The Structural Model of Chronic Pain Based on Mindfulness, Social Support and Life Events with the Mediating Role of Psychological Distress and Pain Catastrophizing

Chronic pain results from a complex interaction of biological, psychological and social factors that causes the experience of pain. The purpose of this research was to identify the structural model of chronic pain based on mindfulness, social support and life events with the mediating role of psychological distress and pain catastrophizing.

This was a descriptive-correlational study with structural equation modeling. The study population included all patients suffering from chronic pain with musculoskeletal and rheumatoid arthritis related pain, which had referred to Tehran medical centers for follow-up in 2023. A total of 496 people were selected using the convenience sampling method. They completed the McGill Pain Questionnaire (1957), the Bauer Five Factor Mindfulness Questionnaire (2006), the Perceived Social Support of Zimmet et al. (1988), the Pickel's Stressful Life Events (1971), the Leviband's Depression, Anxiety and Stress Questionnaire (1995) and the Pain Catastrophizing Scale of Sullivan et al. (1995). Research data were analyzed using SPSS-26 and AMOS-23 softwares using Pearson correlation coefficient and structural equation modeling.

The results of the structural equation model indicated that this model fits the experimental data well. The direct effects of the standard pathway mindfulness coefficient and the amount of stressors on chronic pain were significant (p<0.01) and the direct effects of social support and the number of stressors for chronic pain was insignificant. Additionally, the effects of standard indirect path coefficients for mindfulness, social support and the number and the amount of stressors with the mediating role of psychological distress and pain catastrophizing on chronic pain was significant (p<0.01).

Mindfulness, social support and life events play an important role in explaining chronic pain through the mediation of psychological distress and pain catastrophizing. Therefore, the findings of this study can be used in more detailed planning of psychotherpeutic interventions for patients with chronic pain.