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Depression, Cognition, and Pain: Exploring Individual, Cultural and Country-Level Effects Across Europe

James, Richard J.E.; Ferguson, Eamonn

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Authors

EAMONN FERGUSON eamonn.ferguson@nottingham.ac.uk
Professor of Health Psychology



Abstract

The aim of this paper was to investigate the role of economic (eg, GDP per capita), political (eg, healthcare spending), cultural (country-level aggregates norms) and individual correlates (eg, depression) of pain in a secondary analysis of a sample of 76,000 adults in 19 countries across Europe. The sample was aggregated from 2 waves of the Study of Health, Ageing and Retirement in Europe cohort, using multilevel models with cross-level interactions between individual and country-level effects. While there has been extensive focus on individual risk factors (eg, depression, cognition, BMI), the role of social, political and cultural contextual factors has been relatively underexplored. In addition to replicating well-established individual risk factors (eg, increased depression), we demonstrate that higher levels of depression, chronic pain diagnosis, and collectivism, aggregated at the country-level, are also associated with increased pain severity. There was evidence that these country-level effects moderate the effect of individual correlates of pain. These results contribute to the literature by identifying the importance of broader cultural factors alongside individual psychological indices of pain reporting. Perspective: In this study we model how individual, political and cultural factors influence pain in a large cross-national sample. In addition to replicating established individual effects, it shows how cultural (ie, collectivism) and political (eg, GDP, healthcare spending) factors affect individual expressions of pain, and how the cultural and individual factors interact with each other.

Citation

James, R. J., & Ferguson, E. (2023). Depression, Cognition, and Pain: Exploring Individual, Cultural and Country-Level Effects Across Europe. Journal of Pain, 24(6), 1104-1115. https://doi.org/10.1016/j.jpain.2023.03.006

Journal Article Type Article
Acceptance Date Mar 14, 2023
Online Publication Date Mar 24, 2023
Publication Date 2023-06
Deposit Date Mar 22, 2023
Publicly Available Date Mar 28, 2024
Journal Journal of Pain
Print ISSN 1526-5900
Electronic ISSN 1528-8447
Publisher Elsevier BV
Peer Reviewed Peer Reviewed
Volume 24
Issue 6
Pages 1104-1115
DOI https://doi.org/10.1016/j.jpain.2023.03.006
Keywords Pain; cross-country variation; arthritis; policy; cognitive function
Public URL https://nottingham-repository.worktribe.com/output/18810453
Publisher URL https://www.sciencedirect.com/science/article/pii/S1526590023003711?via%3Dihub

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