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How chronic pain patients cope with pain: Relation to treatment outcome in a multidisciplinary pain clinic

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Abstract

One hundred male and 100 female chronic pain patients in a multidisciplinary pain clinic completed a 34-item Pain Coping Questionnaire (PCQ). Factor analysis identified four pain coping factors: self-management, helplessness, social support, and medical remedies. Multiple-regression analyses were conducted to determine the relation between PCQ factors and measures of adjustment at admission to the pain program as well as admission to discharge changes in adjustment measures. The following concepts relevant to coping with chronic pain were defined: cognitive strategies, self-efficacy, helplessness, catastrophizing, and cognitive distortion. Suggestions were made for integrating these concepts in the development of scales for assessing strategies for coping with chronic pain.

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References

  • Beck, A. T. (1967).Depression: Clinical, experimental, and theoretical aspects. New York: Harper & Row.

    Google Scholar 

  • Beck, A. T., Weissman, A., Lester, D., & Trexler, L. (1974). The measurement of pessimism: The Hopelessness Scale.Journal of Consulting and Clinical Psychology, 42 861–865.

    Google Scholar 

  • Billings, A. G., & Moos, R. H. (1981). The role of coping responses and social resources in attenuating the stress of life events.Journal of Behavioral Medicine, 4 139–155.

    Google Scholar 

  • Block, A. R. (1982). Multidisciplinary treatment of chronic low back pain: A review.Rehabilitation Psychology, 27 51–63.

    Google Scholar 

  • Brown, G. K., & Nicassio, P. M. (1987). Development of a questionnaire for the assessment of active and passive coping strategies in chronic pain patients.Pain, 31 53–64.

    Google Scholar 

  • Brown, G. K., Nicassio, P. M., & Wallston, K. A. (1989). Pain coping strategies and depression in rheumatoid arthritis.Journal of Consulting and Clinical Psychology, 57 652–657.

    Google Scholar 

  • Crook, J., Tunks, E., Kalaher, S., & Roberts, J. (1988). Coping with persistent pain: A comparison of persistent pain sufferers in a specialty pain clinic and in a family practice clinic.Pain, 34 175–184.

    Google Scholar 

  • Derogatis, L. R., & Spencer, P. M. (1982).Brief Symptom Inventory. Baltimore: Clinical Psychometric Research.

    Google Scholar 

  • Dolce, J. J. (1987). Self-efficacy and disability beliefs in behavioral treatment of pain.Behavior Research and Therapy, 25 289–299.

    Google Scholar 

  • Dolce, J. J., Crocker, M. F., & Doleys, D. M. (1986). Prediction of outcome among chronic pain patients.Behavior Research and Therapy, 24 313–319.

    Google Scholar 

  • Fernandez, E., & Turk, D. C. (1989). The utility of cognitive coping strategies for altering pain perception: A meta-analysis.Pain, 38 123–135.

    Google Scholar 

  • Follick, M. J., Ahern, D. K., Attanasio, V., & Riley, J. F. (1985). Chronic pain programs: Current aims, strategies, and needs.Annals of Behavioral Medicine, 7 12–20.

    Google Scholar 

  • Fordyce, W. E. (1976).Behavioral methods in chronic pain and illness. St. Louis: C. V. Mosby.

    Google Scholar 

  • Gil, K. M., Abrams, M. R., Phillips, G., & Keefe, F. J. (1989). Sickle cell disease pain: Relation of coping strategies to adjustment.Journal of Consulting and Clinical Psychology, 57 725–731.

    Google Scholar 

  • Gil, K. M., Williams, D. A., Keefe, F. J., & Beckham, J. C. (1990). The relationship of negative thoughts to pain and psychological distress.Behavior Therapy, 21 349–362.

    Google Scholar 

  • Kaplan, H. B., Martin, S. S., & Robbins, D. (1984). Pathways to adolescent drug use: Self-derogation, peer influence, weakening of social controls, and early substance use.Journal of Health and Social Behavior, 25 270–289.

    Google Scholar 

  • Keefe, F. J., Brown, G. K., Wallston, K. A., & Caldwell, D. S. (1989). Coping with rheumatoid arthritis pain: Catastrophizing as a maladaptive strategy.Pain, 37 51–56.

    Google Scholar 

  • Keefe, F. J., Caldwell, D. S., Queen, K. T., Gil, K. M., Martinez, S., Crisson, J. E., Ogden, W., & Nunley, J. (1987a). Osteoarthritic knee pain: A behavioral analysis.Pain, 28 309–321.

    Google Scholar 

  • Keefe, F. J., Caldwell, D. S., Queen, K. T., Gil, K. M., Martinez, S., Crisson, J. E., Ogden, W., & Nunley, J. (1987b). Pain coping strategies in osteoarthritis patients.Journal of Consulting and Clinical Psychology, 55 208–212.

    Google Scholar 

  • Keefe, F. J., Caldwell, D. S., Williams, D. A., Gil, K. M., Mitchell, D., Robertson, C., Martinez, S., Nunley, J., Beckham, J. C., Crisson, J. E., & Helms, M. (1990). Pain coping skills training in the management of osteoarthritic knee pain: A comparative study.Behavior Therapy, 21 49–62.

    Google Scholar 

  • Keefe, F. J., & Williams, D. A. (1989). New directions in pain assessment and treatment.Clinical Psychology Review, 9 549–568.

    Google Scholar 

  • Kerns, R. D., Turk, D. C., & Holzman, A. D. (1983). Psychological treatment for chronic pain: A selective review.Clinical Psychology Review, 3 15–26.

    Google Scholar 

  • Kerns, R. D., Turk, D. C., & Rudy, T. E. (1985). The West Haven-Yale Multidimensional Pain Inventory (WHYMPI).Pain, 23 345–356.

    Google Scholar 

  • Kleinke, C. L. (1987). Patients' preferences for pain treatment modalities in a multidisciplinary pain clinic.Rehabilitation Psychology, 32 113–120.

    Google Scholar 

  • Lawson, K., Reesor, K. A., Keefe, F. J., & Turner, J. A. (1990). Dimensions of pain-related cognitive coping: Cross-validation of the factor structure of the Coping Strategy Questionnaire.Pain, 43 195–204.

    Google Scholar 

  • Lazarus, R. S., & Folkman, S. (1984).Stress, appraisal, and coping. New York: Springer.

    Google Scholar 

  • McNair, D. M., Lorr, M. L., & Droppleman, L. F. (1971).Manual for the Profile of Mood States. San Diego: Educational and Industrial Testing Service.

    Google Scholar 

  • Melzack, R. (1975). The McGill Pain Questionnaire: Major properties and scoring methods.Pain, 1 277–299.

    Google Scholar 

  • Peck, J. R., Smith, T. W., Ward, J. R., & Milano, R. (1989). Disability and depression in rheumatoid arthritis: A multitrait-multimethod investigation.Arthritis and Rheumatism, 32 1100–1106.

    Google Scholar 

  • Reesor, K. A., & Craig, K. D. (1988). Medically incongruent chronic back pain: Physical limitations, suffering, and ineffective coping.Pain, 32 35–45.

    Google Scholar 

  • Rosenstiel, A. K., & Keefe, F. J. (1983). The use of coping strategies in chronic low back pain patients: Relationship to patient characteristics and current adjustment.Pain, 17 33–44.

    Google Scholar 

  • Roy, R. (1984). Pain clinics: Reassessment of objectives and outcomes.Archives of Physical Medicine and Rehabilitation, 65 448–451.

    Google Scholar 

  • Russell, D., Peplau, L. A., & Cutrona, C. E. (1980). The revised UCLA Loneliness Scale: Concurrent and discriminant validity evidence.Journal of Personality and Social Psychology, 39 472–480.

    Google Scholar 

  • Smith, T. W., Follick, M. J., Ahern, D. K., & Adams, A. (1986). Cognitive distortion and disability in chronic low back pain.Cognitive Therapy and Research, 10 201–210.

    Google Scholar 

  • Smith, T. W., Peck, J. R., Milano, R. A., & Ward, J. R. (1988). Cognitive distortion in rheumatoid arthritis: Relation to depression and disability.Journal of Consulting and Clinical Psychology, 56 412–416.

    Google Scholar 

  • Smith, T. W., Peck, J. R., & Ward, J. R. (1990). Helplessness and depression in rheumatoid arthritis.Health Psychology, 9 377–389.

    Google Scholar 

  • Spangler, A. S., Jr. (1985). Treatment outcome of patients in a comprehensive pain program: Influence of hopelessness and depression.Dissertation Abstracts International. (University Microfilms No. 85-22, 968).

  • Turk, D. C., Holzman, A. D., & Kerns, R. D. (1986). Chronic pain. In K. A. Holroyd & T. L. Creer (Eds),Self-management of chronic disease (pp. 441–472). New York: Academic Press.

    Google Scholar 

  • Turk, D. C., & Rudy, T. E. (1986). Assessment of cognitive factors in chronic pain: A worthwhile enterprise?Journal of Consulting and Clinical Psychology, 54 760–768.

    Google Scholar 

  • Turner, J. A., & Clancy, S. (1986). Strategies for coping with chronic low back pain: Relationship to pain and disability.Pain, 24 355–364.

    Google Scholar 

  • Turner, J. A., Clancy, S., & Vitaliano, P. P. (1987). Relationship of stress, appraisal and coping to chronic low back pain.Behavior Research and Therapy, 25 281–288.

    Google Scholar 

  • Vitaliano, P. P. (1988).ADS and WCCL Manual. Seattle: University of Washington.

    Google Scholar 

  • Wagner, J. W. (1982).Coping strategies in response to chronic pain: Effects on illness course. Unpublished doctoral dissertation, New School for Social Research, New York.

    Google Scholar 

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  1. Psychology Department, University of Alaska, 99508, Anchorage, Alaska, USA

    Chris L. Kleinke

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Kleinke, C.L. How chronic pain patients cope with pain: Relation to treatment outcome in a multidisciplinary pain clinic. Cogn Ther Res 16, 669–685 (1992). https://doi.org/10.1007/BF01175406

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