Emotions matter: The role of emotional approach coping in chronic pain

Abstract

Background Emotional approach coping (EAC) is a potentially adaptive emotion‐focused coping style that involves understanding or processing one's emotions and expressing them appropriately. Although EAC has been studied in various populations, little is known about this construct among people with chronic pain, including potential mediators such as negative affect, which might link EAC to pain‐related variables, and moderators of these relationships. Methods Participants (N = 670; 76% women; 30% older adults—age 60 or over) with chronic pain completed online the Emotional Approach Coping Scale and measures of pain severity, pain interference and negative affect. Analyses correlated EAC to pain severity and interference and tested whether gender and age group (older adults versus young/middle‐age adults) moderated the mediated relationships of EAC with pain‐related variables through negative affect. Results Findings reveal that higher EAC was associated with lower pain intensity through lower negative affect in the young/middle‐age portion of the sample, but not older adults. Also, higher EAC was associated with lower pain interference through lower negative affect among women in the sample, but not men. The associations of EAC to pain intensity and interference are small in magnitude, however, and should be considered preliminary. Conclusion EAC is associated with lower pain intensity in young/middle‐age adults and lower pain interference in women, and lower negative affect mediates these relationships. These results suggest the potential value of assessing and bolstering emotional approach coping processes in some people with chronic pain.

Grieving a disrupted biography: an interpretative phenomenological analysis exploring barriers to the use of mindfulness after neurological injury or impairment

“…The current results demonstrated active self-management of grief, with participants reporting 'turning towards' their injury or illness within meditation practice. This exemplifies adaptive approachbased coping which can aid in the self-regulation of emotions and psychological wellbeing [35]. The current study demonstrated that by prioritising acceptance of the present, inclusive of one's health status, psychological flexibility was enhanced, as also exhibited in chronic pain [36].…”

Comparing Perceived Pain Impact Between Younger and Older Adults With High Impact Chronic Pain: A Cross-Sectional Qualitative and Quantitative Survey

“…One study on adolescents with chronic pain reports increased cognitive burden for hiding pain symptoms to avoid social judgment, avoid being a social burden, and be treated normally (66), which is also worth exploring in adults with chronic pain. Notably, this study did not conduct a priori power analysis and had a small sample size, but other studies with a large sample size consistently found no significant difference in the PROMIS-PI scores between younger and older adults with chronic pain (14,67,68). This study noted the effect size, which would be useful for a priori sample size calculation in the future study comparing the groups with and without HICP.…”

“…While chronic pain is more common in older adults (≥65 years of age), relatively few studies on pain have focused on this potentially vulnerable population. So far, the research has found small but significant differences in health status between younger and older adults with chronic pain (12)(13)(14). Specifically, older adults with chronic pain generally report worse physical health status and pain-related disability but better mental health and quality of life than younger adults with chronic pain (12,13).…”

Managing medical and psychiatric multimorbidity in older patients

“… 130 Conversely, emotional approach coping has been associated with lower pain severity among patients with chronic pain and multimorbidity. 131 Yet clinicians often do not ask enough about people’s childhoods, past traumas, and emotion regulation in the course of chronic pain treatment. 132 Consideration of the critical psychological drivers of centralized pain has important treatment implications, as the ‘treatment of choice’ 133 for centralized pain is emotional awareness and expression therapy (EAET), a psychological approach that encourages approach rather than avoidance of difficult emotional experiences, such as healthy anger, grief, guilt, and love.…”