(199) Pain Acceptance Partially Mediates the Relationship between Perceived Injustice and Chronic Pain Outcomes over Three Months

Abstract

Pain-related injustice perception is a potentially important determinant of chronic pain outcomes, with recent research suggesting that injustice perception may negatively affect pain outcomes by lowering pain acceptance. Specifically, a cross-sectional analysis of a chronic pain sample demonstrated that pain acceptance mediated the relationship between perceived injustice and physical function as well as opioid use status; and, partially mediated the relationship between perceived injustice and pain intensity. To further test this relationship, we analyzed data from a prospective study to examine the potential mediating role of pain acceptance on a variety of pain-related outcomes three months after an acute episode of low back pain. Using Amazon Mechanical Turk, we recruited 341 participants who experienced an episode of back pain in the past two weeks. Participants completed a survey including psychosocial measures as well as measures of pain and quality of life at recruitment, one month later, and three months later. Path analyses were used to examine if acceptance at month 1 mediated the relationship between baseline pain and perceived injustice at recruitment and pain intensity, disability, depressive symptoms, and opioid use at month 3. Perceived injustice had significant direct effects on opioid use (OR = 1.026, s = .157, se =.077, p =.042), pain intensity (s = .249, se =.061, p