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Broadening the Understanding of Resiliency in Chronic Pain (Abstract)

Emily J. Bartley, PhD, Michael E. Robinson, PhD, & Roger B. Fillingim, PhD
University of Florida, Gainesville, FL

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

Background: A burgeoning literature supports the adaptive benefits of resilience among older adults with chronic pain. While numerous factors (e.g., optimism, hope) confer resilience, prior research has largely examined these measures in isolation, despite evidence of their additive and synergistic effects. The extent to which various resilience factors overlap, or are distinct in relation to pain, has received limited attention. 

Methods: Sixty older adults (ages 60-93) with chronic low back pain (CLBP) completed measures of resilience (hope, optimism, positive affect, grit, gratitude, pain acceptance, pain self-efficacy), pain (interference, physical function), and psychological vulnerability (depression, anxiety, perceived stress). Principal components analysis (PCA) was conducted to characterize the set of resilience measures, followed by hierarchical multiple regression analysis to examine factors that contributed independently to pain and psychological outcomes. 

Results: PCA resulted in a two-factor solution that accounted for 70.9% of the variance: Psychological resilience and pain resilience. While both factors were significantly associated with depression, anxiety, and stress (all ps<.01), Pain resilience was the only factor that contributed to pain interference and physical function (all ps<.001).

Conclusions: Targeting psychological resilience may be insufficient for improving pain outcomes in CLBP. Addressing mechanisms of pain-specific resiliency may optimize interventions for older adults with chronic pain.

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