Mediating Effect of Psychological Inflexibility, Insomnia, and Resilience on the Association Between Pain and Depression Among Patients With Chronic Pain

Abstract

Objective Chronic pain, impacting roughly 20% of the population, significantly affects quality of life and productivity. This study explored the mediating effects of psychological inflexibility, insomnia, and resilience on the association between pain and depression in patients with chronic pain.Methods Data on demographics, pain characteristics, and psychological factors were obtained through an online survey involving 100 patients from the Asan Medical Center Pain Clinic. Measures included the Patient Health Questionnaire-9, Insomnia Severity Index (ISI), Acceptance and Action Questionnaire-II (AAQ-II), and Brief Resilience Scale (BRS). Statistical analyses involved correlation, linear regression, and mediation analyses.Results A linear regression analysis revealed that the severity of depression was predicted by pain severity (β=0.18, p=0.018), ISI (β=0.22, p=0.010), AAQ-II (β=0.32, p<0.001), and BRS (β=-0.28, p=0.002). The mediation analysis showed that pain severity directly influenced depression severity. This relationship was partially mediated by ISI, AAQ-II, and BRS.Conclusion This study underscores the necessity for holistic approaches in chronic pain management that address the mediating effect of psychological factors. Targeted interventions focusing on insomnia, psychological inflexibility, and resilience can significantly enhance mental health outcomes for patients with chronic pain.