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J Consult Clin Psychol. 2018 Mar;86(3):231-241. doi: 10.1037/ccp0000283.

Satisfaction with life moderates the indirect effect of pain intensity on pain interference through pain catastrophizing.

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Hand and Upper Extremity Service, Massachusetts General Hospital.
Department of Orthopedic Surgery, Dell Medical School, The University of Texas at Austin.
Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital.



Satisfaction with life buffers the effect of stress on health, but its role in the mechanism through which pain may impact engagement in activities of daily living is not known. We tested whether satisfaction with life protects against engaging in pain catastrophizing and through this explains individual differences in the extent to which pain interferes with activities of daily living.


One-hundred and 42 patients with upper extremity musculoskeletal illness participated in this cross-sectional study and completed the PROMIS pain intensity, PROMIS pain interference, pain catastrophizing scale (PCS), satisfaction with life scale (SWLS), and demographic variables.


A simple mediation model confirmed that the indirect effect of pain intensity on pain interference through PCS was 35.9% of the total effect. A moderated mediation analysis showed that the indirect effect of pain intensity on pain interference through PCS was differentially moderated by SWLS after controlling for relevant covariates. As satisfaction with life increased from low to moderate to high, a smaller proportion of the effect of pain intensity on pain interference (41.6%, 26.1%, and 10.5%) was carried through PCS, such that at the highest satisfaction with life, the indirect effect becomes completely nonsignificant.


Satisfaction with life appears to buffer the effect of pain in individuals with upper extremity musculoskeletal illness. If replicated through longitudinal designs, results suggest that clinical interventions focused on increasing satisfaction with life, such as acceptance and commitment therapy, mindfulness training, gratitude, and other positive psychology skills, may improve outcomes in this population. (PsycINFO Database Record


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