Associations between pain intensity, psychosocial factors, and pain-related disability in 4285 patients with chronic pain, Live Landmark et al, 2024

Abstract:

Pain, a widespread challenge affecting daily life, is closely linked with psychological and social factors.

While pain clearly influences daily function in those affected, the complete extent of its impact is not fully understood.

Given the close connection between pain and psychosocial factors, a deeper exploration of these aspects is needed.

In this study, we aim to examine the associations between psychosocial factors, pain intensity, and pain-related disability among patients with chronic pain.

We used data on 4285 patients from the Oslo University Hospital Pain Registry, and investigated pain-related disability, pain intensity, pain catastrophizing, psychological distress, perceived injustice, insomnia, fatigue, and self-efficacy.

We found significant associations between all psychosocial variables and pain-related disability, even after adjusting for demographic factors.

In the multiple regression model, sleep problems and pain intensity were identified as primary contributors, alongside psychological distress, and fatigue.

Combined, these factors accounted for 26.5% of the variability in pain-related disability, with insomnia and pain intensity exhibiting the strongest associations.

While the direction of causation remains unclear, our findings emphasize the potential of interventions aimed at targeting psychosocial factors.

Considering the strong link between psychosocial factors and pain-related disability, interventions targeting these factors—particularly insomnia—could reduce disability and enhance quality of life in those who suffer.

https://www.nature.com/articles/s41598-024-64059-8

 

A little puzzle for you Trish. What mantra do you remember that goes:
A B A B,
B B A A,
A C A C,
C C A A

with some jingly bells, drums and stuff.

 

Aside from the clownery of having significant digits on such a probability (why not 5 significant digits? why not 10 while you're at it? it's not as if this number is anywhere close to be accurate or relevant), the idea that it doesn't matter what the direction of causality is, that you can simply assume that it works the traditional way and not bother any further would pretty much give Socrates 4 heart attacks, two emboli and probably a testicular torsion for good measure.

Is clinical psychology / psychosomatic medicine the only discipline to have simply decided to completely ignore "correlation is not causation"? Because this isn't just stats 101, it's stuff covered in the first class and the first chapters of every stats 101 class. No one else does anything this ridiculous. Certainly not building an entire concept on it about correlations that are far more likely to be the other way around. This is all just because of traditional beliefs, identical to creation myths in intent and purpose.

I mean they actually flag insomnia without giving a nanosecond of thought to the fact that when chronic pain is involved, it is the cause of insomnia. And they actually reason out of this that if they address the insomnia, they treat the pain. This is literally insane, complete wackadoodle stuff.

And Nature publishes stuff like this? The crisis of validity in science is outrageously bad and growing.

 

I'm pretty sure we played it on recorder at junior school, only with piano and shaky eggs.

 

This

 

They label "insomnia" and "fatigue" as "psychosocial" factors, without any explanation as to why these should be considered "psychosocial", rather than some other categorization. Then they find that these factors (unsurprisingly) might influence pain and how much it interferes with your life. Then they conclude that this means that "psychosocial factors are important in pain".

This is circular reasoning. Why should fatigue be considered a primarily psychosocial phenomena and not a biological one? What is the reasoning behind this? Because it fits the narrative they are trying to push, that psychosocial factors are important. They are creating "evidence" to support the conclusion they have already arrived at.

There's also the problem that has been discussed already, about how they seem to think that the direction of causality is not very important, and that they can interpret the direction of causality in their preferred direction without any strong justification, other than "this is what fits with our own preconceived notions".

This article is probably supposed to be a part of Live Landmarks PhD, so this is her justification as to why research into interventions that target psychosocial factors should be prioritized (such as her own study on the Lightning Process).

Confirmation bias disguised as research, is what this is.