Effects of Individual Psychological Factors and Cumulative Psychological Distress on Prospective Pain Quality in Older Adults With Chronic Low Back Pain
Bibliographic record
Abstract
OBJECTIVE: Although pain quality may be a component of the geriatric chronic pain experience that influences disability, no research has investigated the psychological underpinnings of pain quality in any geriatric chronic pain population. We sought to address this knowledge gap by examining associations between both general (ie, depressive symptoms) and pain-specific psychological risk factors (ie, fear-avoidance beliefs, pain catastrophizing, and kinesiophobia) and prospective pain quality in older adults with chronic low back pain. METHODS: Questionnaires for each psychological factor were collected at baseline, while pain quality was measured by the McGill Pain Questionnaire at baseline and 12 months. Preliminary analyses identified pain catastrophizing as the individual factor with the highest correlation to future pain quality for subsequent analyses. To assess if baseline psychological factors were cumulatively associated with 12-month pain quality, questionnaire values were entered into principal component analysis to yield a combined psychological component score. Robust regression models with HC3 standard errors were used to examine associations between baseline psychological risk factors (both individually and cumulatively) and prospective pain quality. RESULTS: In adjusted analyses, higher baseline pain catastrophizing independently predicted worse pain quality at 12 months ( b =0.342, t =4.225, P <0.001). Similarly, higher baseline psychological component scores were independently associated with worse prospective pain quality after adjustment ( b =3.816, t =4.518, P <0.001). DISCUSSION: The combined psychological component score had comparatively stronger predictive ability than pain catastrophizing alone; however, overall model prediction was modest, suggesting that future research is needed to identify other biopsychosocial variables that may impact pain quality in the geriatric chronic LBP population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.012 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".