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The Correlation of Cognitive Flexibility with Pain Intensity and Magnitude of Disability in Upper Extremity Illness

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Journal of Hand and Microsurgery

Abstract

Cognitive flexibility – the ability to restructure one’s knowledge, incorporate new facts, widen perspective, and adapt to the demands of new and unexpected conditions - can help one adapt to illness. The aim of this study was to assess the relationship between cognitive flexibility and hand and upper extremity specific disability in patients presenting to a hand surgeon. Secondarily, we determined predictors of cognitive flexibility and pain. Eighty-nine consecutive outpatients completed the Cognitive flexibility questionnaire (CFS), Short Health Anxiety Inventory-5 (SHAI-5), Pain Self-Efficacy Questionnaire (PSEQ), Disabilities of Arm, Shoulder and Hand, short form (QuickDASH), and Patient Health Questionnaire for Depression-2 (PHQ-2) in a cross-sectional study. CFS did not correlate with disability or pain intensity. Disability correlated with PSEQ (r = −0.66, p < 0.01), PHQ-2 (r = 0.38, p = <0.01), and SHAI-5 (r = 0.33, p < 0.01). Pain intensity correlated with PSEQ (r = −0.51 p < 0.01) and PHQ-2 (r = 0.41 p < 0.01). There was a small correlation between the CFS and PSEQ (r = 0.25, p = 0.02). The best multivariable models for QuickDASH and pain intensity included PSEQ and PHQ and explained 35 % and 28 % of the variability respectively. Upper extremity specific disability and pain intensity are limited more by self-efficacy than cognitive flexibility. Interventions to improve self-efficacy might help patients with upper extremity illness.

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Acknowledgment

M.G. Hageman is supported by Dutch research grants from Marti-Keunig Eckhart Stichting and Anna Foundation.

Conflict of Interest

None of the authors has a conflict of interest related directly to the subject matter.

Ethical Statement

This research was approved by our human research committee and was performed in accordance with the Helsinki Declaration. Informed consent was obtained from each subject.

Disclosures

No benefits in any form have been received or will be received related directly or indirectly to the subject of this article. The authors report no proprietary or commercial interest in any product mentioned or concept discussed in this article.

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Authors and Affiliations

  1. Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA, 02114, USA

    Michiel G.J.S. Hageman, Jan Paul Briet, Thijs C.H. Oosterhoff, Arjan G. Bot, David Ring & Ana-Maria Vranceanu

  2. Behavioral Medicine Service, Clinical Psychologist, Harvard Medical School, Massachusetts General Hospital, One Bowdoin Square, 7th floor, Boston, MA, 02114, USA

    Michiel G.J.S. Hageman, Jan Paul Briet, Thijs C.H. Oosterhoff, Arjan G. Bot, David Ring & Ana-Maria Vranceanu

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  1. Michiel G.J.S. Hageman
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  2. Jan Paul Briet
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  3. Thijs C.H. Oosterhoff
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  6. Ana-Maria Vranceanu
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Correspondence to Ana-Maria Vranceanu.

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Hageman, M.G., Briet, J.P., Oosterhoff, T.C. et al. The Correlation of Cognitive Flexibility with Pain Intensity and Magnitude of Disability in Upper Extremity Illness. J Hand Microsurg 6, 59–64 (2014). https://doi.org/10.1007/s12593-014-0140-8

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  • DOI: https://doi.org/10.1007/s12593-014-0140-8

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