Abstract
Operant and cognitive-behavioral models of chronic pain have called attention to the importance of examining the marital and family environments of chronic pain patients. In this study, 50 chronic pain patients and their spouses and 33 control participants and their spouses completed measures of the family environment, marital satisfaction, and patient physical and psychological functioning. Patients' overt pain behaviors were coded from videotapes of patient–spouse interactions. Compared to controls, pain patients and their spouses rated their family environments as lower in cohesion and higher in control, and there was a trend for spouses to report more marital dissatisfaction. Chronic pain patient depression was associated negatively with patient-rated family cohesion and expressiveness and spouse-rated family organization and positively with patient-rated family conflict. Overt patient pain behaviors and spouse-rated patient disability were related negatively to spouse-rated family cohesion. Spouse marital satisfaction was associated negatively with patient depression and with spouse ratings of patient disability and pain behaviors.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
REFERENCES
Ahern, D. K., Adams, A. E., & Follick, M. J. (1985). Emotional and marital disturbance in spouses of chronic low back pain patients. Clinical Journal of Pain, 1, 69–74.
Bergner, M., Bobbitt, R. A., Carter, W. B., & Gilson, B. S. (1981). The Sickness Impact Profile: Development and final revision of a health status measure. Medical Care, 19, 787–805.
Block, A. R., Kremer, E. R., & Gaylor, M. (1980). Behavioral treatment of chronic pain: The spouse as a discriminative cue for pain behavior. Pain, 8, 243–252.
Brown, G. K., Wallston, K, A., & Nicassio, P. M. (1989). Social support and depression in rheumatoid arthritis: A one-year prospective study. Journal of Applied Social Psychology, 19, 1164–1181.
Dura, J. R., & Beck, S. J. (1988). A comparison of family functioning when mothers have chronic pain. Pain, 35, 79–89.
Faucett, J. A. (1994). Depression in painful chronic disorders: The role of pain and conflict about pain. Journal of Pain Symptom Management, 9, 520–526.
Faucett, J. A., & Levine, J. D. (1991). The contributions of interpersonal conflict to chronic pain in the presence or absence of organic pathology. Pain, 44, 35–43.
Fernandez, E., & McDowell, J. J. (1995). Response-reinforcement relationships in chronic pain syndrome: Applicability of Herrnstein's law. Behaviour Research and Therapy, 33, 855–863.
Feuerstein, M., Sult, S., & Houle, M. (1985). Environmental stressors and chronic low back pain: Life events, family and work environment. Pain, 22, 295–307.
Flor, H., Kerns, R. D., & Turk, D. C. (1987). The role of spouse reinforcement, perceived pain, and activity levels of chronic pain patients. Journal of Psychosomatic Research, 31, 251–259.
Flor, H., Turk, D. C., & Scholz, O. B. (1987). Impact of chronic pain on the spouse: Marital, emotional, and physical consequences. Journal of Psychosomatic Research, 31, 63–71.
Flor, H., Turk, D. C., & Rudy, T. E. (1989). Relationship of pain impact and significant other reinforcement of pain behaviors: The mediating role of gender, marital status, and marital satisfaction. Pain, 38, 45–50.
Hops, H., Biglan, A., Tolman, A., Arthur, J., Sherman, L., Warner, P., Romano, J., Turner, J., Friedman, L., Bulcroft, R., Holcomb, C., Oosternick, N., & Osteen, V. (1990). Living in Family Environments (LIFE) coding system (rev. ed.). Eugene: Oregon Research Institute.
Kerns, R. D., & Turk, D. C. (1984). Depression and chronic pain: The mediating role of the spouse. Journal of Marriage and the Family, 46, 845–852.
Kerns, R. D., & Weiss, L. H. (1994). Family influences on the course of chronic illness: A cognitive-behavioral transactional model. Annals of Behavioral Medicine, 16, 116–121.
Kopp, M., Richter, R., Rainer, J., Kopp-Wilfling, P., Rumpold, G., & Walter, M. H. (1995). Differences in family functioning between patients with chronic headache and patients with chronic low back pain. Pain, 63, 219–224.
Manne, S. L., & Zautra, A. J. (1989). Spouse criticism and support: Their association with coping and psychological adjustment among women with rheumatoid arthritis. Journal of Personality and Social Psychology, 56, 608–617.
Maruta, T., Osborne, D., Swanson, D. W., & Halling, J. M. (1981). Chronic pain patients and spouses: Marital and sexual adjustment. Mayo Clinic Proceedings, 56, 307–310.
Melzack, R. (1975). The McGill Pain Questionnaire: Major properties and scoring methods. Pain, 1, 277–299.
Mohamed, S. N., Weisz, G. M., & Waring, E. M. (1978). The relationship of chronic pain to depression, marital adjustment, and family dynamics. Pain, 5, 285–292.
Moos, R. H. (1986). Family Environment Scale (2nd ed.). Palo Alto, CA: Consulting Psychologists Press.
Naidoo, P., & Pillay, Y. G. (1994). Correlations among general stress, family environment, psychological distress, and pain experience. Perceptual and Motor Skills, 78, 1291–1296.
Nicassio, P. M., & Radojevic, V. (1993). Models of family functioning and their contribution to patient outcomes in chronic pain. Motivation and Emotion, 17, 295–316.
Patterson, J. M., & Garwick, A. W. (1994). The impact of chronic illness on families: A family systems perspective. Annals of Behavioral Medicine, 16, 131–142.
Radloff, L. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychosocial Measurement, 1, 385–401.
Romano, J. M., Turner, J. A., Friedman, L. S., Bulcroft, R. A., Jensen, M. P., & Hops, H. (1991). Observational assessment of chronic pain patient-spouse behavioral interactions. Behavior Therapy, 11, 549–567.
Romano, J. M., Turner, J. A., Friedman, L. S., Bulcroft, R. A., Jensen, M. P., Hops, H., & Wright, S. F. (1992). Sequential analysis of chronic pain behaviors and spouse responses. Journal of Consulting and Clinical Psychology, 60, 777–782.
Romano, J. M., Turner, J. A., Jensen, M. P., Friedman, L. S., Bulcroft, R. A., Hops, H., & Wright, S. F. (1995). Chronic pain patient-spouse behavioral interactions predict patient disability. Pain, 63, 353–360.
Spanier, G. B. (1976). Measuring dyadic adjustment: New scales for assessing the quality of marriage and similar dyads. Journal of Marriage and the Family, 38, 15–28.
Syrjala, K., & Chapman, C. R. (1984). Measurement of clinical pain: A review and integration of research findings. In C. Benedetti, C. R. Chapman, & G. Moricca (Eds.), Recent advances in the management of pain, Vol. 7. Advances in pain research and therapy (pp. 257–296). New York: Raven Press.
Turk, D. C., & Kerns, R. D. (1985). The family in health and illness. In D. C. Turk & R. D. Kerns (Eds.), Health, illness and families: A life span perspective (pp. 1–22). New York: Wiley.
Turk, D. C., Wack, J. T., & Kerns, R. D. (1985). An empirical examination of the “pain-behavior” construct. Journal of Behavioral Medicine, 8, 119–130.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Romano, J.M., Turner, J.A. & Jensen, M.P. The Family Environment in Chronic Pain Patients: Comparison to Controls and Relationship to Patient Functioning. Journal of Clinical Psychology in Medical Settings 4, 383–395 (1997). https://doi.org/10.1023/A:1026253418543
Issue Date:
DOI: https://doi.org/10.1023/A:1026253418543