Work

Psychological Network Structure of Kinesiophobia and Pain Catastrophizing in Patients with Stable Coronary Heart Disease: An Exploratory Cross-Sectional Dimension-Level Network Analysis

Year: 2026

Type: article

Abstract: Background: Kinesiophobia and pain catastrophizing are psychological barriers to physical activity in patients with coronary heart disease (CHD). Their dimension-level interconnected structure remains unclear. Objectives: To characterize the network structure of kinesiophobia and pain catastrophizing dimensions in stable CHD, identify central dimensions, and identify bridge dimensions. Methods: A cross-sectional survey was conducted among 395 patients with stable CHD from two tertiary hospitals in Xinjiang, China. The Tampa Scale for Kinesiophobia-Heart version (four dimensions) and Pain Catastrophizing Scale (three dimensions) were used. A Gaussian Graphical Model was estimated using gLASSO with EBIC. Strength and expected influence were used for centrality, and bridge expected influence (one-step) for cross-community connectivity. Stability was assessed by bootstrap; the correlation-stability coefficient was 0.749. Results: In total, 68.61% scored above the reference TSK threshold (>37), and 11.90% scored at or above the reference PCS threshold (≥38). The network was predominantly positively connected. The strongest within-community edge was PCS Helplessness-Rumination (0.463). Cross-community edges linked PCS Helplessness to TSK Avoidance of activity (0.187) and Fear of adverse cardiac outcomes (0.154). One weak negative edge was observed: PCS Rumination-TSK Avoidance (-0.066). PCS Helplessness had the highest Strength (1.243), Expected Influence (1.243), and Bridge Expected Influence (0.446). TSK Danger had the lowest Strength (0.579). Conclusions: In this exploratory cross-sectional sample, kinesiophobia and pain catastrophizing formed a predominantly positively connected network. Pain-related helplessness showed the highest centrality and bridge centrality. These hypothesis-generating findings suggest that helplessness may be relevant for future longitudinal and intervention research; the cross-sectional design precludes causal inference.

Source: Patient Preference and Adherence

DOI: 10.2147/ppa.s647003

Author: Ruo-han Wang

Institutions: Shihezi University, Kashi University

Language: English

Topic: Cardiac Health and Mental Health

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,836