All ETDs from UAB

Advisory Committee Chair

Burel R Goodin

Advisory Committee Members

Casey Azuero

Olivio Clay

Document Type


Date of Award


Degree Name by School

Master of Science (MS) College of Arts and Sciences


Considerable evidence demonstrates that radiographic findings (e.g., osteophytes) are only modestly associated with the severity of knee pain, suggesting that other biopsychosocial factors likely influence symptom severity. Multiple psychological factors have been linked to worse health outcomes in people with chronic knee pain; however, it remains unclear whether psychological profiles might help explain variability in knee pain severity. The primary goal of this study was to identify unique psychological differences among people with and without chronic knee pain, and then examine whether psychological profiles longitudinally predicted knee pain trajectories over two years. Individuals with (n = 175) and without (n = 65) knee pain were enrolled via community and clinic-based recruitment at two study sites in the Southeastern US. All participants provided sociodemographic information and self-reported psychological measures. Baseline psychological measures included assessments of perceived stress, passive/active coping, somatic symptoms, positive/negative affect, optimism, depression, and anxiety. Individuals with knee pain completed X-rays to determine radiographic disease severity via the Kellgren-Lawrence (KL) scale prior to provision of self-reported pain severity and pain interference every 3 months for two years. Individuals with knee pain had higher ratings of depression, anxiety, positive/negative affect, passive/active coping, perceived stress, and somatic symptoms when compared to individuals without knee pain (all p’s < .05). Individuals with knee pain were clustered into four separate psychological profiles (Low-risk, low-moderate risk, iii high-moderate risk, and high risk). Controlling for baseline KL scores, age, education, and income, linear mixed models revealed the group with the high-risk psychological profile demonstrated the greatest severity of pain and interference over two years when compared to the other groups. Results indicate that psychological profiles, in addition to other pieces of evidence such as radiographic disease severity, may be useful for longitudinally predicting severity of knee pain and related interference over time.



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