(307) The Role of Fluctuations in Pain Acceptance, Coping, and Catastrophizing in the Daily Lives of People with Chronic Pain and Spinal Cord Injury

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The experience of chronic pain can be influenced by choice of coping skills, the presence of catastrophizing, and the degree of acceptance of chronic pain. Neither the independent contributions of coping, catastrophizing, and acceptance of the pain experience nor the relative variability of these factors on a day-to-day basis are well understood. Thus, this study aimed to examine the role of daily changes in pain acceptance, coping, and catastrophizing in the daily lives of people with chronic pain and spinal cord injury (SCI). We collected seven days of end-of-day diary assessments of pain acceptance, pain coping, and pain catastrophizing, and five additional criterion variables of interest – pain interference, social participation, depressive symptoms, and positive affect and well-being in 124 individuals. In multilevel random effects modeling (controlling for age, gender, mobility, and pain intensity), pain acceptance, coping, and catastrophizing were each independently associated with some, but not all, of the daily criterion variables. Both acceptance and catastrophizing demonstrated similarly robust and consistent associations with outcomes, whereas pain coping demonstrated weaker and less consistent relationships with outcomes. Days of higher than usual catastrophizing were related to same-day lower positive affect and well-being and higher pain interference and depressed mood. Days of high pain acceptance were associated with higher same-day social participation and lower pain interference and depressed mood. Interestingly, when people reported higher than usual pain coping, they also reported higher same-day depressed mood. The findings suggest that psychosocial interventions targeting both pain catastrophizing and pain acceptance may be beneficial in terms of pain, mood, and social outcomes for those with chronic pain. Individuals may engage in more behavioral coping strategies to manage pain when experiencing negative mood. Further research examining the complex dynamics of adaptive and maladaptive responses to pain in daily life is warranted.