An Examination of Psycho-Behavioral Risk and Resilience in People with Chronically Painful Knee Osteoarthritis

Knee osteoarthritis (OA) is a common chronic condition that often results in high levels of pain severity and functional impairment. People with chronic pain tend to have poor sleep and are at greater psychological risk for experiencing persistent negative mood states. Additionally, measurements of psychological resilience also tend to be lower in people with knee OA. However, there are still mixed findings within the literature as to the exact relationships between psychological risk/resilience, sleep quality, pain and functioning in people with chronic pain. The current analysis examined the overall impact of psycho-behavioral risk/resilience on self-reported pain and functioning at rest. This project utilized baseline data collected as part of a larger multisite clinical trial called Pain Relief for Osteoarthritis through Combined Treatment. 136 Non-Hispanic White (NHW) and Non-Hispanic Black (NHB) community-dwelling adults (67% female, 55% NHB) with knee OA completed measures that assessed psychological risk/resilience, sleep, pain, and functional impairment. Greater sleep disturbance, sleep-related impairment, pain catastrophizing, and negative affect were positively correlated with the Western Ontario McMaster University Osteoarthritis Index (WOMAC) pain and physical functioning subscales. Additionally, higher scores on pain self-efficacy and pain resilience were inversely correlated with pain and physical functioning. Results indicate that measures of risk and resilience may serve as potential therapeutic targets for interventions to reduce pain and improve functioning in people with knee OA. Future research should focus on characterizing individuals with knee OA into profiles based on these psycho-behavioral risk/resilience factors and validate these profiles on measures of pain and functioning. This trial was registered at clinicaltrials.gov (NCT03884374). Funded by the National Institutes of Health and Aging (R37 AG033906).