Psychological Network Structure of Kinesiophobia and Pain Catastrophizing in Patients with Stable Coronary Heart Disease: An Exploratory Cross-Sectional Dimension-Level Network Analysis.
- 1School of Medicine, Kashi University, Kashi, Xinjiang, People's Republic of China.
- 2School of Medicine, Shihezi University, Shihezi, Xinjiang, People's Republic of China.
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.
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BibTeX
@article{wang2026psychological,
title = {{Psychological Network Structure of Kinesiophobia and Pain Catastrophizing in Patients with Stable Coronary Heart Disease: An Exploratory Cross-Sectional Dimension-Level Network Analysis.}},
author = {Ruo-Han Wang},
journal = {Patient preference and adherence},
year = {2026},
month = oct,
doi = {10.2147/ppa.s647003},
url = {https://europepmc.org/article/MED/42936292},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Psychological Network Structure of Kinesiophobia and Pain Catastrophizing in Patients with Stable Coronary Heart Disease: An Exploratory Cross-Sectional Dimension-Level Network Analysis.
AU - Ruo-Han Wang
PY - 2026
DA - 2026/10/22
JO - Patient preference and adherence
DO - 10.2147/ppa.s647003
UR - https://europepmc.org/article/MED/42936292
AB - 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.
SN - 1177-889X
ER -