Pain-related anxiety mediates the relationship between depressive symptoms and pain interference in veterans with hepatitis C

Melissa H. Adams, Travis I. Lovejoy, Dennis C. Turk, Steven K. Dobscha, Peter Hauser, Benjamin J. Morasco

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Objective: Depression and chronic pain are common in persons chronically infected with the hepatitis C virus (HCV), although little is known about the rate of co-occurrence or mechanisms by which they are associated. We evaluated whether pain-related anxiety mediates the relationship between depressive symptoms and pain-related physical functioning in patients with HCV. Methods: Patients with HCV (n = 175) completed self-report measures assessing demographic characteristics, pain-related function and mental health. Path analyses examined direct effects of cognitive-affective and somatic symptoms of depression on pain interference and indirect effects of these relationships via four subscales of the Pain Anxiety Symptoms Scale-20. Results: Cognitive-affective and somatic symptoms of depression were positively and significantly related to pain interference. Pain-related anxiety mediated the relationship between both cognitive-affective and somatic symptoms of depression, and this mediation was predominantly accounted for by the escape-avoidance component of pain-related anxiety. Conclusions: Findings indicate a potential mediating role of pain-related anxiety, particularly escape-avoidance anxiety, on the relationship between depression and pain interference in patients with HCV. These findings suggest that escape-avoidance anxiety may be a particularly germane target for treatment in patients with HCV and chronic pain, particularly when depression, with characteristic features of withdrawal and inhibition, is a comorbid condition.

Original languageEnglish (US)
Pages (from-to)533-537
Number of pages5
JournalGeneral Hospital Psychiatry
Volume37
Issue number6
DOIs
StatePublished - Nov 2015

Keywords

  • Chronic pain
  • Comorbidity
  • Depression
  • Hepatitis C virus
  • Pain-related anxiety

ASJC Scopus subject areas

  • Psychiatry and Mental health

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