Does age moderate self-pain enmeshment in chronic pain patients?

Research has demonstrated that chronic pain can compromise identity by becoming enmeshed and centralised with pain. Pain-identity enmeshment and pain-identity centrality are associated with greater affective distress and poorer chronic pain adjustment. However, the literature infers differences between older and younger individuals in terms of pain adjustment, whereby older adults perceive pain as concomitant of aging and experience this as less biographically disruptive and perceive themselves to be younger than their chronological age, which is associated with greater psychological wellbeing. Research has yet to explore the relationship between perceived age and pain-identity enmeshment and adjustment in chronic pain. The purpose of this research was to investigate age in relation to pain-identity enmeshment and centrality and to examine the predictive value of age in pain adjustment.
90 patients with osteoarthritis (OA) and chronic pain were recruited from a musculoskeletal service. Participants completed standardised measures of pain intensity and perceived control (VAS), pain severity and interference (BPI), acceptance (CPAQ), identity (CES, Possible Selves Interviews), affective distress (HADS), and catastrophising (PCS) and provided information regarding their perceived age. Statistical analysis included; correlation, chi square, analysis of variance and linear regression to investigate potential age differences.
Chronological age evidenced few significant relationships with variables of pain adjustment and identity. Perceived age evidenced significant relationships with all variables of adjustment and identity, however, did not statistically predict chronic pain adjustment. However, hoped-for proximity and centrality significantly predicted chronic pain adjustment. The CES demonstrated significant relatedness to enmeshment, although effect sizes were small. Therefore, it appears possible that an individual may experience pain becoming central to their identity yet remain un-enmeshed with pain.
These findings indicate the necessity to assess hoped-for proximity and centrality in chronic pain populations across all age groups. This research indicates the potential for incorrectly perceiving expectedness and adjustment ease in old age. The implications of these findings are explored, in conjunction with the limitations of this research and potential areas for further research.