The interrelationships among pain interference, depressive symptoms, loneliness, and employment status: a moderated mediation study

Objective:To explore the mediating effect of loneliness on the relationship between pain interference and depressive symptoms and to determine whether this mechanism is contingent on employment status.Design:Cross-sectional study.Subjects:A total of 876 adult caregivers of adolescents living in extremely impoverished conditions.Analysis:Mediation and moderated mediation analyses using standard path-analytic approaches.Results:The mean age of the sample was 39.0 (SD = 12.8) years and 80.7% (n = 707) identified as female. Almost half (48.9%, n = 425) of the participants did not report any pain, while 32.5% (n = 285) reported non-disabling pain, and 19.0% (n = 166) reported disabling pain. The mean depressive symptoms score was 16.20 (SD = 10.6), and the mean loneliness score was 40.09 (SD = 10.5). Loneliness mediated the effect of both non-disabling and disabling pain on depressive symptoms. However, the indirect effect of pain interference on depressive symptoms through loneliness was more pronounced among...