Psychological stress and musculoskeletal pain: the moderating effect of childhood and adulthood trauma

Doctoral thesis English OPEN
Woodward, April (2015)
  • Subject: R1

The aetiology of widespread musculoskeletal pain is complex. Psychological stress is a robust predictor of symptom onset and persistence but not everyone who experiences stress goes on to develop widespread pain. The aim of the studies presented in this thesis was to as... View more
  • References (79)
    79 references, page 1 of 8

    2.2 Trauma and widespread pain .............................................................................18 2.2.1 Trauma: Definition and history........................................................................18 2.2.2 Childhood interpersonal trauma .....................................................................21 2.2.3 Adult physical trauma.....................................................................................32

    2.3 Psychological stress and widespread pain .........................................................38 2.3.1 Defining and assessing psychological stress..................................................38 2.3.2 The relationship between widespread pain and life events, anxiety, depression, somatisation and sleep problems .............................................40

    2.4 Theoretical models of trauma and widespread pain ...........................................45 2.4.1 Diathesis stress models .................................................................................45 2.4.2 A model of trauma exposure and physical health ...........................................47

    2.5 Trauma diathesis stress model of widespread pain ............................................50 2.5.1 Direct relationship: Psychological stress and widespread pain .......................51 2.5.2 Mediators of the stress pain relationship ........................................................54 a) Biological mediators of the stress pain relationship ...........................................54

    2.5.3 Moderators of the stress pain relationship......................................................65

    2.5.4 Summary of the trauma diathesis stress model of widespread pain ...............71

    5.4 GPSS study questionnaire .................................................................................96 5.4.1 Demographic details ......................................................................................97 5.4.2 Assessment of pain........................................................................................97 5.4.3 Assessment of childhood abuse.....................................................................98 5.4.4 Assessment of psychological stress.............................................................100 5.4.5 Potential mediators ......................................................................................102

    4.6 Structural equation modelling (SEM) ..................................................................81 4.6.1 Latent variables..............................................................................................84 4.6.2 Basic predictor outcome models ....................................................................87 4.6.3 Moderation models.........................................................................................88 4.6.4 Mediation models...........................................................................................89 4.6.5 Moderated Mediation models .........................................................................90 4.6.6 The influence of baseline pain in prospective modelling .................................90

    7.2 Participant characteristics and association with baseline number of pain sites.118 7.2.1 Number of pain sites ....................................................................................118 7.2.2 Association between number of pain sites at baseline and covariates..........119

    7.3 Participant characteristics and association with follow up number of pain sites 123 7.3.1 Number of pain sites at follow up .................................................................123 7.3.2 Association between number of pain sites at follow up and covariates.........123

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