for mediation of the pain-disability relationship. These findings provide an opportunity to decrease the risk of long-term disability through early identification and management of depressive and stress symptoms.

Integrity signals

Registry

Crossref · 10.1016/j.pain.2011.01.014

Cites

20 of 20 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • A handful of studies suggest that the working alliance statistically mediates the positive effects of rehabilitative treatments in people with musculoskeletal pain.

    “A handful of studies suggest that an index of the therapeutic relationship (i.e., the working alliance) statistically mediates the positive effects of rehabilitative treatments among people with musculoskeletal pain 141–145.”

    From Evaluating psychosocial contributions to chronic pain outcomes (2018) · cites this paper as [141]

Cites

Flagged first, then by citations

1 of the 21 references couldn’t be matched to a known paper.

Cited by

Sorted by citations

Related

Authors
Hall, A. M., Kamper, S. J., Maher, C. G., Latimer, J., Ferreira, M. L., & Nicholas, M. K.
Affiliations
  • The University of Sydney (AU)
  • The George Institute for Global Health (AU)
Corresponding author
Hall, Amanda M.
ORCID
Venue
Pain
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2011-05
Volume
152
Issue
5
Pages
1044-1051
ISSN
0304-3959 (ISSN-L)
DOI
10.1016/j.pain.2011.01.014
OpenAlex
W2052416153
Cited by
149
References
21
Citations by year
2026: 8 · 2025: 7 · 2024: 9 · 2023: 12 · 2022: 11 · 2021: 6 · 2020: 10 · 2019: 7 · 2018: 8 · 2017: 6 · 2016: 10 · 2015: 12 · 2014: 14 · 2013: 15 · 2012: 10
FWCI
10.07
Type
journal article
Language
en
Open access
closed
Locations
  • Pain (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Spine and Intervertebral Disc Pathology
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
Keywords
low back pain, pain-related disability, depression, stress, anxiety, psychological distress, mediation, subacute pain, exercise therapy, long-term disability
MeSH terms
Depression, Disability Evaluation, Persons with Disabilities, Humans, Longitudinal Studies, Pain Measurement, Psychiatric Status Rating Scales, Surveys and Questionnaires, Regression Analysis, Stress, Psychological, Time Factors, Low Back Pain

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review