(410) Pain acceptance is negatively associated with use of other types of pain coping on a daily basis in people with chronic pain and spinal cord injury

Abstract

Chronic pain acceptance is associated with positive outcomes for people with chronic pain and has been linked to a more flexible approach to pain self-management. Contrasts between acceptance and other types of coping are often made. However, little is known about how pain acceptance may work in concert with other types of pain self-management. We examined the extent to which pain acceptance predicted daily use of other types of pain coping strategies, with the expectation that pain acceptance would be related to greater use of other types of coping. Participants with chronic pain and spinal cord injury (SCI; N=121) completed baseline surveys of demographics, injury characteristics and chronic pain acceptance (Chronic Pain Acceptance Questionnaire) followed by seven days of end-of-day surveys of seven types of pain coping1 and daily pain intensity (PROMIS Pain Intensity Short Form). Sample mean age=47.53±13.48, and average pain=5.01±1.76 (Brief Pain Inventory). Results of mixed-effects multi-level models showed that, controlling for age, education, sex, time since injury and injury cause, daily pain intensity (β =0.33, t=14.54, p<0.001) was a significant predictor of a more diverse use of coping strategies on a daily basis. However, chronic pain acceptance (β=-0.05, t=-3.33, p=0.001) was associated with use of fewer types of pain coping on a daily basis. No demographic factors or clinical characteristics significantly predicted daily coping. Findings suggest higher chronic pain acceptance is associated with use of fewer coping strategies on a daily basis, above and beyond the effects of pain intensity. Although contrasts between acceptance and other types of pain coping are often made, future work examining whether an approach that emphasizes either pain acceptance or other types of coping, or a more integrative approach that emphasizes both, is optimal for those with chronic pain. Supported by a grant from the Craig H. Neilsen Foundation. (1. Stone & Neale, JPSP,1984)