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Interpersonal problems as a predictor of pain catastrophizing in patients with chronic pain

Ryum, Truls; Jacobsen, Henrik Børsting; Borchgrevink, Petter Chr.; Landrø, Nils Inge; Stiles, Tore C
Peer reviewed, Journal article
Published version
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Ryum (Locked)
URI
https://hdl.handle.net/11250/2648178
Date
2019
Metadata
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Original version
Scandinavian Journal of Pain. 2019, 1-9.   10.1515/sjpain-2019-0064
Abstract
Background and aims

Pain catastrophizing has consistently been related to a variety of negative outcomes within chronic pain conditions, but competing models exist explaining the role of catastrophizing. According to the fear-avoidance model (FAM), catastrophizing is primarily related to the appraisal of pain (i.e. “intrapersonal”), whereas the communal coping model (CCM) suggests that catastrophizing is a strategy to elicit support (i.e. “interpersonal”). In order to examine the interpersonal nature of catastrophizing, this cross-sectional study examined interpersonal problems as a predictor of pain catastrophizing in a sample of patients (n = 97) with chronic pain.

Methods

Self-report data was taken from patients entering a multidisciplinary, inpatient rehabilitation program. The four quadrants of the Inventory of Interpersonal Problems circumplex model (Hostile-Dominant, Hostile-Submissive, Friendly-Submissive, Friendly-Dominant) were used as predictors of pain catastrophizing in a series of separate, hierarchical regression analyses.

Results

After controlling for relevant confounding variables such as demographics (gender, age), pain severity, psychiatric symptoms (anxiety/depression, fatigue, insomnia), adverse life experiences and perceived social support, higher levels of Hostile-Dominant interpersonal problems predicted higher levels of pain catastrophizing (p ≤ 0.01, d = 0.56).

Conclusions

The results add support to the notion that pain catastrophizing may serve a communicative functioning, as predicted by the CCM, with cold, dominant and controlling behaviors as a maladaptive interpersonal strategy to elicit support. It may thus be useful to consider the broader interpersonal context of the individual, and not only the patient’s appraisal of pain, when conceptualizing the role of pain catastrophizing in patients with chronic pain.

Implications

Future psychosocial research and treatment of chronic pain could be informed by including interpersonal theory as a useful theoretical framework, which may help shed more light on how interpersonal problems relates to pain catastrophizing.
Publisher
De Gruyter
Journal
Scandinavian Journal of Pain

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