PERSONALITY, COPING STYLES AND CHRONIC PAIN

1
PERSONALITY,COPING STYLES AND CHRONIC PAIN

• Toward a structural approach to adjustment

2
Outline

• 1. Introduction
• 2. Goal
• 3. Definitions
• 4. Hypotheses
• 5. Sample and Measures
• 6. Results
• 7. Conclusion

3
Outline

• 1. Introduction
• 2. Goal
• 3. Definitions
• 4. Hypotheses
• 5. Sample and Measures
• 6. Results
• 7. Conclusion

4
1.1. The biopsychosocial model of pain

• The Gate Control Theory
• Melzack Wall (1965)
• Multidimensional model of pain
• 4 components sensory-discriminative
• affective-emotional
• cognitive
• behavioral
• Definition of the IASP

5
1.2. Models of Personality

• Trait ? State Model
• (Cottraux Blackburn, 1995)
• Big Five Model (Digman, 1990)
• The Five-Factor Theory
• (McAdams, 1996 Costa McCrae, 1999)

6
1.3. Coping and correlates

• Dispositional vs. Situational approach
• Coping styles vs. Coping responses
• Regulating role vs. Outcomes
• Adjustment vs. Adaptation

7
1.4. Model proposed

• Structural approach
• Postulate Regularities in behavior
• Type of relationship between variables
• A three-level hierarchical model

8
Outline

• 1. Introduction
• 2. Goal
• 3. Definitions
• 4. Hypotheses
• 5. Sample and Measures
• 6. Results
• 7. Conclusion

9
2. Goal

• Answer this question
• Does taking into consideration usual patterns of
  cognition and behavior allow a better
  understanding of specific cognitive-behavioral
  responses to the experience of chronic pain ?

10
Outline

• 1. Introduction
• 2. Goal
• 3. Definitions
• 4. Hypotheses
• 5. Sample and Measures
• 6. Results
• 7. Conclusion

11
3. Definitions

• A theoretical position constrains
• the definition of concepts
• the operationalization of variables

12
3.1. Usual patterns of behavior

• Three levels of patterns
• personality dimensions (Big Five)
• coping styles
• usual coping responses to pain
• characterized by
• temporal stability
• cross-situational consistency

13
3.2. Components of adjustment

• Sensory component of pain
• Sensory / affective descriptors
• Functional component Impact on everyday
  life
• Emotional component
• Depressive / Anxious states

14
Outline

• 1. Introduction
• 2. Goal
• 3. Definitions
• 4. Hypotheses
• 5. Sample and Measures
• 6. Results
• 7. Conclusion

15
4.1. Main Hypothesis

• Chronic pain patients adopt specific pain-related
  behaviors that depend on their personality traits
  and coping styles
• The components of their adjustment to pain
  are related to their usual patterns of behavior

16
4.2. Operationalization

• The relationship between usual patterns of
  behavior and specific pain-related adjustment
  responses differs according to the aspect of pain
  experience measured
• intensity and description of pain
• functional status (daily activities)
• emotional state (depression, anxiety)

17
Outline

• 1. Introduction
• 2. Goal
• 3. Definitions
• 4. Hypotheses
• 5. Sample and Measures
• 6. Results
• 7. Conclusion

18
5.1. Population and Sample

• Outpatients from a multidisciplinary pain clinic
• A specific category of pain patients
• An heterogeneous sample.
• Random diversity of pathologies
• Average duration of pain 7.8 years

19
5.2. Measures of usual patterns of
behavior

• 3 degrees of predictors
• Personality traits
• Coping styles
• Coping responses to pain

• D5D
• CISS
• CSQ

20
5.3. Measures of pain adjustment

• 4 categories of outcome variables
• Intensity of pain
• Description of pain
• Functional impact
• Emotional impact

21
Outline

• 1. Introduction
• 2. Goal
• 3. Definitions
• 4. Hypotheses
• 5. Sample and Measures
• 6. Results
• 7. Conclusion

22
6.1. Proportions of variance
explained

• Sensory components
• intensity of pain 21
• description of pain 41
• Functional impact
• daily activities 30
• outdoor and social activities 44
• Emotional impact
• Depressive state 53
• Anxious state 52

23
6.3. Prediction of pain intensity
Proportion of variance explained
D5D
24
6.2. Partial Correlations
25
6.4. Prediction of affective
description of pain
Proportion of variance explained
D5D
26
6.2. Partial Correlations
27
6.5. Prediction of functional impact of
pain On everyday life
Proportion of variance explained
D5D
28
6.5. Prediction of functional impact of
pain On household chores
Proportion of variance explained
D5D
29
6.2. Partial correlations
30
6.5. Prediction of functional impact of
pain On outdoor and social activities
Proportion of variance explained
D5D
31
6.2. Partial correlations
32
6.6. Prediction of emotional impact of
pain Depressive state (BDI 13)
Proportion of variance explained
D5D
33
6.2. Partial correlations
34
6.6. Prediction of emotional impact of
pain Depressive state (HAD Depression)
Proportion of variance explained
D5D
35
6.6. Prediction of emotional impact of
pain Anxious state (HAD Anxiety)
Proportion of variance explained
D5D
36
6.2. Partial correlations
37
Outline

• 1. Introduction
• 2. Goal
• 3. Definitions
• 4. Hypotheses
• 5. Sample and Measures
• 6. Results
• 7. Conclusion

38
7. Conclusion

• Usual patterns of behavior
• distal variables personality
• proximal variables coping
• ? are significantly correlated with the
  components of pain adjustment
• ? Different patterns of predictors with different
  aspects of adjustment

39
7. Conclusion Personality Dimensions

• Neuroticism is associated
• with poorer adjustment to pain
• Emotional stability, openness, and
  conscientiousness are associated
• with better adjustment to pain

40
7. Conclusion Coping Styles

• Emotion-oriented coping is associated with poorer
  adjustment to pain
• Task-oriented coping and avoidance are associated
  with better adjustment to pain

41
7. Conclusion Coping responses to pain

• Catastrophizing, praying and hoping, and
  distraction are associated with poorer adjustment
  to pain
• Coping self-statements and reinterpreting
  sensations are associated with better adjustment
  to pain