Examining the role of structural and functional social network characteristics in the context of chronic pain: An ego-centered network design

Abstract

The well-being and functioning of individuals with chronic pain (CP) varies significantly. Social factors, such as social integration, may help explain this differential impact. Specifically, structural (network size, density) as well as functional (perceived social support, conflict) social network characteristics may play a role. However, it is not yet clear whether and how these variables are associated with each other. Objectives were to examine: (1) both social network characteristics in individuals with primary and secondary CP, (2) the association between structural network characteristics and mental distress, and functioning/participation in daily life, and (3) whether the network’s functionality mediated the association between structural network characteristics, and mental distress respectively functioning/participation in daily life. Using an online ego-centered social network tool, cross-sectional data were collected from 303 individuals with CP (81.85% women). No significant differences between individuals with fibromyalgia versus secondary CP were found regarding network size and density. In contrast, ANCOVA models showed lower levels of perceived social support and higher levels of conflict in primary (vs. secondary) CP. Structural equation models showed that: (1) larger network size indirectly predicted lower mental distress via lower levels of conflict; (2) higher network density increased mental distress via the increase of conflict levels. Network size or density did not (in)directly predict functioning/participation in daily life. The findings highlight that the role of conflict, in addition to support, should not be underestimated as a mediator for mental well-being. Research on explanatory mechanisms for associations between the network’s structure, functionality and well-being is warranted.