Abstract
Although threat and challenge appraisals of pain have been linked to both the acute and laboratory-induced pain experience, these appraisals have not yet been explored in relation to chronic pain. In addition, although attachment theory has been separately linked to the chronic pain experience and to responses to perceived threat, it has not been explored in the context of threat and challenge appraisals of chronic pain. The present paper addresses these two main goals. A sample of 141 participants reporting noncancer pain longer than two months in duration completed a battery of assessments before commencing treatment in one of two multidisciplinary rehabilitation programs. Analysis of the pain appraisal inventory produced two factors (threat and challenge), replicating earlier findings. Reliability coefficients for the two extracted scales were 0.87 and 0.86, respectively. Links between the two pain appraisal scales and adult attachment variables proved to be significant. In particular, comfort with closeness was strongly related to challenge appraisal, while anxiety over relationships was strongly associated with threat appraisal. As expected, both appraisals and attachment variables were also related to catastrophizing and emotional distress. Results support use of the pain appraisal inventory as an evaluation tool for those with chronic pain. Findings further suggest a substantial association between adult attachment and pain appraisal, supporting the need for more in-depth analysis and consideration of implications for treatment.
Highlights
MethodsAll clients attending two private metropolitan chronic pain rehabilitation centres, Gregory Terrace Rehabilitation and PainLogic (Brisbane, Australia), over a 14-month period were invited to participate
The mean challenge appraisal score (2.92) was somewhat lower than the mean threat appraisal score (4.11), but both scores were higher than those reported for an acute sample
To permit further comparison with data in the acute sample used in Unruh and Ritchie’s [12] study, it was calculated that 83.7% of the participants reported a threat appraisal greater than three, while 45.7% of participants reported a challenge appraisal greater than three
Summary
All clients attending two private metropolitan chronic pain rehabilitation centres, Gregory Terrace Rehabilitation and PainLogic (Brisbane, Australia), over a 14-month period were invited to participate. A total of 141 participants agreed to participate in this stage of the study, 88 from Gregory Terrace Rehabilitation and 53 from PainLogic. No record was made of clients not agreeing to participate, 325 clients were registered at the clinics during this period. All participants were volunteers who had chronic pain (between two months and 34 years in duration) of noncancer origin. They had been in pain for an average of three years and nine months (SD=7.07 months), and were between 18 and 82 years of age (mean age 38.89±12.31 years).
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