The present research examined the effect of spousal autonomy support on the need satisfaction and well-being of individuals with chronic pain. Married individuals with a diagnosed musculoskeletal chronic pain condition (N = 109) completed a baseline questionnaire and a follow-up questionnaire after a 6-month time period. Cross-lagged analyses indicated that spousal autonomy support predicted increases in basic need satisfaction, and need satisfaction predicted increases in well-being. Moreover, the analyses in the opposite direction were not significant. Similarly, cross-lagged analyses were more supportive of the direction from pain intensity to lower well-being, rather than well-being to pain intensity. Finally, we tested a longitudinal structural model using pain intensity and spousal autonomy support as the predictors, basic needs as the mediator, and well-being as the outcome. The model provided a good fit to the data. Results showed that spousal autonomy support had a positive effect on the need satisfaction and well-being of individuals with chronic pain, independent of pain intensity. These findings extend self-determination theory to the chronic pain context and lay the groundwork for future chronic pain studies using the self-determination theory framework.
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The data presented in this manuscript are part of a longitudinal study that involves ICPs and their spouses. In addition to the measures used in this study, participants also completed the pain catastrophizing scale, self-concealment scale, self-disclosure scale, and items from the multidimensional pain inventory. Their spouses completed a shorter questionnaire packet. Participants were also given the option to complete the questionnaires online. Five participants at T1, and thirteen participants at T2, completed the digital version.
We repeated all of the cross-lagged analyses using gender as a covariate. The findings remained the same with only minor changes. The association between autonomy support and need satisfaction (H1) changed from (β = .17, p = .06) to (β = .22, p = .04). The association between pain intensity and depression (Table 2) changed from (β = .19, p = .03) to (β = .17, p = .06).
Gender also did not moderate the link between autonomy support and need satisfaction (B = .11, SE = .17, p = .52), and the links between need satisfaction and self-esteem (B = −.14, SE = .24, p = .57), need satisfaction and symptoms (B = .17, SE = .26, p = .51), need satisfaction and life satisfaction (B = .19, SE = .26, p = .47). Finally, we conducted mediation analyses for each dependent variable (e.g., autonomy support → need satisfaction → life satisfaction) separately for each gender. The mediation effects were significant and similar for both genders.
We repeated the analyses using multiple imputation for the data of the participants who dropped out from the study. The results remained the same with minor changes. The association between autonomy support and need satisfaction (H1) changed from (β = .17, p = .06) to (β = .18, p = .047). The association between pain intensity and symptoms changed from (β pain = .16, p = .07) to (β pain = .19, p = .016).
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We would like to thank Baskent University Hospital and Dr. Sacide Nur Cosar for their help with the data collection.
Conflict of interest
Ahmet Uysal, Esra Ascigil, and Gamze Turunc declare that they have no conflict of interest.
Human and animal rights and Informed consent
All procedures followed were in accordance with ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.
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Uysal, A., Ascigil, E. & Turunc, G. Spousal autonomy support, need satisfaction, and well-being in individuals with chronic pain: A longitudinal study. J Behav Med 40, 281–292 (2017). https://doi.org/10.1007/s10865-016-9783-1
- Chronic pain
- Self-determination theory
- Need satisfaction
- Autonomy support
- Spousal support