| Summary: | Data from daily diaries were used to examine the relationships between
daily pain appraisals (Catastrophizing, Self-Efficacy, and perceived control over
pain) and coping strategy use (Distraction, Ignoring Pain, Praying and Hoping, and
Reinterpreting Pain Sensation) and nighttime negative mood and pain intensity for
88 women (mean age 46.83 years, SD 11.90) with chronic low back pain who
were not attending a specialized pain treatment program. These relationships were
examined at two levels using the Hierarchical Linear Modeling program (Bryk &
Raudenbush, 1992). The first level of analyses examined whether pain appraisals
and coping strategy use during the day predicted levels of nighttime depressed and
anxious mood, and pain. This analysis was based on 30 days of monitoring for
each participant. The second level of analyses examined whether these daily
processes could be predicted by psychosocial and functional variables important to
the experience of chronic pain. This analysis was based on the Mutidimensional
Pain Inventory (Kerns, Turk, & Rudy, 1985) completed prior to participants
beginning the daily monitoring.
There were four major findings in this study. First, pain appraisals were
more predictive of negative mood and pain intensity than coping strategy use, with
Catastrophizing the strongest predictor of depressed and anxious mood, and
control the strongest predictor of pain intensity. Second, general affective distress
predicted higher levels of negative mood on a daily basis. Third, women who perceived their pain to be interfering a great deal in their lives were more anxious
on a daily basis. Fourth, punishing spousal responses predicted nightly negative
mood and pain more than solicitous or distracting spousal responses.
These results are similar to findings based on patients attending pain
treatment programs. This suggests that some of the same processes identified in
clinical pain patients may apply to low back pain sufferers in the community who
are comparable to study participants. The implications of these findings for pain
research and treatment are discussed.
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