Relationship between perfectionism, overactivity, pain severity, and pain interference in individuals with chronic pain: A cross-lagged panel model analysis

<bold>Objectives: </bold>Overactivity is a characteristic of individuals with chronic pain. Previous cross-sectional studies demonstrated a relationship between perfectionism and overactivity. Therefore, the present study used a longitudinal design to determine whether pain severity and pain interference were exacerbated by overactivity and whether overactivity was exacerbated by perfectionism. <bold>Methods: </bold>Participants with chronic pain were recruited using crowdsourcing. The participants completed the questionnaires at three time points: T1, T2, and T3 (September, October, and November 2021, respectively). The questionnaire assessed overactivity, perfectionistic strivings, perfectionistic concerns, pain severity, and pain interference. We created cross-lagged panel models to examine the hypothesized relationships among pain, overactivity, and perfectionism. <bold>Results: </bold>After excluding ineligible participants and invalid response sets, we analyzed the questionnaires completed by 666 participants at T1, 560 at T2, and 554 at T3. The average duration of chronic pain at T1 was 36.35 +/- 53.53 months. Perfectionistic strivings were partially linked to overactivity, and pain interference was partially related to overactivity. Contrary to our expectations, overactivity did not predict pain severity or pain interference. <bold>Conclusions: </bold>The hypotheses that perfectionism exacerbates overactivity and that overactivity exacerbates pain severity and pain interference were not supported. These results may have been affected by the quality of the assessment of overactivity. Therefore, further research with a refined evaluation of overactivity is required.