Conceptualizing Multimorbidities in Older Adults: Chronic Pain, Depression, and the Biopsychosocial Model
Issue Date
2020-08-31Author
Minahan, Jacquelyn
Publisher
University of Kansas
Format
127 pages
Type
Dissertation
Degree Level
Ph.D.
Discipline
Psychology
Rights
Copyright held by the author.
Metadata
Show full item recordAbstract
Abstract Multimorbidity, a term referring to the co-occurrence of two or more chronic conditions, is increasing in global prevalence as individuals are living longer with varying disease clusters. Existing data has highlighted the significant association between multimorbidity, chronic pain, and depression. However, the nature of this relationship is poorly understood, largely due to an inconclusive understanding of disease clusters among older adults. The biopsychosocial framework provides an alternative model that incorporates multimorbidities and the impact of psychosocial variables in the conceptualization of overall health. This study utilized a community sample of older adults (55 years of age and older) from Douglas County, Kansas (N=57). Participants completed six self-report measures assessing the presence of chronic conditions, pain, social support, physical disability, and access to health care. Participants reported an average of five (SD=1.86) chronic conditions. A multiple correspondence analysis support disease clustering according to body system. These findings may implicate latent systemic deficits as contributing factors to the development of similar chronic conditions. Formative measurement models suggest that mental health conditions (e.g., depression, anxiety, and chronic pain; p<0.001), pulmonary diseases (e.g., COPD, chronic bronchitis, and asthma; p=0.01), and musculoskeletal conditions (e.g., arthritis, osteoarthritis, osteoporosis, and other musculoskeletal conditions; p=0.01) are significantly associated with depressive symptomatology. Measurement models further implicate mental health (p=0.04) and musculoskeletal conditions (p=0.03) as contributory elements in reported pain interference. Findings additionally discuss the contributing role of psychosocial factors, particularly physical functioning, in depression and pain interference outcomes. The present paper also discusses clinical and research implications, as well as provides suggestions for areas for future research.
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