Evidence map›Paper›PMID 40459572›Full record

ArticleBiological research for nursing2026

Serial Mediation: How Optimism Reduces and Pessimism Intensifies Chronic Low Back Pain Through Depression and Biological Aging.

Khalid W Freij, Fiona B A T Agbor, Vinodh Srinivasasainagendra, Tammie L Quinn, Hemant K Tiwari, Robert E Sorge, Burel R Goodin, Edwin N Aroke

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Biological research for nursing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Khalid W FreijDepartment of Acute, Chronic, & Continuing Care, Nurse Anesthesia Program, School of Nursing, The University of Alabama at Birmingham, Birmingham, AL, USA.ORCID 0009-0001-1795-2927
Fiona B A T AgborDepartment of Acute, Chronic, & Continuing Care, Nurse Anesthesia Program, School of Nursing, The University of Alabama at Birmingham, Birmingham, AL, USA.
Vinodh SrinivasasainagendraDepartment of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
Tammie L QuinnDepartment of Psychology, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, AL, USA.
Hemant K TiwariDepartment of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
Robert E SorgeDepartment of Psychology, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, AL, USA.
Burel R GoodinDepartment of Anesthesiology, School of Medicine, Washington University, St Louis, MO, USA.
Edwin N ArokeDepartment of Acute, Chronic, & Continuing Care, Nurse Anesthesia Program, School of Nursing, The University of Alabama at Birmingham, Birmingham, AL, USA.

Funding

Racial and Socioeconomic Differences in Chronic Low Back PainR01MD010441 · NIMHD · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI GOODIN, BUREL R., SORGE, ROBERT · 2017 to 2021
$2.6M
Epigenomic and Gene Expression Signatures of Racial Differences in Chronic Low Back PainR01AR079178 · NIAMS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI AROKE, EDWIN NGOMUEH · 2021 to 2024
$1.6M
NIAMS NIH HHS R01 AR079178NIMHD NIH HHS R01 MD010441
6 · The paper itself

Abstract

There is growing evidence that psychological (e.g., optimism, pessimism, depressive symptoms) and biological factors play an essential role in the experience of chronic low back pain (CLBP). This study aimed to examine the nature of the relationship between optimism or pessimism, depressive symptoms, the pace of biological aging, CLBP severity, and interference. Using mediation analysis, we tested the hypothesis that depressive symptoms and pace of biological aging measured using the Dunedin Pace of Aging from the Epigenome (DunedinPACE) serially mediate the relationship between optimism or pessimism and CLBP severity and interference. Our sample included non-Hispanic Black and non-Hispanic White adults aged 18-82 years: 74 without pain, 56 with low-impact pain, and 77 with high-impact pain. On average, individuals with high-impact pain reported lower levels of optimism, greater pessimism, and faster DunedinPACE than those in the low-impact or no-pain group (

Indexed as

AgingChronic PainDepressionLow Back PainOptimismPessimismAdolescentAdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedYoung Adultbiological agingchronic low back paindepressionDunedinPACEepigeneticsoptimismpessimism

Identifiers

PMID40459572
PMCPMC12877770

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.