Access Type

Open Access Dissertation

Date of Award

1-1-1998

Degree Type

Dissertation

Degree Name

Ph.D.

Department

Nursing

First Advisor

Mark A. Lumley, Ph. D .

Abstract

In the chronic pain literature, pain coping and adjustment traditionally have been studied using cognitive and behavioral constructs. Little research attention has been devoted to exploring the role of emotional factors and their contribution to adjustment in chronic pain patients. Recent empirical evidence suggests that certain emotional approach coping strategies and competencies are associated with positive adaptation. This study was conducted to provide a better understanding of the relationship between cognitive and emotional coping and adjustment in chronic myofascial pain patients. In particular, this study sought to introduce emotional processes into the pain coping and adjustment literature. Cognitive and emotional models were compared with each other and with the influence of life stress, in the prediction of adjustment. Study participants were 80 adults with chronic myofascial pain syndromes. Patients completed self-report measures of cognitive constructs (self-efficacy and cognitive pain coping strategies), emotional constructs (emotional approach coping, alexithymia, and meta-mood skills), life stress, and adjustment. Healthy adjustment was conceptualized as low levels of sensory and affective pain, physical impairment, and depression. Results of this study revealed that both cognitive and emotional factors were important in the prediction of physical and psychological adjustment outcomes in chronic myofascial pain patients. When factor analyzed, emotional constructs loaded together on one Emotional Coping factor. Cognitive constructs loaded onto two factors, Self-Efficacy and Cognitive Coping. An overall factor analysis including emotional and cognitive constructs produced a three factor solution. Self-Efficacy, Cognitive Coping, and Emotional Coping all were found to be separate predictors, accounting for unique variance in different domains of adjustment and predicting adjustment beyond the effects of life stress. Self-Efficacy was found to be a particularly robust predictor of positive adaptation. Emotional Coping was found to be a more robust predictor than Cognitive Coping. Both cognitive and emotional constructs play a key role in understanding adjustment in chronic myofascial pain patients. Further, assessing emotional constructs can add predictive power to cognitive constructs typically used to predict adaptation to chronic pain.

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