Examining the contributions of coping style, pain appraisals, and emotional reactions to pain expressiveness

Abstract

To successfully communicate the experience of pain, an individual must translate his or her sensory experience into a verbal or nonverbal expression that can be detected by observers. In the present study, we examined the extent to which patients' coping styles, pain beliefs, and emotional reactions influenced one another and ultimately contributed to verbal and nonverbal pain expressions during a pain-eliciting physiotherapy exercise. Participants included 163 patients with back pain who completed a series of standardized questionnaires. Verbal (visual analogue scale) and nonverbal (facial grimacing) pain expressiveness were examined in response to the physiotherapy test. A series of regression analyses were used to examine the data. In the first analysis, the contribution of coping style to pain beliefs was examined. Results indicated that those who used praying to cope were more likely to believe other's should provide help (i.e., were more solicitous) while those who used praying and did not use coping self-statements viewed medication as an appropriate treatment. In the second analysis, the contributions of both coping and beliefs to the patients' emotional reactions were examined. In this analysis, both coping and beliefs were found to predict anger and anxiety. Greater use of praying, higher levels of solicitousness, and greater belief in medication all made unique contributions to anxiety while only a greater belief in medication uniquely contributed to anger. In the final regression series, the contributions of coping, beliefs, and emotion to expressiveness were examined. None of these variables were significant predictors of nonverbal expressiveness but higher levels of praying and higher levels of anxiety were both unique predictors of verbal expressiveness. These findings support the assertion that that verbal expressions of pain are more strongly mediated by cognitive and affective variables then are more reflexive non-verbal expressions.(Support was received from the Canadian Institutes for Health Research.) To successfully communicate the experience of pain, an individual must translate his or her sensory experience into a verbal or nonverbal expression that can be detected by observers. In the present study, we examined the extent to which patients' coping styles, pain beliefs, and emotional reactions influenced one another and ultimately contributed to verbal and nonverbal pain expressions during a pain-eliciting physiotherapy exercise. Participants included 163 patients with back pain who completed a series of standardized questionnaires. Verbal (visual analogue scale) and nonverbal (facial grimacing) pain expressiveness were examined in response to the physiotherapy test. A series of regression analyses were used to examine the data. In the first analysis, the contribution of coping style to pain beliefs was examined. Results indicated that those who used praying to cope were more likely to believe other's should provide help (i.e., were more solicitous) while those who used praying and did not use coping self-statements viewed medication as an appropriate treatment. In the second analysis, the contributions of both coping and beliefs to the patients' emotional reactions were examined. In this analysis, both coping and beliefs were found to predict anger and anxiety. Greater use of praying, higher levels of solicitousness, and greater belief in medication all made unique contributions to anxiety while only a greater belief in medication uniquely contributed to anger. In the final regression series, the contributions of coping, beliefs, and emotion to expressiveness were examined. None of these variables were significant predictors of nonverbal expressiveness but higher levels of praying and higher levels of anxiety were both unique predictors of verbal expressiveness. These findings support the assertion that that verbal expressions of pain are more strongly mediated by cognitive and affective variables then are more reflexive non-verbal expressions.(Support was received from the Canadian Institutes for Health Research.)