Psychosocial factors and adjustment to chronic pain in spinal cord injury: Replication and cross-validation

J Rehabil Res Dev, 2009 · DOI: · Published: January 1, 2009

Spinal Cord Injury Mental Health Pain Management

Simple Explanation

This study investigates how psychological factors affect chronic pain in people with spinal cord injuries (SCI). It looks at beliefs about pain, coping strategies, and mental health in relation to pain outcomes. The research found that negative beliefs about pain and passive coping strategies were linked to worse pain outcomes. This suggests that addressing these psychological factors could help improve pain management for individuals with SCI. The findings support the idea that pain in SCI is best understood using a biopsychosocial model, considering biological, psychological, and social factors.

Study Duration

Not specified

Participants

130 adults with SCI

Evidence Level

Not specified

Key Findings

1
Psychological factors, particularly beliefs about pain and pain-related coping strategies, were significant predictors of pain outcomes.
2
Negative attributions and coping were stronger predictors of pain adjustment than were positive ones.
3
Specific variables most closely associated with negative pain outcomes were perception of oneself as disabled, perceptions of low control over pain, and tendency to catastrophize.

Research Summary

This study replicated and extended previous research on psychosocial factors and chronic pain in individuals with SCI, using shortened measures of pain-related beliefs and coping. The results indicated that psychological factors, such as beliefs about pain and coping strategies, significantly predicted pain outcomes like psychological functioning and pain interference, even after accounting for pain intensity. The study highlighted the importance of addressing negative beliefs and coping strategies, such as catastrophizing, in the treatment of chronic pain in persons with SCI.

Practical Implications

Psychosocial Interventions

Treatments for SCI pain should focus on psychosocial factors like maladaptive coping strategies and negative beliefs, alongside pain intensity reduction.

Cognitive-Behavioral Therapy

Consider cognitive-behavioral and operant models of psychotherapy to target catastrophic thinking, perceived disability, and tendencies to rest or seek excessive assistance.

Early Intervention

Early identification and intervention for negative pain beliefs and coping strategies may prevent the development of chronic pain and improve long-term outcomes.

Study Limitations

1
Self-selected sample may not represent all persons with SCI.
2
Cross-sectional design limits causal inferences.
3
Some important variables, such as pain type and opioid medication use, were not measured.

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