Social and Societal Factors Interact with Psychological Factors to Shape Pain Outcomes in a Community Sample with Chronic Pain: A Network Study

Although the biopsychosocial model of chronic pain is widely recognized, few studies include social-societal factors. Here, we examined how these interact with psychological factors to shape pain outcomes. We collected self-reported data from 262 participants with chronic pain about emotional states, pain coping strategies, social interactions, societal stressors and pain outcomes. After replicating previous partial correlation networks including only psychological factors, we extended our analysis to include social and societal factors, which demonstrated that these had strong direct relationships with quality of life and were indirectly related to pain intensity and pain disability. Our results indicate that social and societal factors are important for understanding pain outcomes and should be considered in interventions targeting chronic pain. Future work should examine the interactions among social-societal and psychological factors in more depth to inform ways to incorporate this into individual pain management and societal interventions for chronic pain.