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This bidirectional relationship is clinically significant as anxiety and depression exacerbate pain perception, leading to poorer treatment outcomes, more severe symptoms, and reduced quality of life (Roughan et al., 2021)

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doi: 10.1097/TP.0b013e31827a3d3e 221 AbbaszadehSNosrati-SiahmazgiVMusaieKRezaeiSQahremaniMXiaoBet al

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