[Psychological factors of pain control and their effects on pain evoking subjective stress]

Abstract

Based upon a multicomponent process model of pain, ways of patients control of pain as well as their pain-related subjective stresses are to be analyzed. In a questionnaire study with 322 patients suffering from persistent pain of degenerative or inflammatory origin, two domains of pain-control (cognitive and concrete modes) and of pain-related stress (emotional and behavioral facets) are identified. The cognitive domain consists of (a) process-related knowledge, (b) planning skills, and (c) cognitive restructuring. Concrete modes are (a) distraction of attention, (b) relaxation, and (c) counter-activities. Within the domain of pain-related stress (a) depression and anxiety, (b) anger and (c) pain behavior prove to be significant. Analyses of interrelations show only small effects for exogenous and illness-related variables. As expected, pain-experience contributes positively to the extent of pain-control and pain-related stress. Negative relations are found between pain-control and pain-related stress. For concrete modes of pain-control conditional effects are identified: Only if cognitive modes are sufficiently high, concrete modes are efficient in reducing pain-related stress. First results from a replication study and from an experimental intervention study indicate, that the model of pain postulated can be supported.