The Moderating role of depression in the relationship between coping strategies and significant others' reactions with the experience of chronic pain

Abstract

Research shows a strong co-morbidity between pain and depression (Schatzberg, 2004). Individuals suffering with both chronic pain and depression exhibit greater pain intensity, greater interference due to pain and more pain behaviours (Haythornthwaite, Sieber & Kerns, 1991). A variety of coping strategies (Endler, Corace, Summerfeldt, Johnson, & Rothbart, 2003; Ramírez-Maestre, Esteve, & Lopez, 2008) and social support (Lopez-Martínez, Esteve-Zarazaga, & Ramírez-Maestre, 2008) have been found to be associated with the pain experience. Previous research on coping among pain patients has not considered the confounding effects of depression in the studies. This project investigates the moderating role of depression in the relationship between pain experiences with coping strategies and reactions from significant others in 201 chronic pain patients. The coping strategies examined include pain-related negative cognitions (pain rumination, pain magnification) and pain-related cognitive coping styles (catastrophizing, coping self-statements, ignoring sensation, distancing, distraction, praying). Reactions from significant others (punishing, solicitous, and distracting responses) were also examined. The various facets of the pain experience examined include pain severity, general interference with functioning, and sense of self-control. The results showed that rumination, catastrophizing, praying and distraction are associated with negative pain experiences, whereas ignoring painful sensations and the use of coping self-statements are associated with more positive pain experiences. Distracting patients from their pain is associated with greater self-efficacy in terms of control over pain. With the exception of the relationship between catastrophizing and work interference, depression was not found to be a moderator between the pain-related factors and pain experience. Instead, it was found to have direct relationship with the pain experience. Supplementary findings suggest that different coping strategies predict the pain experience in men and women.