Coping with chronic pain: a critical review of the literature

Abstract

A growing number of investigators have used models of stress and coping to help explain the differences in adjustment found among persons who experience chronic pain. This article reviews the empirical research which has examined the relationships among beliefs, coping, and adjustment to chronic pain. Although preliminary, some consistent findings are beginning to emerge. For example, patients who believe they can control their pain, who avoid catastrophizing about their condition, and who believe they are not severely disabled appear to function better than those who do not. Such beliefs may mediate some of the relationships between pain severity and adjustment. Although coping strategies appear to be associated with adjustment in chronic pain patients, methodological problems limit conclusions regarding the strength and nature of this association. Our recommendations for future research include the development of coping and belief measures which: (1) do not confound different dimensions (e.g., coping, beliefs, and adjustment) in the same measure; (2) assess specific (rather than composite) constructs; (3) are psychometrically sound; and (4) assess behavioral coping strategies more objectively. We also recommend a greater use of experimental research designs to examine causal relationships among appraisals, coping, and adjustment.

Coping with arthritis: Current status and critique

“…Such items appear to assess emotional responses (in fact, resemble items on the Beck Depression Inventory), rather than efforts to deal with the stressor. Jensen et al (29) and Sullivan and D'Eon (30) discuss this issue and provide evidence supporting both sides: Items on the CSQ have been rated as representing symptoms of depression (30), and longitudinal studies have suggested that initial catastrophization scores predict later depression, even when initial depression scores are controlled for (22). Thus, conclusions about cognitive coping and psychological outcome should be made with caution.…”

Is a positive clinical outcome after exercise therapy for chronic non-specific low back pain contingent upon a corresponding improvement in the targeted aspect(s) of performance? A systematic review

“…Both psychological and psychosocial interventions in addition to conventional exercise therapy may have a more positive effect on treatment outcome [80][81][82][83][84][85][86][87][88][89][90]. The targeted effect of such an approach would be the development of a sense of control over pain and the elimination of pain-avoidance mechanisms, whilst simultaneously improving overall physical fitness/function.…”

An assessment of the relative influence of pain coping, negative thoughts about pain, and pain acceptance on health-related quality of life among people with hemophilia

“…However, it is possible that important aspects of coping are not tapped by the pain coping measure employed here, for the HPCQ is based on the Coping Strategies Questionnaire [33], and there are measures that include other aspects of pain coping [17,32]. It may also be that active coping per se may not be important or relevant in hemophilia.…”

“…Pain coping usually refers to purposeful efforts, including both active and passive strategies, to manage pain or reduce its impact, irrespective of whether those efforts are successful [16,17,44]. Pain coping inventories sometimes also include negative thoughts about pain, such as fear, anger and catastrophizing [12,33], which probably reflect emotional distress associated with pain rather than efforts at coping [13,43,44].…”