OBJECTIVE: Received social support undermining engagement in life activities of individuals with chronic pain (e.g., solicitousness, support for functional dependence) is consistently correlated with worse physical functioning, pain severity, and disability. Whether such responses lead to worse pain outcomes (operant model of pain) or the latter lead to more supportive responses undermining activity engagement (social communication and empathy models of pain) is unknown, given the lack of cross-lagged panel studies. Furthermore, the mediating role of activity patterns in such relationships over time is entirely unclear. This study aimed to bridge these gaps. METHOD: This was a 3-month prospective study with three waves of data collection (T1-T3; 6-week lag in-between), including 130 older adults (71% women; Mage = 78.26) with musculoskeletal chronic pain attending day-care centers. At every time point, participants filled out self-report measures of staff social support for functional dependence, activity patterns, physical functioning, pain severity, and interference. Scales showed good/very good test-retest reliability (ICC = .74-.96) and internal consistency (all α > .90). RESULTS: Parsimonious cross-lagged panel mediation models showed the best fit (χ²/df < 2.44; CFI > .96; GFI > .93; RMSEA < .09). Bidirectional effects were found over time, but poorer pain outcomes at T1 (higher pain severity/interference, lower physical functioning) more consistently predicted higher social support for functional dependence than vice versa. Poorer pain outcomes (T1) predicted more avoidance/less overdoing (T3), via increased received support for functional dependence (T2). CONCLUSION: Further research on the cyclical relationships between the study variables across chronic pain trajectories is needed to harness the power of interpersonal relationships in future self-management interventions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
El miedo generalizado de la COVID-19 parece haber exacerbado el impacto negativo de la pandemia. Por eso, es relevante monitorear el miedo de la COVID-19 y su asociación con la salud mental, el bienestar y los comportamientos de las personas, siendo necesarias medidas válidas y fiables de miedo de la COVID-19. Este estudio tuvo como objetivo evaluar las propiedades psicométricas de una versión en portugués europeo de la escala Fear of COVID-19 (FCV-19S-P). Un objetivo secundario fue evaluar la invariancia de medición transversal multigrupo de FCV-19S-P (mujeres vs. hombres). Una muestra de 572 adultos portugueses (72 % mujeres) completaron el FCV-19S-P y medidas de depresión, ansiedad y estrés. Los resultados del estudio respaldaron la validez de esta versión y fiabilidad (alfa de Cronbach = .84; confiabilidad compuesta = .83) y una estructura factorial similar a de la versión original. El miedo de la COVID-19 se asoció positivamente (.23 < r < .31) con depresión, ansiedad y estrés. Los resultados del análisis transversal de invariancia multigrupo respaldaron la invariancia escalar total de la FCV-19S-P y su invariancia residual parcial, lo que sugiere que esta medida puede usarse para llegar a conclusiones válidas con respecto a las comparaciones de género en muestras de adultos portugueses.(AU)
The novelty and uncertainty of the pandemic nourished a gener-alized fear of the COVID-19, which seems to have exacerbated the pan-demics negative impact. It is thus relevant to monitor fear of COVID-19 and its association with individuals mental health, well-being, and behav-iors. Valid and reliable measures of fear of COVID-19 are necessary for that purpose. This study aimed at assessing the psychometric properties of a European Portuguese version of the Fear of COVID-19 scale (FCV-19S-P). A secondary aim was to assess FCV-19S-Ps multigroup measurement invariance (female vs.male). A sample of 572 Portuguese adults (72 % fe-male) completed the FCV-19S-P and measures of depression, anxiety, and stress. The study results supported this version validityand reliability (Cronbachs alpha = .84; Composite Reliability = .83), and a factorial struc-ture similar to the original version. Fear of COVID-19 was positively asso-ciated (.23 < r < .31) with depression, anxiety, and stress. Results of the multigroup invariance analysis supported the FCV-19S-P total scalar invar-iance and its partial residual invariance, suggesting that this measure may be used to reach valid conclusions in respect to gender comparisons in samples of Portuguese adults in regard to group observed composite means.(AU)
Humans , Male , Female , Coronavirus Infections/epidemiology , Pandemics , Fear , Reproducibility of Results , Portugal
Chronic pain is a multidimensional experience and pain treatments targeting psychosocial factors reduce pain and improve function. These treatments often overlook the sociocultural factors that influence pain and the psychological factors associated with function in people with chronic pain. Although preliminary findings suggest that cultural background may influence pain and function via their effects on beliefs and coping, no previous study has directly tested if the country of origin moderates the associations between these psychological factors and pain and function. This study sought to address this knowledge gap. Five hundred sixty-one adults with chronic pain, born and living in the USA (n = 273) or Portugal (n = 288), completed measures of pain, function, pain-related beliefs, and coping. Between-country similarities were found in the endorsement of beliefs related to disability, pain control, and emotion, and in asking for assistance, task persistence, and coping self-statement responses. Portuguese participants reported greater endorsement of harm, medication, solicitude, and medical cure beliefs, more frequent use of relaxation and support seeking, and less frequent use of guarding, resting, and exercising/stretching. In both countries, disability and harm beliefs and guarding responses were associated with worse outcomes; pain control and task persistence were associated with better outcomes. Six country-related small effect-size moderation effects emerged, such that task persistence and guarding are stronger predictors of pain and function in adults from the USA, but pain control, disability, emotion, and medication beliefs are more important in adults from Portugal. Some modifications may be needed when adapting multidisciplinary treatments from one country to another. PERSPECTIVE: This article examines the similarities and differences in beliefs and coping endorsed by adults with chronic pain from 2 countries, and the potential moderation effects of country on the associations between these variables and pain and function. The findings suggest that some modifications may be needed when culturally customizing psychological pain treatments.
Chronic Pain , Adult , Humans , Adaptation, Psychological , Pain Management , Pain Measurement , Ethnicity , Surveys and Questionnaires , Chronic Disease
This review examined the effects of private and communal participatory prayer on pain. Nine databases were searched. Six randomized controlled trials were included. For private prayer, medium to large effects emerged for 67% to 69% of between-group comparisons; participants in the prayer condition reported lower pain intensity (0.59 < d < 26.17; 4 studies) and higher pain tolerance (0.70 < d < 1.05; 1 study). Pre- to post-intervention comparisons yielded medium to large effects (0.76 < d < 1.67; 2 studies); pain intensity decreased. Although firm conclusions cannot be made because meta-analysis was based on only two studies, the analysis suggested prayer might reduce pain intensity (SMD = - 2.63, 95% CI [- 3.11, - 2.14], I = 0%). (PROSPERO: CRD42020221733).
Pain Management , Pain , Humans , Randomized Controlled Trials as Topic , Religion
Purpose: Previous research supports the usefulness of hypnosis (HYP), mindfulness meditation (MM), and prayer as pain self-management strategies in adults with chronic pain. However, their effects on acute pain have been less researched, and no previous head-to-head study compared the immediate effects of these three approaches on pain-related outcomes. This study compared the immediate effects of HYP, MM, and Christian prayer (CP) on pain intensity, pain tolerance, and stress as assessed by heart rate variability (HRV). Participants and Methods: A total of 232 healthy adults were randomly assigned to, and completed, a single 20-minute session of MM, SH, CP, or an attention control (CN), and underwent two cycles (one pre- and one post-intervention) of Cold Pressor Arm Wrap (CPAW). Sessions were audio-delivered. Participants responded to pre- and post-intervention pain intensity measurements. Pain tolerance (sec) was assessed during the CPAW cycles. HRV was assessed at baseline, and at pre- and post-intervention CPAW cycles. The study protocol was pre-registered at the ClinicalTrials.gov registry (NCT04491630). Results: Small within-group decreases in pain intensity and small increases in pain tolerance were found for HYP and MM from the pre- to the post-intervention. Small within-group improvements in the LH/HF ratio were also found for HYP. The exploratory between-group pairwise comparisons revealed a medium effect size effects of HYP on pain tolerance relative to the control condition. The effects of CP were positive, but small and not statistically significant. Only small to medium, though non-significant, Time × Group interaction effects were found. Conclusion: Study results suggest that single short-term HYP and MM sessions, but not biblical-based CP, may be useful for acute pain self-management, with HYP being the slightly superior option. Future research should compare the effects of different types of prayer and examine the predictors and moderators of these pain approaches' effects on pain-related outcomes.
There is mounting evidence to suggest that individuals with chronic pain adjusted poorly to and were impacted negatively by social distancing measures during the lockdown. However, there is limited data on the factors that might protect against the negative effects associated with social distancing measures, as most research has been conducted in the general population and in the initial stages of the lockdown. The aim of this study was to improve the understanding of the role that resilience, happiness, and social support, all factors that are thought to have a protective role, played in the psychological function (measured as anxiety, depression, and stress) to the social distancing measures during the late stages of the lockdown in a sample of adults with and without chronic pain living in Spain. A group of 434 adults responded to an online survey and provided information on sociodemographic issues, which included measures of pain, perceived health and quality of life, depression, anxiety, stress, resilience, happiness, and social support. The data showed that individuals with chronic pain (N = 200; 46%) reported statistically significant worst psychological function, that is to say, they reported higher levels of anxiety, depression, and stress (all ps < 0.001). Resilience, social support, and happiness proved to be significant predictors of anxiety, depression, and stress, after controlling for the effects of age, gender, and chronic pain. Although the effect sizes were small to medium, they are consistent with the findings of other studies. The findings from this study provide important additional new information regarding the associations between resilience, happiness, and social support and the adjustment to the social distancing measures during the late stages of the lockdown. These findings can be used to develop programs to improve adjustment to and coping with the demands of social distancing measures.
Chronic Pain , Resilience, Psychological , Adult , Anxiety/epidemiology , Anxiety/psychology , Chronic Pain/epidemiology , Chronic Pain/psychology , Happiness , Humans , Pandemics , Physical Distancing , Quality of Life , Social Support
The COVID-19 pandemic is a stressful long-lasting event with an increasingly negative impact upon individuals. This study aimed at assessing the magnitude of depression, anxiety, and stress among adults living in Portugal during the first mandatory lockdown of 2020, and the psychosocial and health-related factors associated with these symptoms. A sample of 484 adults (73% women) with an average age of 40 years old (Standard Deviation, SD = 14.03) responded to an online survey. The survey included measures of depression, anxiety, stress, social support, COVID-19 interference in daily life, attitudes towards COVID-19, and health perception. The impact of the lockdown on psychological well-being was large, with up to 36% of the participants showing signs of at least mild psychological discomfort (i.e., depression, anxiety, and stress). Social support, COVID-19 interference on daily life, health perception, and age, explained all the dependent variables. Education level, income, attitudes towards COVID-19, and gender explained some of the dependent variables. These results suggest that the COVID-19 pandemic has a serious impact on the psychological health of Portuguese adults. The role of the procedures to control the pandemic on the mental health of Portuguese adults should not be underestimated.
COVID-19 , Adult , COVID-19/epidemiology , Communicable Disease Control , Depression/epidemiology , Depression/psychology , Female , Humans , Male , Pandemics , Portugal/epidemiology , Quality of Life/psychology
Research has shown that the confinement measures implemented to curb the spread of COVID-19 can have negative effects on people's lives at multiple levels. The objective of this cross-sectional study was to better understand the mental, physical, and socio-economic status of adults living in Spain during the late stages of the state of emergency caused by COVID-19. Five hundred and forty-four individuals responded to an online survey between 3 June and 30 July 2020. They were asked to report data about their mental and physical health, financial situation, and satisfaction with the information received about the pandemic. Means, percentages, t-test, ANOVAs, and logistic regressions were computed. A third of the participants reported symptoms of anxiety, depression, and stress, and worries about their health and the future. Participants also described mild levels of fatigue and pain during lockdown (66%), and a reduction in household income (39%). Respondents that were female, younger, single, and with lower levels of education reported experiencing a greater impact of the COVID-19 pandemic. The data showed that the negative effects of lockdown were present in the late stages of the state of emergency. The findings can be used to contribute to the development of programs to prevent or mitigate the negative impact of confinement measures.
COVID-19 , Communicable Disease Control , Cross-Sectional Studies , Depression , Economic Status , Female , Humans , Pandemics , SARS-CoV-2 , Spain/epidemiology
This systematic review examined the extent to which measures of religiosity/spirituality (R/S): (1) are associated with pain, function, pain-related beliefs (beliefs), coping responses, and catastrophizing in people with chronic pain; and (2) moderate the association between beliefs, coping and catastrophizing, and pain and function. Experimental and observational studies examining at least one of these research questions in adults with chronic pain were eligible. Two reviewers independently performed eligibility screening, data extraction, and quality assessment. Twenty studies were included. Most studies focused on the association between R/S and pain or function. When significant associations emerged, those between R/S and psychological function were weak to strong and positive; those between religious/spiritual well-being and pain and physical dysfunction were negative, but weak. Few studies examined the associations between R/S and beliefs/coping/catastrophizing; none examined the moderation role of R/S. The findings suggest that R/S is associated with pain and psychological function in people with chronic pain, and that viewing oneself as being "spiritual," regardless of religion, may contribute to positive psychological adjustment. More research is needed to determine the reliability of this finding. PROSPERO registry CRD42018088803.
Chronic Pain , Adaptation, Psychological , Adult , Humans , Religion , Reproducibility of Results , Spirituality
OBJECTIVES: This study aimed to better understand the associations between both sleep disturbance and psychological dysfunction (i.e., anxiety and depressive symptoms, and anger), and pain intensity and pain interference, in a sample of children with chronic pain. DESIGN: Cross-sectional design. METHODS: Three hundred and forty-two children with chronic pain (8-18 years) completed measures assessing pain intensity, pain interference, sleep disturbance, anxiety, depressive symptoms, and anger. Regression analyses examined the direct, interaction (with sex), and mediation effects of sleep quality and psychological dysfunction on pain intensity and interference. RESULTS: Sleep disturbance was significantly associated with both pain intensity and pain interference. However, measures of psychological dysfunction were associated significantly only with pain interference. Sex did not moderate these associations. The measures of psychological dysfunction mediated the associations between sleep disturbance and pain interference but not those between sleep disturbance and pain intensity. CONCLUSIONS: The results confirmed significant cross-sectional associations between both sleep disturbance and psychological dysfunction and pain outcomes in children with chronic pain. Future research to test for causal associations is warranted.
Chronic Pain , Sleep Wake Disorders , Child , Chronic Pain/complications , Chronic Pain/psychology , Cross-Sectional Studies , Depression/psychology , Humans , Pain Measurement , Sleep , Sleep Wake Disorders/psychology
Social distancing measures during the lockdown have had a negative impact on chronic pain patients' function. Research, however, has only focused on the early stages of the first lockdowns. The aim of this study was to improve the understanding of the effects of COVID-19 social distancing measures on individuals with chronic pain living in Spain during the late stages of the lockdown. A group of 361 adults with pain participated in this study. They responded to an online survey and provided information on sociodemographic issues, pain, fatigue, perceived health, and quality of life. The data showed that most participants suffered moderate to severe pain and interferences with pain treatment and an increase in pain intensity during the lockdown. Most participants also informed us that fatigue had worsened during the lockdown (62%). Importantly, females with lower monthly family income and lower education have been found to be associated with greater levels of pain and fatigue. Despite this, participants perceived themselves as having good health and good quality of life. The findings from this study can be used to inform policy and specific responses for future COVID-19 waves and future pandemics where social distancing measures must be implemented.
COVID-19 , Chronic Pain , Chronic Pain/epidemiology , Communicable Disease Control , Female , Humans , Physical Distancing , Quality of Life , SARS-CoV-2 , Spain/epidemiology
PURPOSE: Chronic pain is a multidimensional experience that is influenced by biological, psychological, social, and spiritual factors. The Meaning Making Model is a recent cognitive behavioral model that has been developed to understand how psychosocial factors influence adjustment to stressful events, such as having a chronic illness. This qualitative study aims to understand the potential utility of this model for understanding the role of meaning making in adjustment to chronic pain. MATERIALS AND METHODS: Eighteen community-dwelling adults with chronic low back pain or chronic pain due to osteoarthritis participated in four focus groups. Participants were asked open-ended questions about their pain experience, pain-related beliefs, meaning of pain, and the perceived association between pain and their meaning in life and sense of purpose. Data were submitted to thematic analysis and the identified themes were considered in light of the Meaning Making Model. RESULTS: Three overarching themes emerged, each of which included two themes. The first overarching theme - "appraised meaning of pain" - included the themes "causal attributions" and "primary appraisals." The second - "meaning making processes" - included the themes "assimilation" and "accommodation." The third - "meanings made" - included the themes "pain as an opportunity" and "acceptance." CONCLUSION: The key themes that emerged as individuals with chronic pain discussed pain and its impact are consistent with those that would be hypothesized as important from the Meaning Making Model, providing preliminary support for the utility of this model in the context of chronic pain. People with chronic pain appear to appraise pain in terms of its cause, controllability, threat, loss, or challenge. When a discrepancy between the appraised meaning of pain and one's global meaning emerged, participants engaged in meaning making processes (accommodation and assimilation), resulting in meanings made, such as a reappraised meaning of pain, perceptions of growth, and acceptance.
BACKGROUND: Pain is a universal experience and the most common reason for seeking healthcare. Inadequate pain management negatively impacts numerous aspects of patient health. Multidisciplinary treatment programmes, including psychosocial interventions, are more useful for pain management than purely biomedical treatment alone. Recently, researchers showed increasing interest in understanding the role of spirituality/religiosity and spiritual/religious practices on pain experience, with engagement in religious practices, such as prayer, showing to positively impact pain experience in religious individuals. This systematic review will seek to summarise and integrate the existing findings from randomised controlled trials assessing the effects of prayer and prayer-based interventions on pain experience. METHODS: The systematic review procedures and its report will follow the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement. Electronic searches in nine databases (Web of Science Core Collection, MEDLINE, SCIELO Citation Index, PubMed, Cochrane Central Register of Controlled Clinical Trial, PsycINFO, Scopus, LILACS and Open-SIGLE) will be performed to identify randomised controlled trials of prayer-based interventions. Two independent researchers will assess studies for inclusion and extract data from each paper. Risk of bias assessment will be assessed independently by two reviewers based on the Consolidated Standards of Reporting Trials statement. Qualitative synthesis of the body of research will be conducted using a narrative summary synthesis method. Meta-analysis will be limited to studies reporting on the same primary outcome. Formal searches are planned to start in June 2021. The final report is anticipated to be completed by September 2021. DISCUSSION: Findings will be useful to (1) understand the condition of our knowledge in this field and (2) provide evidence for prayer effectiveness in reducing pain intensity and pain-related stress and increasing pain tolerance in adults experiencing acute or chronic pain. PROSPERO REGISTRATION NUMBER: CRD42020221733.
Pain , Research Design , Adult , Humans , Meta-Analysis as Topic , Randomized Controlled Trials as Topic , Systematic Reviews as Topic
OBJECTIVES: Pain catastrophizing and pain acceptance are psychological factors that have been shown to be associated with pain-related outcomes and predict multidisciplinary pain treatment outcomes. However, they are rarely examined in the same study. This study aimed to: (1) assess the independent roles of pain catastrophizingand pain acceptance as predictors of pain intensity, pain interference, and depression; and (2) evaluate the potential moderating role of pain acceptance on the association between pain catastrophizing and both pain and function. MATERIALS AND METHODS: A sample of 467 adults with chronic pain completed an online survey including measures of pain intensity, pain interference, depression, pain catastrophizing, and pain acceptance. RESULTS: Pain catastrophizing and pain acceptance were independent predictors of pain interference. Only pain catastrophizing and the activity engagement domain of pain acceptance were independent predictors of pain intensity and depression. Activity engagement moderated the association between pain catastrophizing and depression, indicating a buffering effect on the negative effects of catastrophizing on depression. Pain willingness moderated the association between pain catastrophizing and pain interference, such that endorsing low pain willingness may override any negative effects of pain catastrophizing. DISCUSSION: The findings suggest that pain catastrophizing and pain acceptance are independently important to adjustment to chronic pain. Research is needed to determine if treatments that target both for change are more effective than treatments that target only one.
Catastrophization , Chronic Pain , Adult , Depression , Humans , Pain Measurement , Surveys and Questionnaires , Treatment Outcome
BACKGROUND: There has been an increasing interest in studying the potential benefits of so-called complementary and alternative approaches for pain management, such as hypnosis and mindfulness-based interventions. More recently, researchers have been interested in studying the effects of spiritual practices on pain experience as well. These practices may increase pain tolerance, result in a positive re-appraisal of pain and influence other psychological variables that are known to be associated with pain experience. The purpose of this study is to evaluate and compare the immediate effects of self-hypnosis, mindfulness meditation, and a spiritual intervention relative to a control condition for increasing pain tolerance and reducing pain intensity and pain-related stress, in response to experimental painful stimulation. METHODS AND ANALYSIS: Recruitment is anticipated to start in November 2020. This is a randomised quantitative experimental mixed-design repeated-measures study with three assessment points: baseline (T0), pre-test (T1) and post-test (T2). Eligible healthy adults will be randomised to one of the four study conditions. Interventions will be a 20-minute audio-guided practice of either self-hypnosis, mindfulness meditation, or Christian prayer. Participants in the control group will not be instructed to use any specific strategy during the painful stimulation. Participants will be submitted to a first cycle of Cold Pressor Arm Wrap. They will then listen to a 20-minute audio recording inducing one of the three interventions, or, in the case of the control group, to a 20-minute audio recording of text from a natural history textbook. Primary outcomes are pain intensity and pain tolerance. Pain-related stress as measured by salivary cortisol level and heart rate variability are secondary outcomes. ETHICS AND DISSEMINATION: This study was approved by ISPA-University Institute's internal Ethics Committee for Research on 3rd December 2018 (reference I/010/12/2018). Findings will be published in peer-reviewed indexed journals and presented at conferences. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov registry (NCT04491630). Stage: pre-results.
Hypnosis , Meditation , Mindfulness , Adult , Humans , Pain , Pain Management , Randomized Controlled Trials as Topic
This study sought to better understand the associations between perfectionistic self-presentation and measures of pain intensity, pain catastrophizing, pain interference, and fatigue in children and adolescents with pain. In the study, 218 adolescents responded to measures of perfectionistic self-presentation (i.e., perfectionistic self-promotion, nondisplay of imperfection and nondisclosure of imperfection), pain intensity, pain catastrophizing, pain interference, and fatigue. Four hierarchical regression analyses and three mediation analyses were conducted. Our results showed that perfectionistic self-promotion was significantly and independently associated with pain intensity and that nondisplay of imperfection was significantly and independently associated with pain catastrophizing, pain interference, and fatigue. Nondisclosure of imperfection was not significantly associated with any criterion variable. Pain catastrophizing mediated the association between both perfectionistic self-presentation and nondisplay imperfection and pain interference but not between nondisclosure of imperfection and pain interference. The findings provide new information about the role of perfectionistic self-presentation in children and adolescents' experience of pain. These findings, if replicated, support perfectionism as a potential target of pain treatment in young people.
Perfectionism , Adolescent , Catastrophization , Child , Humans , Pain
Background: This study aimed at assessing the mental health status of adults living in Portugal during the national lockdown of March 2020 to May 2020, how study participants coped with stress during the national lockdown, as well as the association between coping responses and mental health status. Methods: 430 adults from the general population living in Portugal completed measures of mental health status and coping. Results: Participants reported a mental health status in the normal range. Most commonly used coping responses were acceptance, planning and active coping. The use of instrumental and emotional support, self-blame, venting, denial, behavioural disengagement, and substance use were associated with poorer mental health. Active coping, positive reframing, acceptance, and humour were associated with better mental health. However, only positive reframing and humour significantly predicted better mental health, while only substance use predicted poorer mental health. Conclusions: Findings suggest that there was not a significant negative impact of the Portuguese national lockdown in the adults living in Portugal. Findings supported positive reframing and humour as being adaptive coping responses in this context. These responses should be encouraged by healthcare professionals and targeted in the context of psychosocial intervention programs directed to most vulnerable populations.
PURPOSE: Research supports a role for coping responses in adjustment to chronic pain. However, it is likely that some coping responses play a larger role in adjustment to pain for some individuals than others. The identification of the factors that moderate the association between coping responses and pain-related outcomes has important clinical implications. This study sought to determine if musculoskeletal pain diagnosis moderates the associations between eight pain-coping responses and both pain and function. PATIENTS AND METHODS: A non-probabilistic sample of 323 persons with different chronic musculoskeletal pain conditions completed measures of pain intensity, physical function, psychological function, and pain-coping responses. RESULTS: With only one exception, the frequency of use of pain-coping responses was not associated with pain diagnosis. Statistically significant moderation effects of pain diagnosis on the association between coping and pain outcomes were found for two coping responses: 1) support seeking when predicting pain intensity, and 2) resting when predicting both physical and psychological function. CONCLUSION: The findings indicate that coping responses tend to play a similar role in patients' pain and function across different musculoskeletal pain conditions, with some important exceptions. If the findings are found to replicate in other samples, they would have important implications for determining when psychosocial pain treatments might (and when they might not) need to be adapted for specific diagnostic groups.
OBJECTIVE: To evaluate the extent to which pain-related beliefs, appraisals, coping, and catastrophizing differ between countries, language groups, and country economy. DESIGN: Systematic review. METHODS: Two independent reviewers searched 15 databases without restriction for date or language of publication. Studies comparing pain beliefs/appraisals, coping, or catastrophizing across two or more countries or language groups in adults with chronic pain (pain for longer than three months) were included. Two independent reviewers extracted data and performed the quality appraisal. Study quality was rated as low, moderate, or high using a 10-item modified STROBE checklist. Effect sizes were reported as small (0.20-0.49), medium (0.50-0.79), or large (≥0.80). RESULTS: We retrieved 1,365 articles, read 42 potential full texts, and included 10 (four moderate-quality, six low-quality) studies. A total of 6,797 adults with chronic pain (33% with chronic low back pain) were included from 16 countries. Meta-analysis was not performed because of heterogeneity in the studies. A total of 103 effect sizes were computed for individual studies, some of which indicated between-country differences in pain beliefs, coping, and catastrophizing. Of these, the majority of effect sizes for pain beliefs/appraisal (60%; eight large, eight medium, and eight small), for coping (60%; seven large, 11 medium, and 16 small), and for catastrophizing (50%; two medium, one small) evidenced statistically significant between-country differences, although study quality was low to moderate. CONCLUSIONS: In 50% or more of the studies, mean scores in the measures of pain beliefs and appraisals, coping responses, and catastrophizing were significantly different between people from different countries.
Chronic Pain , Low Back Pain , Adaptation, Psychological , Adult , Catastrophization , Humans
