Pain Coping Style Research Articles

Increased Somatic Complaints and Health-Care Utilization in Children: Effects of Parent IBS Status and Parent Response to Gastrointestinal Symptoms

Irritable bowel syndrome (IBS) runs in families. The aims of this study were (i) to exclude biased perception by a mother with irritable bowel as the explanation for increased gastrointestinal (GI) symptoms in their children, (ii) to determine whether non-GI as well as GI symptoms run in families, and (iii) to determine whether parent IBS status and solicitous responses to illness exert independent effects on children's symptom reports, medical clinic visits, and school absences. Two hundred and eight mothers with irritable bowel and their 296 children (cases: average age 11.9 yr; 48.6% male) and 241 nonirritable bowel mothers and their 335 children (controls: 11.8 yr; 49.0% male) were interviewed. Other factors assessed were stress, mother's and child's psychological symptoms, child's perceived competence, pain coping style, age, and sex. Children were interviewed apart from their parents. Case children independently reported more frequent stomach aches (F(591) = 9.22; p= 0.0025) and non-GI symptoms (F(562) = 21.03; p < 0.001) than control children. Case children also had more school absences (F(625) = 26.53; p < 0.0001), physician visits for GI symptoms (F(602) = 8.09; p= 0.005), and non-GI clinic visits (F(602) = 27.92; p < 0.001) than control children. Children whose mothers made solicitous responses to illness complaints independently reported more severe stomach aches (F(590) = 11.42; p < 0.001), and they also had more school absences for stomach aches (F(625) = 5.33; p < 0.05), but solicitous behavior did not significantly impact non-GI symptom reporting, clinic visits, or school absences. Differences between cases and controls remained significant after adjusting for potential moderators. (i) Frequent GI complaints in children whose mothers have irritable bowel are not explained by the mother's biased perceptions; (ii) children of mothers with irritable bowel have more non-GI as well as GI symptoms, disability days, and clinical visits; (iii) and parent IBS status and solicitous responses to illness have independent effects on the child's symptom complaints.

Pain in children, psychosocial: Pain tolerance in children: Effects of age, attentional direction and coping style

Attentional coping strategies (e.g., distraction) are often taught and used clinically to help children “tolerate” pain. Yet there has been little research to directly test assumptions about the efficacy of these techniques. Using the cold-pressor pain procedure, the present study sought to compare the efficacy of two attentional imagery-based interventions: Distraction and Sensory-Focusing. It was hypothesized that Distraction would be more effective than Sensory-Focusing. Interventions congruent with children's coping style were expected to result in better pain outcomes. 120 healthy children (7-14 years) were randomly assigned to one of 3 attentional conditions: Distraction, Sensory-Focusing, Control (no-imagery). The Distraction and Sensory-Focusing conditions involved listening to short images described on audio-tape during the cold-pressor procedure. The Distraction condition prompted the child to focus attention externally; the Sensory-Focuisng condition prompted the child to focus internally, on physical sensations in the arm. Vividness and familiarity of images were controlled for. Using a 10°C cold-pressor test, pain tolerance was defined as total time of arm immersion. Pain intensity ratings were requested each minute. Each child also completed self-report measures of pain coping style and imagery ability. Pain tolerance was higher, and pain intensity ratings were lower after 1 minute, in both intervention conditions than in the control condition. Younger children (7-9 years) were found to have significantly higher pain tolerance in the Distraction than in the Sensory-Focusing condition, whereas both interventions were equally effective in older children (10-14 years). Among older children, there was an interaction of coping style with condition: for children in the Sensory-Focusing condition, pain tolerance was negatively associated with self-reported distraction-based coping style, whereas in the Distraction condition this association was positive. These results have implications not only for models of attention and pain in childhood, but also for clinical paediatrics in selecting age-appropriate attentional coping strategies for pain.

Coping with chronic pain

Chronic pain is the primary reason individuals seek medical treatment and such pain is associated with elevated levels of psychological distress. Thus, this study examined how coping and distress impacts one's subjective experience of chronic pain. During their first visit to a pain clinic, 166 chronic pain patients completed questionnaires on pain, distress, and both dispositional and health-specific coping styles (Time 1). Six months after completing Time 1, participants ( N=49) willing to participate in the second part of the study (Time 2) completed questionnaires on pain, and health-specific coping styles. Results showed that (1) health related coping styles and pain were stable from Time 1 to 2; (2) generally, at Time 1, both dispositional and health related coping styles were positively related to both pain and distress; (3) at Time 2 only palliative coping was positively correlated with pain; (4) distress was positively correlated with pain at Times 1 and 2; (5) emotion-oriented coping at Time 1 was positively related to pain at Time 2. Therefore, pain clinic coordinators should focus on reducing patients’ avoidance and emotion-oriented coping styles and decreasing patients’ distress in helping patients adjust to their chronic pain.

PAIN COPING STYLES OF ATHLETES

The purpose of this study was to test the hypothesis that differences in pain coping styles exist in athletes across rank (top, bottom), gender, type of sport athlete (individual, team), and type of sport (traditional, nontraditional). Following written informed consent, the Sports Inventory for Pain (SIP; Meyers et al., 1992) was completed by 480 athletes (mean age = 23.1 ± 8.7 yrs) involved in football, swimming/diving, volleyball, tennis, soccer, golf, track, basketball, downhill sking, rockclimbing, equestrian, skydiving, ballet, telemark, mountain biking, rodeo, and taekwondo. The SIP included 5 pain dimensions: direct coping (COP), cognitive (COG), avoidance (AVD), catastrophizing (CAT), body awareness (BOD), and a composite score, Total Coping Response (TCR = COP+COG-CAT). MANOVAs (Wilks' Lambda) indicated significant rank (F6,424 = 0.9217, P = 0.00001), gender (F6,473 = 0.8505, P = 0.00001), type of sport athlete (F6,473 = 0.7783, P = 0.00001), and type of sport (F6,473 = 0.7945, P = 0.00001) effects. ANOVAs (T-scores; mean = 50, SD = 10) revealed that top ranked athletes scored higher in COP (54.2 vs 48.8; P = 0.0004), BOD (54.9 vs 54.7; P = 0.00001), and TCR (54.0 vs 49.8; P = 0.00001), and lower in CAT (46.9 vs 50.6; P = 0.0001) and AVD (50.3 vs 54.2; P = 0.0109) than low ranked athletes. Males scored higher in COP (56.0 vs 45.0; P = 0.00001), COG (52.3 vs 49.1; P = 0.0108), BOD (58.0 vs 51.3; P = 0.00001), and and TCR (55.9 vs 48.9; P = 0.00001), and lower in CAT (43.3 vs 50.6; P = 0.00001) and AVD (50.2 vs 54.3; P = 0.0001) than females. Team sport athletes scored higher in COP (63.0 vs 50.6; P = 0.00001), COG (58.7 vs 49.1; P = 0.00001), BOD (58.1 vs 52.0; P = 0.00001), and TCR (63.0 vs 50.0; P = 0.00001), and lower in AVD (47.0 vs 54.0; P = 0.0009) than individual sport athletes. Traditional sport athletes scored higher in COP (59.6 vs 50.0; P = 0.00001), COG (58.7 vs 49.1; P = 0.00001), BOD (58.0 vs 53.9; P = 0.0003), and TCR (59.5 vs 49.8; P = 0.0001), and lower in AVD (50.2 vs 54.2; P = 0.01) than nontraditional sport athletes. In conclusion, significant differences in pain coping styles exist between rank, gender, type of sport athlete, and type of sport.

Development of a screen for predicting clinical outcomes in patients with work-related upper extremity disorders.

This study prospectively examined the extent to which a set of medical, physical, ergonomic, occupational psychosocial, and individual psychosocial variables would predict clinical outcome associated with a diverse set of work-related upper extremity disorders in recently diagnosed individuals. This investigation was designed to develop a tool for use in a clinical setting to assist in identifying patients at risk for poorer outcome. Outcome was measured at 1, 3, and 12 months after completing a baseline questionnaire. Outcome status was based on a median split of a standardized composite index (symptoms, function, workdays lost, and mental health). Logistic regression indicated that predictors of poorer outcome at 1 month were: upper extremity comorbidity (risk ratio [RR], 1.58), pain severity (RR, 1.45), ergonomic risk exposure (RR, 1.07), low job support (RR, 1.03), and pain coping style (RR, 1.54). At 3 months, poorer outcome was predicted by: symptom severity (RR, 10.46), job stress (RR, 1.20), and pain coping style (RR, 1.98). The number of prior treatments/providers (RR, 1.77), past recommendation for surgery (RR, 6.43), and pain coping style were found to predict poorer outcome at 12 months. Sensitivity and specificity, respectively, for the models were 77.4% and 71.8% at 1 month, 80.6% and 82.4% at 3 months, and 80.6% and 83.3% at 12 months. The results indicate that baseline measures of ergonomic and psychosocial stress, pain severity, and pain coping style predict clinical outcome at shorter intervals, whereas number of past treatments/providers, recommendation for surgery and pain coping style predict longer-term outcome. The resulting prognostic screen provides a simple tool that assesses the multidimensional nature of work-related upper extremity disorders and predicts clinical outcome. Furthermore, the findings suggest the importance of early intervention that addresses both physical and psychosocial stressors at work. Specific recommendations to reduce the impact of observed risk factors are discussed.

The negative effect of decreasing the level of activity in coping with pain in rheumatoid arthritis: an increase in psychological distress and disease impact.

The objective of this study was to analyze the effect of coping with pain in rheumatoid arthritis (RA) on subsequent changes in psychological distress and disease impact. A sample of 109 randomly selected RA patients was asked to participate in a longitudinal study. Patients were measured at baseline and after 3 years. Both measurements were completed in 80 patients. At each assessment the following variables were assessed: disease activity, pain, physical and psychological distress, disease impact, and coping. The relation between coping with pain at baseline and subsequent changes in psychological distress and disease impact was analyzed using stepwise regression. Disease status variables assessed at baseline and after 3 years were entered in the regression analysis as control variables. Results show that cognitive coping with pain at baseline was not related to subsequent changes in psychological distress or disease impact. On the other hand, behavioral pain coping assessed at baseline was related to subsequent changes in psychological distress and disease impact. "Decreasing activity" was related to an increase in self-reported psychological distress and disease impact after controlling for disease status at both assessments. It was concluded that cognitive pain coping did not predict any subsequent changes in psychological distress or disease impact. "Decreasing activity" as a behavioral pain coping style has a negative effect on subsequent changes in psychological distress and disease impact.

PAIN COPING STYLES OF BALLET PERFORMERS

1017 Although ballet is considered a major division of the performing arts, ballet dancers and athletes experience similar levels of physical and mental stress during training and performances (Heil, 1993: Tajet-Foxell & Rose, 1995). Although the high prevalence of injury in ballet is well documented, no studies have focused on how ballet performers address pain. Therefore, the purpose of this study was to quantify pain coping styles of ballet dancers in regard to skill level and gender. Following written informed consent, the Sports Inventory for Pain (SIP; Meyers, Bourgeois, Stewart, & LeUnes, 1992) was administered to 135 ballet dancers (mean age 19.2 ± 0.6 yrs; 114 females, 21 males). The SIP consisted of coping (COP), cognitive (COG), catastrophize (CAT), avoidance (AVD), body awareness (BOD), HURT (COP + COG − CAT − AVD), and OUCH (COP + COG − CAT). MANOVA and subsequent Wilks' Lambda criterion indicated no significant skill effect (F14,250 = 1.662; p = 0.064) among academy, pre-professional, or professional level dancers. There was a trend, however, for professionals to score lower (mean ± SEM) on COG (12.5 ± 0.5 vs 13.8 ± 0.5) and CAT (11.9 ± 0.5 vs 12.7 ± 0.5) subscales but higher on BOD (12.8 ± 0.4 vs 12.3 ± 0.4) than less-skilled participants. Interestingly, there was a trend for males to score lower in COP (23.6 ± 1.3 vs 24.4 ± 0.5), COG (11.8 ± 0.8 vs 13.9 ± 0.3), and CAT (11.8 ± 0.8 vs 12.8 ± 0.3) than female performers. Subtle differences between gender across all subscales collectively revealed a more positive overall pain coping style among females than males as observed in the composite scores HURT (11.0 ± 0.8 vs 8.4 ± 1.9) and OUCH (25.8 ± 0.8 vs 23.5 ± 1.8). In conclusion, ballet dancers do not exhibit pain coping styles similar to other sport performers. The nonsignificant differences in response styles between skill level may simply be attributed to greater psychological uniformity of individuals that are drawn to this type of competitive environment.

PAIN COPING STYLES OF MALE OLYMPIC DEVELOPMENTAL SOCCER ATHLETES

1014 Recent studies utilizing the Sports Inventory for Pain (SIP; Meyers et al., 1992) demonstrate the ability to psychometrically identify an athlete's pain coping style. Limited research efforts, however, have focused on addressing pain coping strategies in youth sports. Therefore, the purpose of this study was to quantify pain coping styles of adolescent soccer athletes. Following written informed consent, the SIP was administered to 76 male soccer athletes (mean age = 14.3 ± 0.7 yrs) at the Region IV Olympic Developmental Program (ODP) soccer camp in Bozeman, MT. The 25-item SIP included 5 pain dimensions: coping (COP), cognitive (COG), catastrophizing (CAT), avoidance (AVD), body awareness (BOD), and two composite scores (HURT = COP+COG−CAT−AVD; OUCH = COP+COG−CAT). Data were grouped by team level/age [U-82 (15 yr), U-83 (14 yr)], position [goalie (GO), defense (DF), midfielder (MD), forward (FO)], current injury status, and number of injuries (0, 1-2, 3-5, 6+). MANOVAs indicated a significant team level effect (Wilks' Lambda F5.65 = 2.46; p < .05) but no significant main effect by position (F15.171 = 0.51; p = 0.94), injury status (F5.64 = 1.81; p = 0.13), or number of injuries (F15.174 = 1.41; p = 0.15). Subsequent ANOVAs revealed that U-83 athletes scored higher in AVD (13.6 ± 0.4 vs 11.8 ± 0.6; p < .01), but lower in BOD (14.7 ± 0.4 vs 16.1 ± 0.5; p < .03) than U-82 athletes. Coping response was higher than observed in other male, high school athletes. When compared to collegiate populations, ODP athletes revealed higher COP and COG skills, reflective of a more demanding competitive schedule and greater potential for injury. In conclusion, significant but limited team level/age differences exist in pain coping styles of elite, adolescent soccer athletes.

PAIN COPING STYLES OF INJURED AND NONINJURED HIGH SCHOOL RODEO ATHLETES

697 Recent studies utilizing the Sports Inventory for Pain (SIP; Meyers et al., 1992) demonstrate the ability to psychometrically identify an athlete's pain coping style. No studies, however, have addressed pain coping style in an adolescent sport population. Therefore, the purposes of this study were to 1) identify a relationship between pain coping styles and injury status, and 2) further substantiate construct and concurrent validity of the SIP in a sample of injured vs noninjured high school athletes. Following written informed consent, the SIP was administered to 89 high school athletes (40 males, 49 females; mean age= 16.1 ± 1.1 yrs) competing in the National High School Rodeo Association (NHSRA). The 25-item SIP included 5 pain dimensions: coping (COP), cognitive (COG), avoidance (AVD), catastrophizing (CAT), body awareness (BOD), and two composite scores (HURT=COP+COG-CAT-AVD; OUCH=COP+COG-CAT). Current injury status (20 injured, 69 noninjured) was determined by self-response questionnaire. MANOVA indicated a significant injury status(Wilks' Lambda F5,82 = 3.53, p =.006) effect. Subsequent ANOVAs revealed that injured athletes scored higher in COG (34.1 ± 1.2 vs 30.0± 0.6; p =.003), HURT (29.5 ± 2.3 vs 24.1 ± 1.2; p =.04), and OUCH (41.7 ± 1.9 vs 36.5 ± 1.0; p =.02) than noninjured athletes. In conclusion, significant differences in pain coping styles exist between injured and noninjured high school rodeo athletes. This study provides further evidence of construct and concurrent validity of the SIP. Further research delineating and contrasting pain coping strategies in traditional sport athletes seems warranted.

Assessment of pain coping styles: development of an inventory.

The Pain Coping Style Inventory (PCSI) is an instrument designed to measure the pain coping style of individuals. It is based on the pain coping model and typology described by Copp. A study with a convenience sample of 145 university graduates, undergraduates, and faculty revealed a Cronbach's alpha reliability coefficient of 0.90, adequate stability, and a nine factor analysis solution representing 57% of the variance. Four of Copp's five coping styles are clearly defined by the factor analysis: interactive, reactive, combatant, and victim. Five more coping styles are named: contractor, distractor, spiritual coping, substance users, and mind over matter. The development and piloting of the PCSI is a step towards empowering the nurse with the ability to provide patients with individualized pain coping strategies.

A review of evidence about factors affecting quality of pain management in sickle cell disease.

To assess the evidence for pharmacological, behavioural, and interpersonal influences on quality of pain management in sickle cell disease. English-language reports from the research literature up to 1995, identified using Medline, Psychlit, and the Bath Information Data Service. Studies are reviewed that (a) reported quantitative clinical outcomes for particular analgesic methods used to treat painful episodes or (b) provide data on patient factors, interpersonal treatment factors, or levels of drug dependence in relation to pain management in sickle cell disease. Findings vary on the effectiveness of longer-acting opiates, patient-controlled or continuously infused analgesia, and behavioural analgesic techniques, with better results for trials where interpersonal aspects of pain management were also addressed. Risks for poorer pain management are greatest for patients in adverse social circumstances, who are more severely affected by painful episodes and who are poorly adjusted and have less effective personal strategies for coping with pain, but the limited evidence on drug dependence indicates very low levels by comparison with risk and exposure factors. Analgesic methods and approaches should continue to be developed and evaluated, but conflicting perceptions between patients and staff about pain that is reported and analgesia that is required probably contribute most to poor pain management in sickle cell disease. Promising areas for future research include the assessment of patients' everyday pain coping styles and patterns of drug use in relation to their hospital experiences of pain management, and the evaluation of psychological interventions to improve patients' styles and strategies for coping with pain.

Endocrine effects of the cold pressor test: Relationships to subjective pain appraisal and coping

Blood was drawn from 14 normal volunteers twice before, immediately after a 1-minute immersion of the nondominant hand in ice water (cold pressor test), and twice during recovery. Serum levels of β-endorphin, cortisol, prolactin, growth hormone, and opioid activity were determined, and measures of subjective pain appraisal and coping styles were obtained. Cortisol was the only variable to show a significant increase as a function of noxious stimulation. Correlational analysis yielded relationships between neuroendocrine variables and subjective pain appraisal as well as coping styles, suggesting complex interactions between neuroendocrine and psychological processes in human pain.

Relationship between pain description and coping style in chronic pain patients

Relationship between pain description and coping style in chronic pain patients