The DOI matches its Crossref record; 19 of the 21 references it cites were found in a registry or an index.
Symptoms of depression and stress mediate the effect of pain on disability
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.
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“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]
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Cites
Baron, R. M., & Kenny, D. A. (1986) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.51.6.1173 · Cited by 91,532
A Study of the Natural History of Back Pain: Part I
ROLAND, M., & MORRIS, R. (1983) · Spine · doi:10.1097/00007632-198303000-00004 · Cited by 3,395 · cited 1×
“Each item that is answered ‘‘yes’’ is scored 1 point, with scores ranging from 0, representing ‘‘no disability,’’ to 24, representing ‘‘extremely severe disability’’ [12].”
Outline of a fear-avoidance model of exaggerated pain perception--I.
Lethem, J., Slade, P. D., Troup, J. D. G., & Bentley, G. (1983) · Behaviour Research and Therapy · doi:10.1016/0005-7967(83)90009-8 · Cited by 1,327
Koes, B. W., van Tulder, M. W., Lin, C. C., Macedo, L. G., McAuley, J. H., & Maher, C. G. (2010) · European Spine Journal · doi:10.1007/s00586-010-1502-y · Cited by 1,301
Self-citationDiagnosis and treatment of low back pain
Koes, B. W., van Tulder, M. W., & Thomas, S. (2006) · BMJ · doi:10.1136/bmj.332.7555.1430 · Cited by 1,287
The Prevalence of Low Back Pain: A Systematic Review of the Literature from 1966 to 1998
Walker, B. F. (2000) · Journal of Spinal Disorders · doi:10.1097/00002517-200006000-00003 · Cited by 1,143
Acute low back pain: systematic review of its prognosis
Pengel, L. H. M., Herbert, R., Maher, C. G., & Refshauge, K. M. (2003) · BMJ · doi:10.1136/bmj.327.7410.323 · Cited by 874
Self-citationClinically important outcomes in low back pain
Ostelo, R. W. J. G., & de Vet, H. C. W. (2005) · Best Practice & Research Clinical Rheumatology · doi:10.1016/j.berh.2005.03.003 · Cited by 840
Disability Resulting From Occupational Low Back Pain
Frank, J. W., Brooker, A., DeMaio, S. E., Kerr, M. S., Maetzel, A., Shannon, H. S., Sullivan, T. J., Norman, R. W., & Wells, R. P. (1996) · Spine · doi:10.1097/00007632-199612150-00025 · Cited by 582
Henschke, N., Maher, C. G., Refshauge, K. M., Herbert, R., Cumming, R. G., Bleasel, J. F., York, J., Das, A., & McAuley, J. H. (2008) · BMJ · doi:10.1136/bmj.a171 · Cited by 555
Self-citationFear avoidance and prognosis in back pain: A systematic review and synthesis of current evidence
Pincus, T., Vogel, S. K., Burton, K. A., Santos, R., & Field, A. P. (2006) · Arthritis & Rheumatism · doi:10.1002/art.22273 · Cited by 262
Low Back Pain and Best Practice Care
Williams, C. M. (2010) · Archives of Internal Medicine · doi:10.1001/archinternmed.2009.507 · Cited by 262
Clinical Course and Prognostic Factors in Acute Low Back Pain
Grotle, M., Brox, J. I., Veierød, M. B., Glomsrød, B., Lønn, J. H., & Vøllestad, N. K. (2005) · Spine · doi:10.1097/01.brs.0000158972.34102.6f · Cited by 202
Physiotherapist-Directed Exercise, Advice, or Both for Subacute Low Back Pain
Pengel, L. H. M., Refshauge, K. M., Maher, C. G., Nicholas, M. K., Herbert, R., & McNair, P. J. (2007) · Annals of Internal Medicine · doi:10.7326/0003-4819-146-11-200706050-00007 · Cited by 152
Self-citationPsychosocial Interventions for Low Back Pain in Primary Care
van der Windt, D., Hay, E. M., Jellema, P., & Main, C. J. (2008) · Spine · doi:10.1097/brs.0b013e31815e39f9 · Cited by 136
Deyo, R. A. (1998) · Scientific American · doi:10.1038/scientificamerican0898-48 · Cited by 114
Psychosocial approaches to the prevention of chronic pain: the low back paradigm
Kendall, N. A. S. (1999) · Best Practice & Research Clinical Rheumatology · doi:10.1053/berh.1999.0044 · Cited by 110
Gibbs, W. W. (1998) · Scientific American · doi:10.1038/scientificamerican1298-48 · Cited by 52
Shaw, W. S., Pransky, G., & Winters, T. H. (2009) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0b013e318192bcf8 · Cited by 48
Cited by
Sorted by citations
The role of psychosocial processes in the development and maintenance of chronic pain
Edwards, R. R., Dworkin, R. H., Sullivan, M. D., Turk, D. C., & Wasan, A. D. (2016) · The Journal of Pain · doi:10.1016/j.jpain.2016.01.001 · Cited by 954
Hannibal, K. E., & Bishop, M. D. (2014) · Physical Therapy · doi:10.2522/ptj.20130597 · Cited by 729
Evaluating psychosocial contributions to chronic pain outcomes
Meints, S. M., & Edwards, R. R. (2018) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2018.01.017 · Cited by 719
Neck pain: global epidemiology, trends and risk factors
Kazeminasab, S., Nejadghaderi, S. A., Amiri, P., Pourfathi, H., Araj-Khodaei, M., Sullman, M. J. M., Kolahi, A., & Safiri, S. (2022) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-021-04957-4 · Cited by 683
Lee, H., Hübscher, M., Moseley, G. L., Kamper, S. J., Traeger, A. C., Mansell, G., & McAuley, J. H. (2015) · Pain · doi:10.1097/j.pain.0000000000000146 · Cited by 526
Self-citation
Metadata
- 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.
- Venue
- Pain
- Published
- 2011-05
- Volume
- 152
- Issue
- 5
- Pages
- 1044-1051
- ISSN
- 0304-3959 (ISSN-L)
- 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 › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Orthopedics and Sports 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
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