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The relationship between pain appraisals and coping strategy use and adaptation to chronic low back pain: a daily diary study

University of British Columbia

Data from daily diaries were used to examine the relationships between daily pain appraisals (Catastrophizing, Self-Efficacy, and perceived control over pain) and coping strategy use (Distraction, Ignoring Pain, Praying and Hoping, and Reinterpreting Pain Sensation) and nighttime negative mood and pain intensity for 88 women (mean age 46.83 years, SD 11.90) with chronic low back pain who were not attending a specialized pain treatment program. These relationships were examined at two levels using the Hierarchical Linear Modeling program (Bryk & Raudenbush, 1992). The first level of analyses examined whether pain appraisals and coping strategy use during the day predicted levels of nighttime depressed and anxious mood, and pain. This analysis was based on 30 days of monitoring for each participant. The second level of analyses examined whether these daily processes could be predicted by psychosocial and functional variables important to the experience of chronic pain. This analysis was based on the Mutidimensional Pain Inventory (Kerns, Turk, & Rudy, 1985) completed prior to participants beginning the daily monitoring. There were four major findings in this study. First, pain appraisals were more predictive of negative mood and pain intensity than coping strategy use, with Catastrophizing the strongest predictor of depressed and anxious mood, and control the strongest predictor of pain intensity. Second, general affective distress predicted higher levels of negative mood on a daily basis. Third, women who perceived their pain to be interfering a great deal in their lives were more anxious on a daily basis. Fourth, punishing spousal responses predicted nightly negative mood and pain more than solicitous or distracting spousal responses. These results are similar to findings based on patients attending pain treatment programs. This suggests that some of the same processes identified in clinical pain patients may apply to low back pain sufferers in the community who are comparable to study participants. The implications of these findings for pain research and treatment are discussed.

Thesis/Dissertation

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2009-04-01

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http://hdl.handle.net/2429/6695

Counselling Psychology

University of British Columbia

UBCV

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