Pain beliefs, coping, and social support as predictors of physical and psychological adjustment in chronic pain patients.

The cognitive-behavioral model of chronic pain (Turk, 1984) has dominated the literature on adjustment to chronic pain. Many studies have examined the role of pain beliefs and coping in the development of depression and physical disability among chronic pain patients. In the current study, a biopsychosocial model of chronic pain is proposed and evaluated. This model builds on the cognitive-behavioral model by positing that social support also plays a role in the adjustment process in addition to pain beliefs and coping. Thus, this study examined how pain locus of control, coping, and emotional and instrumental support predict depression and physical adjustment in a sample of chronic pain patients. The mechanisms by which social support affects adjustment are also examined by looking at mediating relationships between social support and adjustment and by evaluating main effects versus buffer effects of social support. A sample of 93 chronic pain patients recruited from three specialized pain clinics completed a battery of self-report measures. Data were analyzed using a series of multiple regression analyses controlling for covariates and pain intensity. Powerful Others Locus of Control was found to have a weak but significant positive relationship with depression. Passive Coping was positively associated with depression and physical disability and negatively associated with physical functioning. Emotional Support was found to be a significant predictor of decreased physical disability. Results did not support the role of pain locus of control as mediator in the relationship between social support and adjustment but strong support was found for the mediating role of coping in the relationship between attributions of control to powerful others and depression. Also, observed relationships between social support and coping were consistent with the conceptualization of social support as coping assistance. No support was found, however, for the buffer model of social support. Predictive models for depression, physical functioning, and physical disability are described and implications of these findings for the usefulness of a biopsychosocial model of chronic pain are discussed.Dept. of Psychology. Paper copy at Leddy Library: Theses & Major Papers - Basement, West Bldg. / Call Number: Thesis2001 .B48. Source: Dissertation Abstracts International, Volume: 63-04, Section: B, page: 2049. Adviser: Cheryl Thomas. Thesis (Ph.D.)--University of Windsor (Canada), 2001