Family Strain, Depression, and Somatic Amplification in Adults with Chronic Pain

The associations between family strain, depression, and chronic pain interference vary across individuals, suggesting moderated relations, and one possible moderator is somatic amplification. The current study examined a moderated mediation model that investigated (a) whether depression mediated the relation between non-spouse family strain and chronic pain interference and (b) whether somatic amplification moderated the association between depression and chronic pain interference. Data came from 933 adults who participated in the National Survey of Midlife Development in the USA. Participants completed telephone interviews or self-report measures. The relationship between non-spouse family strain and chronic pain interference was mediated by depression, and this mediation depended on the degree of somatic amplification. Specifically, individuals who experienced more non-spouse family strain were more likely to experience depression and higher levels of chronic pain interference. Somatic amplification significantly moderated the effect of depression on chronic pain, such that individuals with higher levels of somatic amplification and depression were likely to experience higher levels of chronic pain interference. The indirect effect of non-spouse family strain on chronic pain through depression was significant for low, middle, and high levels of somatic amplification. The presence of chronic pain has been associated with family dynamics changing, which may be linked with higher levels of non-spouse family strain. A negative family environment may be related to the development of depression, which may be associated with the severity and inability to cope with chronic pain. Somatic amplification may strengthen the association between depression and pain intensity.