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Race/ethnicity moderates the association between psychosocial resilience and movement-evoked pain in knee osteoarthritis (Extended Abstract)

Emily J. Bartley, PhD1, Nadia I. Hossain, BS, BA2, Clarence C. Gravlee, PhD3, Kimberly T. Sibille, PhD1, Ellen L. Terry, PhD1, Ivana A. Vaughn, PhD, MPH1, Josue S. Cardoso, BS1, Staja Q. Booker, PhD, RN1, Toni L. Glover, PhD, GNP, ACHPN4, Burel R. Goodin, PhD5, Adriana Sotolongo, MPH5,  Kathryn A. Thompson, BS5, Hailey W. Bulls, PhD6, Roland Staud, MD, Jeffrey C. Edberg, PhD5, Laurence A. Bradley, PhD5, & Roger B. Fillingim, PhD1

1 University of Florida, Pain Research and Intervention Center of Excellence, Gainesville, FL
2 Harvard School of Dental Medicine, Boston, Massachusetts
3 University of Florida, Gainesville, Florida
4 Oakland University, Rochester, Michigan
5 University of Alabama at Birmingham, Birmingham, Alabama 6 Moffitt Cancer Center, Tampa, Florida

Corresponding Author: Emily J. Bartley, PhD, University of Florida, Email: EBartley@dental.ufl.edu

Source: (published online March 2019). Race/ethnicity moderates the association between psychosocial resilience and movement-evoked pain in knee osteoarthritis. ACR Open Rheumatology. doi:10.1002/acr2.1002 

Introductory Statement: The following extended abstract is of a multi-center study on the importance of understanding the psychosocial factors of race and ethnicity in promoting resilience for mitigating knee osteoarthritis pain.

Race/ethnicity moderates the association between psychosocial resilience and movement-evoked pain in knee osteoarthritis (Extended Abstract)

Objective: Racial/ethnic disparities in pain are well recognized, with non-Hispanic Blacks (NHB) experiencing greater pain severity and pain-related disability than non-Hispanic Whites (NHW). While numerous risk factors are posited as contributors to these disparities, there is limited research addressing how resilience differentially influences pain and functioning across race/ethnicity. Therefore, this study examined associations between measures of psychosocial resilience, clinical pain, and functional performance among adults with knee osteoarthritis (OA), and assessed the moderating role of race/ethnicity on these relationships. 

Methods: In a secondary analysis of the Understanding Pain and Limitations in Osteoarthritic Disease (UPLOAD-2) study, 201 individuals with knee OA (NHB=105, NHW=96) completed measures of resilience (i.e., trait resilience, optimism, positive well-being, social support, positive affect) and clinical pain, as well as a performance-based measure assessing lower-extremity function and movement-evoked pain. 

Results: Bivariate analyses showed that higher levels of psychosocial resilience were associated with lower clinical pain and disability and more optimal physical functioning. NHBs reported greater pain and disability, poorer lower-extremity function, and higher movement-evoked pain compared to NHWs; however, measures of psychosocial resilience were similar across race/ethnicity. Figure 1 illustrates the associations between measures of psychosocial resilience and race/ethnicity for movement-evoked pain. As depicted in Figure 1A and 1B, lower levels of optimism and positive well-being were associated with higher movement-evoked pain for NHBs. For NHWs (Figure 1C), lower positive affect was associated with attenuated movement-evoked pain. 

 

Figure 1. Interaction of psychosocial resilience measures and race/ethnicity for movement-evoked pain

Conclusion: Our findings underscore the importance of psychosocial resilience on OA-related pain and function and highlight the influence of race/ethnicity on the resilience-pain relationship. Treatments aimed at targeting resilience may help mitigate racial/ethnic disparities in pain.

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