Carrying a double burden: The impact of pain and gender-related stigma in women with chronic pelvic pain

Journal of Pain · 2026-02-26 · 1 citations

Joint call to action paper—Pain disparities special issues: Why this, why now? A unified call at a critical time

Journal of Pain · 2025-11-05

Emerging approaches to addressing longstanding inequities: Insights from the Journal of Pain special issue on pain disparities

Journal of Pain · 2025-07-29 · 1 citations

Internalized stigma mediates the relationship between pelvic pain severity and both depression and anxiety in women with chronic pelvic pain

Women s Health · 2025-06-24 · 3 citations

BACKGROUND: Chronic pelvic pain (CPP, i.e., pain related to the abdomen) disproportionately affects women, with about one in four women experiencing CPP worldwide. CPP has been found to be associated with numerous poor mental health outcomes (e.g., depression and anxiety). Prior research has indicated associations between CPP and stigma, yet much of this research has been qualitative. OBJECTIVES: The present study builds on that literature by quantitatively exploring associations between CPP severity and both depression and anxiety sensitivity, as well as exploring the moderating role of internalized stigma. DESIGN: Quantitative, cross-sectional design. METHODS: A sample of 241 adult women with CPP from the United States completed a series of questionnaires via an online survey. Hierarchical linear regression models and moderation analyses were used to determine associations among the variables of interest (i.e., CPP, depression, anxiety sensitivity, and internalized stigma). RESULTS: < 0.001). These associations were moderated by internalized stigma, such that the effects of depression and anxiety sensitivity on CPP severity were stronger in women who reported more internalized stigma. CONCLUSION: Clinical implications are that providers treating women with pelvic pain should screen them for emotional distress (e.g., depression and anxiety) and intervene and/or refer them as appropriate. Future work should continue to explore the role of internalized stigma in women with CPP, as well as explore potential interventions aimed at reducing stigma.

Joint call to action paper—Pain disparities special issues: Why this, why now? A unified call at a critical time.

Health Psychology · 2025-12-15 · 1 citations

As the gatekeepers of scientific knowledge, journal editors, reviewers, and study section members hold a profound responsibility for shaping what is valued and disseminated in our field. Achieving equity in pain science requires a critical reevaluation of how rigor is defined and applied, as well as a commitment to dismantling the biases embedded in academic publishing and peer review. The priorities described in this joint call to action paper outline a path toward a more inclusive and representative scientific record. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Promoting a foundation of resilience in older adults: pilot trial of a strengths-based positive psychology intervention for chronic low back pain

Health Psychology and Behavioral Medicine · 2024-12-05 · 5 citations

Introduction: Chronic low back pain (cLBP) is a global public health problem and a leading cause of disability among older adults. Recent years have seen a burgeoning interest in promoting resilience in individuals with chronic pain; however, therapeutic strategies that focus on positive psychological resources and individual strengths are understudied among older adult populations. The aim of this study was to examine the feasibility and acceptability of a resilience-promoting intervention among older adults with cLBP, and to assess preliminary treatment effects on pain severity, pain interference, and quality of life. Methods: Participants included 50 adults, ages ≥50 years, with back pain rated (at minimum) of moderate intensity and having a significant impact on daily activities. This single-arm trial included seven weekly group sessions targeting positive psychology concepts and techniques that have established benefits in pain management. Results: Results suggest high credibility and engagement in the intervention program. Participants found the weekly session content to be beneficial and global treatment satisfaction was high. Pain intensity (-4.3 [-6.14, -2.54]), pain interference (-3.3 [-4.83, -1.80]), depression (-1.6 [-3.16, -0.04]) and QoL-health satisfaction (0.3 [0.01, 0.55]) improved from pre- to post-intervention. At the 3-month follow-up, improvements were also observed for pain intensity (-2.1 [-9.29, -5.04]), pain interference (-5.3 [-6.54, -2.86]), and QoL-physical health (0.9 [0.11, 1.74]). Discussion: Results support the feasibility, acceptability, and potential efficacy of a resilience intervention for older adults with cLBP. These findings may be a step toward the advancement of therapeutic pain modalities and provide a foundation for future research on resilience-promoting interventions for aging populations with chronic pain.

Examining Reactivity and Recovery Patterns of Pain-Evoked Cortisol and Alpha-Amylase Trajectories: Relations Between Psychological Markers of Risk and Resilience

Journal of Pain · 2024-01-21 · 6 citations

Presence of endometriosis and chronic overlapping pain conditions negatively impacts the pain experience in women with chronic pelvic–abdominal pain: A cross-sectional survey

Women s Health · 2024-01-01 · 15 citations

Background: Evidence of overlap between endometriosis and chronic pain conditions is emerging; however, little is known about how the pain experience differs based on the presence or absence of endometriosis. Objectives: In a sample of women reporting chronic pelvic–abdominal pain (CPP), the aim of this study was to characterize differences in pain symptomatology between women with and without endometriosis and to examine the influence of chronic overlapping pain conditions (COPCs) on pain among these two groups. Design: This was a cross-sectional study, based on an online survey. Methods: Participants (aged 18+ years) completed a survey collecting pain diagnoses and symptoms assessing pelvic pain severity, pain interference, and pain impact. Independent sample t-tests, chi-square, and multiple linear regression models were employed to analyze group differences in pain symptomatology and COPCs. Results: Of the 525 respondents with CPP, 25% (n = 133) reported having endometriosis. Women with endometriosis were younger at the onset of pelvic pain, relative to women without endometriosis ( p = 0.04). There were no differences in age, race, ethnicity, or duration of pelvic pain between women with and without endometriosis. Women with endometriosis reported higher pelvic pain severity (+0.8, 95% CI = 0.4–1.1), pain interference (+5.9, 95% CI = 2.4–9.3), and pain impact (+1.9, 95% CI = 0.8–2.9). Endometriosis was associated with a higher number of COPCs ( p = 0.003), with 25% (n = 33) of women reporting ⩾3 overlapping pain conditions compared with 12% (n = 45) of those without endometriosis. Women with endometriosis had a higher frequency of fibromyalgia ( p &lt; 0.001), chronic fatigue syndrome ( p &lt; 0.001), and temporomandibular disorder ( p = 0.001). The number of COPCs was associated with higher pain severity, interference, and impact, independently of endometriosis. Conclusion: Women with endometriosis experienced higher levels of pain-related burden and COPCs compared with those without endometriosis. Pain intensity, interference, and impact increased with a higher number of pain conditions regardless of endometriosis presence.

Haves and have-nots: socioeconomic position improves accuracy of machine learning algorithms for predicting high-impact chronic pain

Pain · 2024-10-11 · 4 citations

ABSTRACT: Lower socioeconomic position (SEP) is associated with increased risk of developing chronic pain, experiencing more severe pain, and suffering greater pain-related disability. However, SEP is a multidimensional construct; there is a dearth of research on which SEP features are most strongly associated with high-impact chronic pain, the relative importance of SEP predictive features compared to established chronic pain correlates, and whether the relative importance of SEP predictive features differs by race and sex. This study used 3 machine learning algorithms to address these questions among adults in the 2019 National Health Interview Survey. Gradient boosting decision trees achieved the highest accuracy and discriminatory power for high-impact chronic pain. Results suggest that distinct SEP dimensions, including material resources (eg, ratio of family income to poverty threshold) and employment (ie, working in the past week, number of working adults in the family), are highly relevant predictors of high-impact chronic pain. Subgroup analyses compared the relative importance of predictive features of high-impact chronic pain in non-Hispanic Black vs White adults and men vs women. Whereas the relative importance of body mass index and owning/renting a residence was higher for non-Hispanic Black adults, the relative importance of working adults in the family and housing stability was higher for non-Hispanic White adults. Anxiety symptom severity, body mass index, and cigarette smoking had higher relevance for women, while housing stability and frequency of anxiety and depression had higher relevance for men. Results highlight the potential for machine learning algorithms to advance health equity research.

Pain Self-Management in Individuals With Chronic Musculoskeletal Pain During Lebanon's Overlapping Crises

Pain Management Nursing · 2024-10-04