Pain Coping but Not Readiness to Change Is Associated With Pretreatment Pain-related Functioning

Abstract

The purpose of the present study was to determine if readiness to use adaptive and avoid maladaptive pain-coping skills before initiation of psychosocial treatment for chronic pain was related to reports of present coping, and whether those variables, together or separately, explained variance in pain, pain interference, and symptoms of depression. A total of 132 patients with chronic low back pain completed measures of readiness, coping, and pain-related functioning before participation in a clinical trial of cognitive-behavioral therapy for pain. Pearson correlations indicated that the content-matched subscales of readiness and coping were moderately correlated (rs between 0.30 and 0.60), and "mismatched" subscales were generally more weakly related or unrelated. None of the readiness subscales were significantly associated with variance in any of the functioning variables. However, several aspects of coping were significantly associated with functioning. Task persistence was associated with lower pain interference and symptoms of depression; asking for assistance was associated with higher pain interference; and pain-contingent rest was associated with higher pain interference. Overall, the results indicate that adaptive coping is associated with better pain-related functioning and maladaptive coping is associated with poorer functioning, whereas readiness appears to not play a significant role in patient functioning before psychosocial pain treatment. The findings support the discriminant validity of the coping and readiness measures and inform treatment conceptualization.