scholarly journals Interpersonal problems as a predictor of pain catastrophizing in patients with chronic pain

2019 ◽  
Vol 20 (1) ◽  
pp. 51-59
Author(s):  
Truls Ryum ◽  
Henrik Børsting Jacobsen ◽  
Petter Christian Borchgrevink ◽  
Nils Inge Landrø ◽  
Tore Charles Stiles
Keyword(s):  
Chronic Pain ◽  
Psychiatric Symptoms ◽  
Pain Catastrophizing ◽  
Interpersonal Problems ◽  
Rehabilitation Program ◽  
Self Report ◽  
Interpersonal Theory ◽  
Circumplex Model ◽  
Cross Sectional

AbstractBackground and aimsPain catastrophizing has consistently been related to a variety of negative outcomes within chronic pain conditions, but competing models exist explaining the role of catastrophizing. According to the fear-avoidance model (FAM), catastrophizing is primarily related to the appraisal of pain (i.e. “intrapersonal”), whereas the communal coping model (CCM) suggests that catastrophizing is a strategy to elicit support (i.e. “interpersonal”). In order to examine the interpersonal nature of catastrophizing, this cross-sectional study examined interpersonal problems as a predictor of pain catastrophizing in a sample of patients (n = 97) with chronic pain.MethodsSelf-report data was taken from patients entering a multidisciplinary, inpatient rehabilitation program. The four quadrants of the Inventory of Interpersonal Problems circumplex model (Hostile-Dominant, Hostile-Submissive, Friendly-Submissive, Friendly-Dominant) were used as predictors of pain catastrophizing in a series of separate, hierarchical regression analyses.ResultsAfter controlling for relevant confounding variables such as demographics (gender, age), pain severity, psychiatric symptoms (anxiety/depression, fatigue, insomnia), adverse life experiences and perceived social support, higher levels of Hostile-Dominant interpersonal problems predicted higher levels of pain catastrophizing (p ≤ 0.01, d = 0.56).ConclusionsThe results add support to the notion that pain catastrophizing may serve a communicative functioning, as predicted by the CCM, with cold, dominant and controlling behaviors as a maladaptive interpersonal strategy to elicit support. It may thus be useful to consider the broader interpersonal context of the individual, and not only the patient’s appraisal of pain, when conceptualizing the role of pain catastrophizing in patients with chronic pain.ImplicationsFuture psychosocial research and treatment of chronic pain could be informed by including interpersonal theory as a useful theoretical framework, which may help shed more light on how interpersonal problems relates to pain catastrophizing.

scholarly journals The Cyclical Relation Between Chronic Pain, Executive Functioning, Emotional Regulation, and Self-Management

2020 ◽  
Author(s):  
Line Caes ◽  
Bruce Dick ◽  
Christina Duncan ◽  
Julia Allan
Keyword(s):  
Chronic Pain ◽  
Executive Functioning ◽  
Parental Support ◽  
Emotional Regulation ◽  
Intervention Development ◽  
Self Report ◽  
Self Management ◽  
Cross Sectional ◽  
Pain Experiences

Abstract Objective  To propose a new model outlining a hypothesized cyclical relation between executive functioning, emotional regulation, and chronic pain in adolescence and to highlight the likely importance of such a relation for self-management behavior and pain-related disability. Methods  A review of the existing literature that critically explores the role of executive functioning in understanding chronic pain experiences and self-management in adolescence in order to develop the Cyclical model Of Pain, Executive function, emotion regulation, and Self-management (COPES). Results  Growing evidence points towards a potential cyclical relation between chronic pain and impaired executive functioning, which forms the basis of COPES. The COPES model proposes that the relative immaturity of executive functioning in adolescence negatively influences their ability to engage with self-management, which in turn increases adolescents’ disability due to pain and contributes to the maintenance of chronic pain, which perpetuates the reduced capacity of executive functioning. The moderating influence of flexible parental support is hypothesized to offset some of these influences. However, the available evidence is limited due to methodological shortcomings such as large variety in executive functioning operationalization, reliance on self-report and cross-sectional designs. Conclusions  It is anticipated that the COPES model will stimulate more systematic, theory-driven research to further our understanding of the links between executive functioning, chronic pain, self-management, and wellbeing. Such enhanced understanding has the potential to drive forward intervention development and refinement aimed at improving self-management uptake and adherence amongst adolescents with chronic pain.

scholarly journals The “self” in pain: high levels of schema-enmeshment worsen fibromyalgia impact

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Myrella Paschali ◽  
Asimina Lazaridou ◽  
Eric S. Vilsmark ◽  
Jeungchan Lee ◽  
Michael Berry ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Catastrophizing ◽  
Well Being ◽  
Cross Sectional Study ◽  
The Self ◽  
Self Report ◽  
Pain Severity ◽  
Pictorial Representation ◽  
Cross Sectional ◽  
Mediation Analyses

Abstract Objective Chronic pain can have detrimental effects on quality of life and a profound impact on one’s identity. The Pictorial Representation of Illness- and Self-Measure (PRISM), is a visual tool designed to measure the self-illness separation (SIS) that represents the degree of schema-enmeshment (i.e., the degree to which the self-schema and the illness-schema come to overlap). Our aim was to investigate the relationship between schema-enmeshment and pain-related outcomes in patients with fibromyalgia. Methods In this cross-sectional study, 114 patients with fibromyalgia completed self-report assessments of pain catastrophizing, pain severity and interference, impact of symptoms, anxiety, and depression. SIS was assessed using an iPad version of PRISM. Mediation analyses evaluated the mediating role of schema-enmeshment on the association between pain catastrophizing and fibromyalgia impact. Results A higher degree of schema-enmeshment was associated with greater pain catastrophizing, pain severity and interference, impact of symptoms, and depression. Moreover, a mediation analysis revealed that schema-enmeshment significantly mediated the association between pain catastrophizing and fibromyalgia impact (p < 0.001). Conclusions Our results indicate that schema-enmeshment is associated with greater intrusiveness of chronic pain on everyday life, thereby posing significant limitations on the emotional and physical well-being of fibromyalgia patients. Schema-enmeshment also appears to partly account for the deleterious effect of pain catastrophizing on disease impact. The PRISM is a simple tool that may uniquely capture the extent to which chronic pain and illness infiltrates and affects one’s self-concept.

Does validation and alliance during the multimodal investigation affect patients’ acceptance of chronic pain? An experimental single case study

2019 ◽  
Vol 19 (1) ◽  
pp. 73-82 ◽  
Author(s):  
Mikael Svanberg ◽  
Ann-Christin Johansson ◽  
Katja Boersma
Keyword(s):  
Chronic Pain ◽  
Therapeutic Effect ◽  
Pain Catastrophizing ◽  
Single Case ◽  
Rehabilitation Program ◽  
Self Report ◽  
Pain Coping ◽  
Chronic Pain Patients ◽  
Before And After ◽  
Pain Patients

Abstract Background and aims Among chronic pain patients who are referred to participation in a multimodal rehabilitation program (MMRP), pain catastrophizing and dysfunctional pain coping is common. In many cases it may have driven the patient to a range of unsuccessful searches for biomedical explanations and pain relief. Often these efforts have left patients feeling disappointed, hopeless and misunderstood. The MMRP process can be preceded by a multimodal investigation (MMI) where an important effort is to validate the patient to create a good alliance and begin a process of change towards acceptance of the pain. However, whether the MMI has such therapeutic effect is unclear. Using a repeated single case experimental design, the purpose of this study was to investigate the therapeutic effect of MMI by studying changes in patients’ experience of validation, alliance, acceptance of pain, coping, catastrophizing, and depression before and during the MMI process. Methods Participants were six chronic pain patients with high levels of pain catastrophizing (>25 on the Pain Catastrophizing Scale) and risk for long term disability (>105 on the Örebro Musculoskeletal Pain Screening Questionnaire) who were subjected to MMI before planned MMRP. For each patient, weekly self-report measures of validation, alliance and acceptance of pain were obtained during a 5–10-weeks baseline, before the MMI started. Subsequently, these measures were also obtained during a 6–8 weeks MMI process in order to enable comparative analyses. Additionally, pain coping, depression and pain catastrophizing were measured using standardized questionnaires before and after the MMI. Results Irrespective of experiences of validation and alliance before MMI, all six patients felt validated and experienced a good alliance during MMI. Acceptance of pain improved only in one patient during MMI. None of the patients showed clinically relevant improvement in pain coping, depression or catastrophizing after the MMI. Conclusions The patients did not change their acceptance and pain coping strategies despite of good alliance and experience of validation during the MMI process. Even if the design of this study precludes generalization to chronic pain patients in general, the results suggest that MMI may not have a therapeutic effect.

scholarly journals Attentional Engagement for Pain-Related Information among Individuals with Chronic Pain: The Role of Pain Catastrophizing

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
J. E. Lee ◽  
S. H. Kim ◽  
S. K. Shin ◽  
A. Wachholtz ◽  
J. H. Lee
Keyword(s):  
Chronic Pain ◽  
Attentional Bias ◽  
Time Course ◽  
Pain Catastrophizing ◽  
Self Report ◽  
Related Information ◽  
Pain Disability ◽  
Attentional Engagement ◽  
Time Course Of Attention

Although the evidence of the attentional bias of chronic pain individuals toward pain-related information is established in the literature, few studies examined the time course of attention toward pain stimuli and the role of pain catastrophizing on attentional engagement toward pain-related information. This study examined the time course of attention to pain-related information and the role of pain catastrophizing on attentional engagement for pain-related information. Participants were fifty young adult participants with chronic pain (35% male, 65% female; M = 21.8 years) who completed self-report questionnaires assessing pain catastrophizing levels (Pain Catastrophizing Scale (PCS)), depression (the Center for Epidemiologic Studies Depression Scale (CES-D)), anxiety (State-Trait Anxiety Inventory (STAI)), and pain disability (the Pain Disability Index: (PDI)). Attentional engagements to pain- and anger-related information were measured by the eye tracker. Significant interaction effects were found between (1) time and stimulus type for pain-related information (F (5, 245) = 11.55, p<0.001) and (2) bias scores and pain catastrophizing (F (1, 48) = 6.736, p<0.05). These results indicated that the degree of increase for pain bias scores were significantly greater than anger bias scores as levels of pain catastrophizing increased. Results of the present study provided the evidence for the attentional bias and information processing model which has clinical implications; high levels of pain catastrophizing may impair individuals’ ability to cope with chronic pain by increasing attentional engagement toward pain-related information. The present study can add knowledge to attentional bias and pain research as this study investigated the time course of attention and the role of pain catastrophizing on attentional engagement toward pain-related information for adults with chronic pain conditions.

A multilevel path model analysis of the relations between sleep, pain, and pain catastrophizing in chronic pain rehabilitation patients

2016 ◽  
Vol 10 (1) ◽  
pp. 122-129 ◽  
Author(s):  
Joshua A. Wilt ◽  
Sara Davin ◽  
Judith Scheman
Keyword(s):  
Chronic Pain ◽  
Pain Catastrophizing ◽  
Cleveland Clinic ◽  
Clinical Importance ◽  
Theoretical Models ◽  
Post Treatment ◽  
Path Model ◽  
Self Report ◽  
Poor Sleep ◽  
Cross Sectional

AbstractBackground and aimPain catastrophizing is linked to heightened pain and poorer coping among individuals with chronic pain, yet little is known about how pain catastrophizing associates with sleep and pain over the course of treatment for chronic pain. Previous research employing a cross-sectional design suggests that sleep mediates the association between pain catstrophizing and pain, but there have been no longitudinal studies examining the directionality of these associations. Thus, the aim of this study was to test two competing theoretical models. The first model specified that pain catastrophizing leads to increased pain via poor sleep. The second model specified that poor sleep leads to increased pain catastrophizing via increased pain.MethodsThis study examined the relations between pain catastrophizing, sleep, and pain among 50 consecutive patients (36 female, 14 male) ages 20–80 (M = 45.96, SD = 13.94) with chronic, non-malignant pain who were admitted to the Cleveland Clinic, Chronic Pain Rehabilitation Programme (CPRP). The CPRP, within the Neurological Centre for Restoration, Neurologic Institute at the Cleveland Clinic, is a comprehensive, interdisciplinary programme designed to treat patients with disabling chronic pain. As part of their daily, morning update with their case manager, patients completed self-report ratings of their previous night’s sleep time (TST), and their current pain, anxiety, and depression. Pain catastrophizing was assessed at admission and discharge.ResultsOver the course of treatment, daily TST increased from approximately 5 h and 20 min per night to nearly 6 h and 30 min per night, and average daily pain, daily depression, and daily anxiety decreased over the course of treatment. As the data in this study has a multilevel structure, with daily reports nested with in patients, we conducted multilevel path models to examine the longitudinal relations between pain catastrophizing, sleep, and pain. Multilevel path analysis permits the analysis of interdependent data without violating the assumptions of standard multiple regression. Models were conducted for pain catastrophizing and each of its subscales: rumination, magnification and helplessness. The findings were uniform across the composite pain catastrophizing scale and its subscales. There was an indirect path from sleep to pain catastrophizing (post-treatment) via pain, but not from pain catastrophizing (pre-treatment) to pain via sleep. There were also direct effects of sleep on pain and from pain to pain catastrophizing (post-treatment). Additionally, decreases in pain over the course of treatment were related to lower pain catastrophizing post-treatment.Conclusion and implicationsThese results call into question previous evidence that pain catastrophizing indirectly affects pain by way of its impact on sleep. Rather, our findings suggest that pain mediates the relationship between sleep and levels of pain catastrophizing. These results therefore underscore importance and value in collecting longitudinal data and potential influence on the conclusions gained with regards to sleep, pain and psychological variables. These findings may be of clinical importance when tailoring interventions for individuals with chronic pain and perhaps even more so for those with comorbid pain and sleep disturbance; prioritizing the treatment of sleep difficulties could result in improvements to pain-related outcomes.

scholarly journals The role of positive goal engagement in increased mental well-being among individuals with chronic non-cancer pain

2019 ◽  
Vol 13 (4) ◽  
pp. 230-238
Author(s):  
Joanne E Iddon ◽  
Peter J Taylor ◽  
Jen Unwin ◽  
Joanne M Dickson
Keyword(s):  
Chronic Pain ◽  
Pain Intensity ◽  
Well Being ◽  
Protective Role ◽  
Self Report ◽  
Pain Interference ◽  
Cross Sectional ◽  
Positive Goal ◽  
Mental Well Being

Individuals with chronic pain commonly report significant functional impairment and reduced quality of life. Despite this, little is known about psychological processes and mechanisms underpinning enhancements in well-being within this population. The study aimed to investigate whether (1) increased levels of pain intensity and interference were associated with lower levels of mental well-being, (2) increased positive goal engagement was associated with higher levels of mental well-being and (3) whether the relationships between pain characteristics and mental well-being were mediated by increased positive goal engagement. A total of 586 individuals with chronic pain participated in the cross-sectional, online study. Participants completed self-report measures to assess pain intensity and interference, mental well-being and goal motivation variables. Results showed that pain interference and positive goal engagement were associated with mental well-being. Moreover, the relationship between pain interference and mental well-being was partially mediated by positive goal engagement. The results provide tentative evidence for the protective role of positive goal engagement in enabling individuals with chronic pain to maintain a sense of mental well-being. The study develops the biopsychosocial model of chronic pain by examining the roles and relationships of relevant yet previously unexplored psychological constructs. The promotion of mental well-being through the enhancement of positive goal engagement is discussed, offering a platform for further research and clinical interventions.

scholarly journals Pain Catastrophizing Correlates with Early Mild Traumatic Brain Injury Outcome

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Geneviève Chaput ◽  
Susanne P. Lajoie ◽  
Laura M. Naismith ◽  
Gilles Lavigne
Keyword(s):  
Traumatic Brain Injury ◽  
Chronic Pain ◽  
Psychological Distress ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Pain Catastrophizing ◽  
Self Report ◽  
Pain Severity ◽  
Cross Sectional ◽  
Postconcussion Symptoms

Background.Identifying which patients are most likely to be at risk of chronic pain and other postconcussion symptoms following mild traumatic brain injury (MTBI) is a difficult clinical challenge.Objectives.To examine the relationship between pain catastrophizing, defined as the exaggerated negative appraisal of a pain experience, and early MTBI outcome.Methods.This cross-sectional design included 58 patients diagnosed with a MTBI. In addition to medical chart review, postconcussion symptoms were assessed by self-report at 1 month (Time 1) and 8 weeks (Time 2) after MTBI. Pain severity, psychological distress, level of functionality, and pain catastrophizing were measured by self-report at Time 2.Results.The pain catastrophizing subscales of rumination, magnification, and helplessness were significantly correlated with pain severity (r=.31to.44), number of postconcussion symptoms reported (r=.35to.45), psychological distress (r=.57to.67), and level of functionality (r=-.43to-.29). Pain catastrophizing scores were significantly higher for patients deemed to be at high risk of postconcussion syndrome (6 or more symptoms reported at both Time 1 and Time 2).Conclusions.Higher levels of pain catastrophizing were related to adverse early MTBI outcomes. The early detection of pain catastrophizing may facilitate goal-oriented interventions to prevent or minimize the development of chronic pain and other postconcussion symptoms.

scholarly journals The Role of Pain Catastrophizing and Pain Acceptance in Performance-Based and Self-Reported Physical Functioning in Individuals with Fibromyalgia and Obesity

2021 ◽  
Vol 11 (8) ◽  
pp. 810
Author(s):  
Giorgia Varallo ◽  
Federica Scarpina ◽  
Emanuele Maria Giusti ◽  
Carlos Suso-Ribera ◽  
Roberto Cattivelli ◽  
...  
Keyword(s):  
Physical Functioning ◽  
Psychological Factors ◽  
Pain Catastrophizing ◽  
Cross Sectional Study ◽  
Self Report ◽  
Cross Sectional ◽  
Pain Acceptance ◽  
Lower Pain ◽  
And Performance

Impaired physical functioning is one of the most critical consequences associated with fibromyalgia, especially when there is comorbid obesity. Psychological factors are known to contribute to perceived (i.e., subjective) physical functioning. However, physical function is a multidimensional concept encompassing both subjective and objective functioning. The contribution of psychological factors to performance-based (i.e., objective) functioning is unclear. This study aims to investigate the contribution of pain catastrophizing and pain acceptance to both self-reported and performance-based physical functioning. In this cross-sectional study, 160 participants completed self-report measures of pain catastrophizing, pain acceptance, and pain severity. A self-report measure and a performance-based test were used to assess physical functioning. Higher pain catastrophizing and lower pain acceptance were associated with poorer physical functioning at both self-reported and performance-based levels. Our results are consistent with previous evidence on the association between pain catastrophizing and pain acceptance with self-reported physical functioning. This study contributes to the current literature by providing novel insights into the role of psychological factors in performance-based physical functioning. Multidisciplinary interventions that address pain catastrophizing and pain acceptance are recommended and might be effective to improve both perceived and performance-based functioning in women with FM and obesity.

scholarly journals The relationship between psychosocial factors and reported disability: the role of pain self-efficacy

2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Antonio J. Varela ◽  
Kathryn W. Van Asselt
Keyword(s):  
Physical Activity ◽  
Chronic Pain ◽  
Psychosocial Factors ◽  
Self Efficacy ◽  
Pain Catastrophizing ◽  
Significant Proportion ◽  
Cross Sectional ◽  
Data Set ◽  
Mediating Role

Abstract Background Chronic pain and the accompanying level of disability is a healthcare crisis that reaches epidemic proportions and is now considered a world level crisis. Chronic non-specific low back pain (CNLBP) contributes a significant proportion to the chronic pain population. CNLBP occurs with overlapping psychosocial factors. This study was design to investigate specific psychosocial factors and their influence on reported disability in a population with CNLBP. Methods The specific psychosocial factors examined included fear, catastrophizing, depression, and pain self-efficacy. This cross-sectional correlational study investigated the mediating role between pain self-efficacy, the specific psychosocial factors, and reported disability. The study recruited 61 female and 29 male participants from physical therapy clinics. The participants were between 20-to-60 years of age and diagnosed with CNLBP. All participants completed the Fear Avoidance Belief Questionnaire, The Pain Catastrophizing Scale, The Patient Health Questionnaire-9, The Pain Self-Efficacy Questionnaire, and The Lumbar Oswestry Disability Index. The battery of questionnaires measured fear of physical activity, pain catastrophizing, depression, pain self-efficacy, and reported disability. Multivariate regression and mediation analyses was used to analyse the data. Results The principal finding was a strong inverse relationship between pain self-efficacy and reported disability with a p-value < 0.001. Further, pain self-efficacy was considered a statistical mediator with consistent p-value < 0.001 for the specific psychosocial factors investigated within this data set. Pain self-efficacy was considered to have a mediating role between reported fear of physical activity and disability, reported pain catastrophizing and disability, and reported depression and disability. Additionally, age and reported pain levels proved to be statistically significant. Adjustments for age and pain level did not alter the role of pain self-efficacy. Conclusion The results identified a mediating role for pain self-efficacy between the specific psychosocial factors (fear, catastrophizing, and depression) and reported disability. Pain self-efficacy plays a more significant role in the relationships between these specific psychosocial factors and reported disability with CNLBP than previously considered.

Factor Structure and Convergent Validity of the Portuguese version of the Inventory of Interpersonal Problems – 32

2020 ◽  
Vol 11 ◽  
Author(s):  
Bruno Faustino ◽  
António Branco Vasco
Keyword(s):  
Factor Structure ◽  
Convergent Validity ◽  
Interpersonal Problems ◽  
Brief Symptom Inventory ◽  
Self Report ◽  
Reactivity Index ◽  
Cross Sectional ◽  
Portuguese Version ◽  
Inventory Of Interpersonal Problems ◽  
Interpersonal Styles

Abstract The identification of dysfunctional patterns in individuals’ interpersonal interactions is a cornerstone of psychotherapy. The Inventory of Interpersonal Problems (IIP-32) is one of the most used measures to explore individuals’ interpersonal styles. However, an IIP-32 Portuguese version is missing. Therefore, this study describes a preliminary psychometric study of an IIP-32 Portuguese version in a nonclinical sample. In a cross-sectional correlational design, 250 participants (M age = 20.67, SD = 4.88, males = 33, females = 217) were assessed with self-report questionnaires. Exploratory factor analysis (EFA), convergent, and divergent validities of the IIP-32 were tested with the Interpersonal Reactivity Index (IRI). Relationships with symptomatology were also tested with the Brief Symptom Inventory (BSI-53). The EFA showed a theoretically coherent eight-factor structure. Almost all of the IIP-32 subscales were positively correlated with personal discomfort and with BSI-53 subscales. Vindictive/self-centred, socially inhibited, domineering/controlling and self-sacrificing subscales predicted symptomatology. Promising preliminary psychometric properties were found that may support the IIP-32 as a reliable instrument to assess interpersonal styles. However, more research is required to deepen the analysis of the IIP-32 in the Portuguese population.

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