Because psychological variables are known to intercorrelate, the goal of this investigation was to compare the unique association between several well-established psychological constructs in pain research and pain-related outcomes. Sex differences are considered because pain is experienced differently across sex groups. Participants were 456 consecutive chronic pain patients attending a tertiary pain clinic (mean age = 58.4 years, SD = 14.8, 63.6% women). The study design was cross-sectional. Psychological constructs included personality (NEO-Five Factor Inventory), irrational thinking (General Attitudes and Beliefs Scale), and coping (Social Problem Solving Inventory). Outcomes were pain severity and interference (Brief Pain Inventory) and physical, general, and mental health status (Short Form-36). To decide whether the bivariate analyses and the two-block, multivariate linear regressions for each study outcome (block 1 = age, sex, and pain severity; block 2 = psychological variables) should be conducted with the whole sample or split by sex, we first explored whether sex moderated the relationship between psychological variables and outcomes. An alpha level of 0.001 was set to reduce the risk of type I errors due to multiple comparisons. The moderation analyses indicated no sex differences in the association between psychological variables and study outcomes (all interaction terms p > .05). Thus, further analyses were calculated with the whole sample. Specifically, the bivariate analyses revealed that psychological constructs were intercorrelated in the expected direction and mostly correlated with mental health and overall perceived health status. In the regressions, when controlling for age, sex, and pain severity, psychological factors as a block significantly increased the explained variance of physical functioning (ΔR2 = .037, p < .001), general health (ΔR2 = .138, p < .001), and mental health (ΔR2 = .362, p < .001). However, unique associations were only obtained for mental health and neuroticism (β = − 0.30, p < .001) and a negative problem orientation (β = − 0.26, p < .001). There is redundancy in the relationship between psychological variables and pain-related outcomes and the strength of this association is highest for mental health status. The association between psychological characteristics and health outcomes was comparable for men and women, which suggests that the same therapeutic targets could be selected in psychological interventions of pain patients irrespective of sex.

中文翻译：

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个体差异和慢性疼痛的健康状况：性别差异是否相关？

因为已知心理变量是相互关联的，所以本研究的目的是比较疼痛研究中几种公认的心理构造与疼痛相关结果之间的独特关联。之所以考虑性别差异，是因为不同性别群体对疼痛的感受不同。参加该研究的有456位连续的慢性疼痛患者在三级疼痛诊所就诊（平均年龄= 58.4岁，SD = 14.8，女性占63.6％）。研究设计是横断面的。心理结构包括人格（NEO-五因素量表），非理性思维（一般态度和信念量表）和应对（社会问题解决量表）。结果是疼痛严重程度和干扰（简短疼痛清单）以及身体，总体和精神健康状况（简短表格36）。为了决定是否应对整个样本或按性别划分，对每个研究结果（区域1 =年龄，性别和疼痛的严重程度；区域2 =心理变量）进行双变量分析和两块多元线性回归，我们首先探讨了性别是否缓解了心理变量与预后之间的关系。设置为0.001的alpha级别可减少由于多次比较而导致的I型错误的风险。适度分析表明，心理变量与研究结果之间的关联没有性别差异（所有相互作用项p> .05）。因此，对整个样品进行了进一步的分析。具体来说，双变量分析表明，心理结构在预期的方向上是相互关联的，并且主要与心理健康和整体感知的健康状况相关。在回归分析中，当控制年龄，性别和疼痛严重程度时，心理因素作为一个整体显着增加了解释的身体机能的变化（ΔR2= .037，p <.001），总体健康状况（ΔR2= .138，p < .001）和精神健康（ΔR2= .362，p <.001）。但是，仅在心理健康和神经质（β=-0.30，p <.001）和负面问题倾向（β=-0.26，p <.001）方面获得独特的关联。心理变量与疼痛相关的结果之间存在冗余关系，这种关联的强度对于心理健康状况是最高的。