Clustering of Social and Physical Pain Variables and Their Association With Mortality in Two Population-Based Cohorts

Bibliographic Data

ID19306228
AuthorsCandyce H Kroenke (0000-0002-6128-3118, Kaiser Permanente, corresponding author), Stacey E Alexeeff (0000-0001-8988-6976), Stacey Alexeeff, Lawrence H Kushi (0000-0001-9136-1175), Marilyn L Kwan (0000-0001-8863-3950), Karen A Matthews (0000-0001-8193-2202)
Year2021
Volume83
Issue3
Pages228-238
Publication date2021-04-01
Open AccessNo
TypeARTICLE
VenuePsychosomatic Medicine (JOURNAL)
Journal identifiersISSN: 0033-3174 • E-ISSN: 1534-7796
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/psy.0000000000000910
PMID33793454
OpenAlexW3123748060
LanguageEN
Citations received1
References cited35

OBJECTIVE: Social pain and physical pain are related bidirectionally, but how these variables cluster in the population is unknown. METHODS: This study included 2833 women from the Study of Women's Health Across the Nation (SWAN), a community-based cohort of middle-aged women, and 3972 women from the Pathways Study, a population-based cohort of women diagnosed with American Joint Committee on Cancer stages I-IV breast cancer diagnosed between 2005 and 2013. Women provided data on measures related to social pain (social network size, social support, loneliness, social well-being) and physical pain (sensitivity to pain, bodily pain) at study baseline. Analyzing each cohort separately, we used latent class analysis to evaluate social-physical pain clusters, logistic regression to evaluate predictors of categorization into clusters, and Cox proportional hazards models to evaluate associations of clusters with all-cause mortality. We also performed a meta-analysis to combine cohort mortality associations. RESULTS: Each cluster analysis produced a "low social-physical pain" cluster (SWAN, 48.6%; Pathways, 35.2%) characterized by low social and pain symptoms, a "high social-physical pain" cluster (SWAN, 17.9%; Pathways, 17.9%) characterized by high symptoms, and a "low social/high physical pain" cluster of women with high pain and compromised social functioning but otherwise low social symptoms (SWAN, 33.5%; Pathways, 46.9%). In meta-analysis, categorization into the high social-physical pain cluster was associated with elevated mortality (adjusted hazard ratio = 1.34, 95% confidence interval = 1.05-1.71, Q statistic = 0.782), compared with those in the low social-physical pain cluster. CONCLUSIONS: In two cohorts of women, latent class analysis produced similar sets of social-physical pain clusters, with the same proportion having both high social and pain symptoms; women in this cluster had elevated mortality.

Cohort · Cohort study · Confidence interval · Hazard ratio · Latent class model · Physical therapy · Population · Proportional hazards model · Cancer survivorship and care · Death Anxiety and Social Exclusion · Demography · Health disparities and outcomes · Internal Medicine · Medicine · Psychology

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