Psychosocial Factors and Adjustment to Chronic Pain in Persons With Physical Disabilities: A Systematic Review

Arch Phys Med Rehabil, 2011 · DOI: 10.1016/j.apmr.2010.09.021 · Published: January 1, 2011

Mental Health Pain Management Rehabilitation

Simple Explanation

This study looks at how psychological and social factors affect how people with physical disabilities cope with chronic pain. It focuses on factors like how people think about their pain (catastrophizing), how they deal with it (coping), what they believe about it, and how their social environment responds to their pain. The review included studies on people with spinal cord injuries, amputations, cerebral palsy, multiple sclerosis, and muscular dystrophy.

Study Duration

Not specified

Participants

Adults with physical disabilities reporting pain

Evidence Level

Systematic Review

Key Findings

1
Psychosocial factors, including catastrophizing, coping styles, and social support, are significantly linked to pain and dysfunction across various disability groups.
2
Catastrophizing, guarding, and resting were consistently associated with poorer outcomes, while task persistence showed positive associations.
3
Pain-related beliefs had a stronger association with pain and dysfunction in SCI, CP, MS, and MD groups compared to the acquired amputation group.

Research Summary

This systematic review investigated the associations between psychosocial factors and adjustment to chronic pain in individuals with physical disabilities, focusing on spinal cord injury (SCI), acquired amputation, cerebral palsy (CP), multiple sclerosis (MS), and muscular dystrophy (MD). The review found that psychosocial factors such as catastrophizing, coping responses, and social support are significantly associated with pain and dysfunction across disability groups. The study concludes that clinical trials are warranted to test the efficacy of psychosocial treatments for pain and dysfunction in these populations and to determine the causal influence of psychosocial factors.

Practical Implications

Clinical trials

Clinical trials to test the efficacy of psychosocial treatments for pain and dysfunction are warranted.

Causal influence

Studies to determine whether psychosocial factors have a causal influence on pain and adjustment are needed.

Treatment Goals

Treatment should aim to reduce catastrophizing, guarding/resting, negative beliefs and solicitous environmental responses while promoting task persistence, acceptance, adaptive coping, and social support.

Study Limitations

1
The review was limited by the studies that were identified for inclusion.
2
No studies were found that studied psychosocial factors as predictors of criterion variables in disability groups other than SCI, acquired amputation, MS, CP, and MD
3
Additional factors may prove to be important to adjustment to pain in disability, such as mindfulness.

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