Positive Affect, Resilience, and Pain in MS With Chronic Pain

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MS tablet
Resilience may mediate the relationships between positive affect and pain interference and depression in patients with multiple sclerosis.

Resilience may mediate the relationships between positive affect, pain interference, and depression in patients with multiple sclerosis (MS), according to a study presented at the 2018 American Pain Society Annual Meeting, held March 4-6 in Anaheim, California.

“Much is known about the associations between negative factors and adjustment to chronic pain,” noted the study investigators, “However, less is known about how protective/promotive factors, such as positive affect and resilience, relate to disability and mood in MS.”

In this study, 455 patients with MS and chronic pain were evaluated to determine whether positive affect and/or resilience moderates the association between pain intensity and function (eg, depressive symptoms, pain interference) and whether resilience mediates the relationship between positive affect and function.

Using an ongoing longitudinal survey, investigators obtained self-reported data from participants for the duration of the study. After controlling for disease- and demographic-related variables and negative affect, resilience and positive affect were not found to moderate the association between pain interference and pain intensity (β positive affect=.01; P =.86; β resilience=.04; P =.33) or the association between depressive symptoms and pain intensity in this cohort (β positive affect=.01; P =.79; β resilience=-.02; P =.60). Resilience was found to mediate the association between positive affect and pain interference and depression (abPAIN INTERFERENCE=−.03; P =.03; abDEPRESSION=−.13; P <.001).

Due to the cross-sectional nature of this study, neither the causality nor the directionality of the observed associations can be established.

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“The results suggest that [positive affect] may be indirectly related to pain interference and depressive symptoms via resilience, rather than serving a protective function,” commented the investigators, adding “Findings indicate that research examining the potential benefits of increasing [positive affect] and resilience in individuals with MS and chronic pain is warranted.”

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Arewasikporn A, Turner A, Alschuler K, Ehde D, Jensen M. Positive affect, resilience, and function in adults with multiple sclerosis and chronic pain. Presented at: 2018 American Pain Society annual meeting. Anaheim, California. March 4-6, 2018. Abstract 167.