Chronic pain in the context of the lives of dyads:Cognitions, Behaviors, and Well-being

Chronic pain has negative influences both on the patient and the entire family. In an attempt to investigate the interplay between the patient and the social environment, the current thesis showed that interactions among family members play a crucial role in the adjustment of patients with chronic pain. Patients who perceive more problems in the family environment tend to focus more negatively on their pain and thus experience more disability. Furthermore, changes in the family environment resulting from pain (e.g., caregiving demands) impact caregivers' well-being. Particularly, partners with more caregiving demands tend to shape maladaptive cognitions regarding the consequences of a patient’s pain condition, such as the notion that the patient’s pain controls their life, which deteriorates their psychological well-being. Apart from the interactions among family members, the results of this thesis inform us about the cognitive processes underlying the interaction between patients and partners, that is, the motives/meanings underlying pain behaviors and partner responses. This thesis shows that there are many variations regarding the motives/meanings that patients and partners attribute to the behaviors manifested in their interaction. The findings of this thesis suggest whether or not a particular pain behavior is adaptive needs to be determined for each couple. Similarly, patient's and partners’ interpretations of a partner response determine whether that response is rewarding or punishing regardless of the content of that response. Patients and partners need to receive guidance on how to engage in constructive mutual communications, where they are able to explicitly communicate the motives underlying their behaviors