BACKGROUND Chronic pain is associated with significant physical and psychological impairments across the adult lifespan. However, there is a relative gap in knowledge on individual differences that predict pain-related functioning. The current study highlights one important source of individual variation: age. METHODS Using cross-sectional data from a large treatment-seeking cohort of 2,905 adults (M age = 46.6 [13.1]; 71.8 % female) presenting to a tertiary pain center in the United Kingdom (UK), we sought to determine age differences in cognitive-affective processes (catastrophizing, acceptance, self-efficacy), including their differential patterns and effects on disability and depression. RESULTS Older adults (ages 65- 75) were found to experience higher pain acceptance and pain self-efficacy compared to both middle-aged (ages 40-64) and young adult (ages 18-39) age groups. Older adults also experienced lower levels of catastrophizing compared to middle-age adults. Testing age as a moderator, we found that the relationships of pain self-efficacy and acceptance with depression as well as the relationship between pain self-efficacy and disability were comparatively weakest among older adults and strongest among young adults. Similarly, the relationship between pain catastrophizing and depression was relatively stronger for young and middle-aged adults compared to older adults. CONCLUSIONS Age-related differences in psychological mechanisms that influence pain-related functioning present unique challenges and opportunities for scientists and clinicians to improve our understanding and treatment of pain across the lifespan. Additional work is needed to refine our knowledge of age-related differences in cognitive-affective, biopsychosocial dimensions of chronic pain and to develop and test the efficacy of age-tailored interventions.

中文翻译：

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慢性疼痛成人认知-情感过程的年龄差异

背景技术慢性疼痛与整个成年期的显着生理和心理损伤有关。然而，在预测疼痛相关功能的个体差异方面的知识存在相对差距。目前的研究强调了个体差异的一个重要来源：年龄。方法 使用来自英国 (UK) 三级疼痛中心的 2,905 名成人（M 年龄 = 46.6 [13.1]；71.8% 女性）的大型寻求治疗队列的横断面数据，我们试图确定认知情感过程（灾难化、接受、自我效能），包括它们的不同模式以及对残疾和抑郁症的影响。结果发现，与中年（40-64 岁）和青年（18-39 岁）年龄组相比，老年人（65-75 岁）的疼痛接受度和疼痛自我效能感更高。与中年人相比，老年人所经历的灾难性程度也较低。以年龄作为调节因素，我们发现疼痛自我效能感和接受与抑郁的关系以及疼痛自我效能感与残疾之间的关系在老年人中相对最弱，在年轻人中最强。同样，与老年人相比，年轻人和中年人的疼痛灾难性和抑郁之间的关系相对更强。结论 影响疼痛相关功能的心理机制的年龄相关差异为科学家和临床医生提供了独特的挑战和机会，以提高我们对整个生命周期的疼痛的理解和治疗。还需要做更多的工作来完善我们对慢性疼痛的认知情感、生物心理社会维度方面与年龄相关的差异的认识，并开发和测试针对年龄的干预措施的功效。