Motive Satisfaction in Chronic Pain Patients: Does It Improve in Multidisciplinary Inpatient Treatment and, if so, Does It Matter?

Abstract

According to consistency theory, insufficient motive satisfaction (motivational incongruence) is associated with psychological distress and mental disorders. High levels of distress and comorbid psychological disorders are common in patients with chronic pain. The aim of the present study was to investigate the role of motivational incongruence in chronic pain patients and the association of incongruence change with symptom improvement. Inpatients with chronic pain in multimodal interdisciplinary treatment (n = 177) completed questionnaires measuring motivational incongruence, psychological distress, pain intensity and pain interference at the beginning and end of a multimodal interdisciplinary inpatient treatment program at a tertiary psychosomatic university clinic. Results demonstrated that pain and motivational incongruence were significantly reduced at post-treatment, and reductions in incongruence were associated with reductions in psychological distress. In particular, better satisfaction of approach motives mediated the association between reduction of pain interference and psychological distress at post-treatment. Findings suggest that a reduction of motivational incongruence may be part of successful treatment of chronic pain.

Motive Satisfaction Among Patients with Chronic Primary Pain: A Replication

“…The present study aims to replicate the findings of Vincent et al ( 2021 ) using a separate and larger sample of patients with chronic primary pain receiving an inpatient interdisciplinary multimodal pain treatment at the same site. It was hypothesized that patients with chronic primary pain experience higher levels of motivational incongruence at intake than a healthy norm sample.…”

“…To the best of our knowledge, Vincent et al ( 2021 ) have been the first to directly investigate the relationship between chronic pain and motivational incongruence as well as respective associations with psychological distress using the INC-S. They hypothesized that patients with chronic pain have higher levels of motivational incongruence than a healthy norm sample and that pain interference and motivational incongruence can be reduced after interdisciplinary multimodal pain treatment (Vincent et al, 2021 ). Accordingly, Vincent et al ( 2021 ) could show that patients with chronic pain in a interdisciplinary multimodal pain treatment have higher levels of motivational incongruence at intake than a healthy norm sample.…”

“…They hypothesized that patients with chronic pain have higher levels of motivational incongruence than a healthy norm sample and that pain interference and motivational incongruence can be reduced after interdisciplinary multimodal pain treatment (Vincent et al, 2021 ). Accordingly, Vincent et al ( 2021 ) could show that patients with chronic pain in a interdisciplinary multimodal pain treatment have higher levels of motivational incongruence at intake than a healthy norm sample. In addition, motivational incongruence and psychological distress were significantly reduced over treatment.…”

“…In addition, it was expected that the treatment would significantly reduce both motivational incongruence and psychological distress across treatment. In contrast to Vincent et al ( 2021 ), who used multiple regression analyses, this study will use hierarchical linear models (HLM) to replicate the association of psychological distress with motivational approach and avoidance incongruence. Using HLM will allow for differentiating within and between patient effects.…”

“…Using HLM will allow for differentiating within and between patient effects. As in Vincent et al ( 2021 ), exploratory analyses will be conducted to replicate the changes in the different incongruence dimensions throughout treatment. Lastly, it is expected that the better satisfaction of approach motives and, therefore, better approach incongruence will mediate the effect of change in pain interference on change in psychological distress.…”