Linking Family and Intimate Partner Relationships to Chronic Pain: An Application of the Biobehavioral Family Model

Introduction: Research is needed to determine mechanisms of effect linking family relationships and chronic pain for adults. Guided by the Biobehavioral Family Model (BBFM), the present study examined indirect effects between a negative family emotional climate and chronic pain disease activity, as mediated by biobehavioral reactivity. Method: Data for this study are from the Midlife Development in the United States; specifically, a subsample of participants who reported experiencing chronic pain (n = 1,461, ages 32-84). Participants self-reported family strain, biobehavioral reactivity (i.e., anxiety, depression), and chronic pain disease activity (i.e., pain interference, global health). A subsample of participants (n = 1,070) completed an intimate partner strain measure, indicating they were married/in a committed relationship. Structural equation models were tested with maximum likelihood estimation and bootstrapping. Results: Family strain was indirectly associated with chronic pain disease activity via biobehavioral reactivity-Model 1; χ²(10) = 40.75, p < .000, root mean square error of approximation [RMSEA] = .07, comparative fit index [CFI] = .96, standardized root-mean-square residual [SRMR] = .04; partial mediation occurred for partnered participants. This finding was replicated when modeling family strain simultaneously with intimate partner strain, though intimate partner strain was not associated with chronic pain disease activity-Model 2; χ²(5) = 8.29, p = .14, RMSEA = .03, CFI = .99, SRMR = .01. Discussion: These findings add to the growing literature that emphasizes the role of family relationships in chronic pain. Future research is needed to replicate our use of the BBFM to specify pathways of effect, incorporating relational and observational data, with diverse samples.