Protective and Risk Factors at the Intersection of Chronic Pain, Depression, Anxiety, and Somatic Amplification: A Latent Profile Approach
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Objective: Research indicates a complex nexus between chronic pain, depression, anxiety, and somatic amplification (PDAS) symptoms, marked by high rates of co-morbidity and mutually maintaining mechanisms. Although recent frameworks have attempted to explain co-occurrence rates of pain and other comorbid disorders, the interrelations between PDAS and their impacts on pain outcomes have not been adequately examined with a person-centered approach. Using nationally representative data, this study assessed the heterogeneity in PDAS symptomatology and examined links among risk and protective factors in different profiles. Methods: Data were derived from 1027 participants in the National Survey of Midlife Development in the United States (MIDUS) who completed telephone interviews or self-report measures that assessed PDAS, various sources of social supports (family, friends, spouses/partners, religion, coworkers, and supervisors), and the number of healthcare visits. Results: We found heterogeneity in symptom severity rather than symptom type across classes over time. Regardless of comorbidity severity, people reported similar levels of somatic symptoms, which may help clinicians more effectively diagnose comorbidity issues among chronic pain patients. As PDAS symptomatology increased by group, the perceived levels of social support decreased. Membership in a higher symptom severity class was associated with being female, younger age, and an increase in medical, but not mental health visits. Limitations: Limitations included the use of a cross-sectional design, reliance on self-report measures, and a sample largely comprised of Whites. Conclusion: PDAS co-occurs across classes, which may relate to shared risk and protective factors. This study lays the foundation to investigate similar questions for overlapping symptoms that occur during the same period, which would shed light on whether—among middle to older age adults—these disorders are attributable to a common mechanism and if they may inform transdiagnostic treatments. Keywords: chronic pain, depression, anxiety, somatic amplification, comorbidity, transdiagnostic
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PATH serves any adult with high impact chronic pain, who typically have a wide variety of musculoskeletal degenerative diseases coupled with comorbid mental health challenges.
“PATH serves any adult with HICP, so they have a wide variety of musculoskeletal degenerative diseases coupled with comorbid mental health challenges, typical of a high impact chronic pain population.11,12”
From Overview and Feasibility of a Novel Transdisciplinary Integrative Approach to High Impact Chronic Pain in Vermont (2024) · cites this paper as [12]
The Introduction describes chronic pain as heterogeneous and discusses its co-occurrence with affective disorders; the Discussion reports groups differing in pain, depression, anxiety, and somatic symptoms. The paper does not establish that PATH serves any adult with high-impact chronic pain or that its patients typically have musculoskeletal degenerative diseases. Its Methods describe a separate sample of employed adults with chronic pain. (LLM, conf=0.86)
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Decoding pain and mental health patterns in youth with chronic pain during COVID-19
Nishat, F., Brennenstuhl, S., MacKenzie, N. E., Tariq, S., Birnie, K. A., Noel, M. E., Lalloo, C., Soltani, S., & Stinson, J. (2026) · Frontiers in Pain Research · doi:10.3389/fpain.2026.1760356
Racing Against Time: Understanding the Temporal Dynamics of Anxiety and Depression in Chronic Pain
Srinivasan, V. S. V., Lima, S., Mathis, V., & Yalçın, İ. (2026) · Neuromethods · doi:10.1007/978-1-0716-5312-8_14
- Authors
- Kim, S., Lee, J., & Boone, D.
- Affiliations
- Texas Tech University (US)
- Johns Hopkins All Children's Hospital (US)
- Corresponding author
- Kim, ShinYe
- Venue
- Journal of Pain Research
- Publisher
- Informa UK Limited
- Published
- 2022-04
- Volume
- Volume 15
- Pages
- 1107-1121
- ISSN
- 1178-7090 (ISSN-L)
- PMC
- PMC9018014
- OpenAlex
- W4224044803
- Cited by
- 26
- References
- 72
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 9 · 2023: 5
- FWCI
- 3.42
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of Pain Research (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Keywords
- chronic pain, depression, anxiety, comorbidities, risk and protective factors, latent profiles, social support, medical visits, transdiagnostic treatment, middle-aged and older adults
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