Self‐compassion predicting pain, depression and anger in people suffering from chronic pain: A prospective study

Abstract

Self-compassion is associated with disability, pain-related anxiety as well as depression and anger in patients with chronic pain. However, the unique value of selfcompassion versus other concepts such as psychological flexibility and self-esteem is unknown. The present study therefore aimed to clarify these relationships. Individuals with chronic pain (N CP = 872) and without chronic pain (N NP = 356) took part in a longitudinal study. Participants completed self-report instruments: Pain Disability Index (PDI), Pain Catastrophizing Scale (PCS), Pain Anxiety Symptom Scale (PASS-20), Patient Health Questionnaire (PHQ-9), State Trait Anger Expression Inventory (STAXI), Self-Compassion Scale (SCS), Psychological Inflexibility in Pain Scale (PIPS) and Rosenberg Self-Esteem Scale (RSES). Assessments were repeated after 8 weeks. We found differences in baseline levels of all relevant variables except for anger-out and anger-control between people with and without chronic pain. Subsequently, we computed a path model analysis regarding individuals suffering from chronic pain (N CP), addressing the predictive value of reduced uncompassionate self-responding (RUS), compassionate self-responding (CS), avoidance (PIPS), cognitive fusion (PIPS) and self-esteem (RSES) regarding pain-related (PDI, PCS, PASS) and emotional variables (PHQ-9, STAXI). Avoidance predicted disability, catastrophizing, anxiety and depression. RUS predicted catastrophizing and painrelated anxiety. Self-esteem predicted depression. CS and cognitive fusion had no unique predictive value. The model explained 65.4%-72.1% of the variance in painrelated variables, 68.7% of the variance in depression and 38.7%-60.7% in the variance of anger-related variables. In conclusion, psychological flexibility, in terms of avoidance, seems to be more relevant for chronic pain than self-compassion. Future research should focus on subgroups and tailored-treatment approaches. Significance: Applying a longitudinal design, this study examined the predictive value of self-compassion regarding pain, depression and anger. The relevance of self-compassion was compared to psychological flexibility and self-esteem. We can conclude that psychological flexibility, in terms of avoidance behaviour, is the most relevant predictor concerning pain. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Potential Role of Pain Catastrophic Thinking in Comorbidity Patients of Depression and Chronic Pain

“…Although previous studies on depression showed that pain-related anxiety can induce pain experience, they did not investigate its accuracy (31). Our study demonstrated that the total PASS score and fear of pain score were most severe in the comorbidity group (32,33). This result is in line with previous studies showing that anxiety sensitivity and anxiety severity are correlated with actual and expected pain-related fear (34).…”

Self‐compassion and fear of cancer recurrence in Chinese breast cancer patients: The mediating role of maladaptive cognitive styles

“…Furthermore, this study found that catastrophising, but not rumination, mediates the relationship between self-compassion and FCR. Our findings add to previous studies 33,34 and provide more empirical evidence showing the mediating role of maladaptive cognition between self-compassion and psychological symptoms. 19,21,35 Moreover, these findings also provide empirical evidence to support theoretical models of FCR by showing that maladaptive cognition (e.g., catastrophising) plays an important role in the development and maintenance of FCR.…”

Personalized Multimodal Lifestyle Intervention as the Best-Evidenced Treatment for Chronic Pain: State-of-the-Art Clinical Perspective

“…Hence, clinicians need to identify possible barriers for engaging in the behavioral change that is required for adhering to a healthy lifestyle. For instance, predominant biomedical beliefs, fear of movement, heightened worry (in the context of pain), hypervigilance, (lack of) self-compassion, perceived injustice and poor acceptance are often seen in patients with chronic pain, and each of them can serve as a barrier for an adaptive lifestyle change [30][31][32][33][34]. Therefore, they should be identified and addressed before initiating the behavioral lifestyle intervention.…”