Jensen Mark P, Turner Judith A, Romano Joan M, Karoly Paul
Department of Rehabilitation Medicine, RJ-30, University of Washington Medical Center, Seattle, WA 98195 U.S.A. Department of Psychiatry and Behavioral Sciences, RP-10, University of Washington Medical Center, Seattle, WA 98195 U.S.A. Multidisciplinary Pain Center, RC-95, University of Washington Medical Center, Seattle, WA 98195 U.S.A. Department of Psychology, Arizona State University, Tempe, AZ 85287 U.S.A.
Pain. 1991 Dec;47(3):249-283. doi: 10.1016/0304-3959(91)90216-K.
A growing number of investigators have used models of stress and coping to help explain the differences in adjustment found among persons who experience chronic pain. This article reviews the empirical research which has examined the relationships among beliefs, coping, and adjustment to chronic pain. Although preliminary, some consistent findings are beginning to emerge. For example, patients who believe they can control their pain, who avoid catastrophizing about their condition, and who believe they are not severely disabled appear to function better than those who do not. Such beliefs may mediate some of the relationships between pain severity and adjustment. Although coping strategies appear to be associated with adjustment in chronic pain patients, methodological problems limit conclusions regarding the strength and nature of this association. Our recommendations for future research include the development of coping and belief measures which: (1) do not confound different dimensions (e.g., coping, beliefs, and adjustment) in the same measure; (2) assess specific (rather than composite) constructs; (3) are psychometrically sound; and (4) assess behavioral coping strategies more objectively. We also recommend a greater use of experimental research designs to examine causal relationships among appraisals, coping, and adjustment.
