Age as a moderator in the interplay among locus of control, coping, and quality of life of people with chronic pain

Abstract

Objective Identifying the factors that determine the quality of life of patients with chronic pain is an integral part of developing interventions to reduce the negative impact of persistent pain. Locus of control (LoC) may play an important role in adaptation to prolonged pain, but the results of studies are inconsistent. We examined the link between pain LoC and quality of life. Moreover, we investigated whether the relationship between LoC and quality of life is mediated by passive and active coping, and whether age moderates the LoC–coping relationship. Methods The study was cross-sectional and variables (internal, chance and powerful-others LoC, pain-coping strategies, average pain intensity, quality of life) were assessed via questionnaires in a sample of 594 individuals (67% females) with chronic pain, aged 18–72 (mean: 36). Results Mediation and moderated mediation analyses were conducted. Internal and external LoC were associated, respectively, with better and with worse quality of life. Passive coping mediated the association between the powerful-others dimension of LoC and poor quality of life. Additionally, indirect effects of internal LoC on quality of life via passive and active coping were found. The relationship between the powerful-others dimension of LoC and coping was stronger for middle-aged and older individuals than for younger individuals. Conclusions This study contributes to a better understanding of the mechanisms linking LoC with quality of life of patients with chronic pain. Depending on the age, control beliefs may differently translate into strategies used to cope with pain, and thus into quality of life.