Gender differences in multidisciplinary pain rehabilitation: The mediating role of pain acceptance

Abstract

The present study aimed to investigate gender differences in multidisciplinary pain treatment outcomes and whether pain acceptance contributes to gender differences. A retrospective cohort study was conducted on participants of a three-week multidisciplinary group pain rehabilitation program (N = 36). To accurately compare men and women, men (n = 18) were matched to similar women on sociodemographic and pain variables. Patients completed a battery of measures at baseline and discharge. Both men and women improved significantly from baseline to discharge (p < .001) in depressive symptoms, but only women had significant reductions in average pain severity. Between-group analyses showed gender differences in changes from baseline to discharge in pain interference, anxiety, and pain acceptance, with women improving more than men. Activity engagement (a behavioral component of pain acceptance) significantly mediated the effects of gender on pain severity, pain interference, and depression, and pain willingness (a cognitive component of pain acceptance) significantly mediated the effects of gender on pain interference and anxiety. Overall, multidisciplinary pain rehabilitation appears to benefit both men and women, but women showed greater improvements than men at discharge. Gender differences in changes in pain severity, pain interference, and anxiety may be explained, in part, by increased pain acceptance in women. Future work is needed to replicate these findings in larger samples and to ascertain how potential modifications to multimodal pain treatment could meet the specific needs of both men and women with chronic pain to optimize outcomes for more patients.