Alina Ioana Cîmpean1,3*, Silviu Andrei Matu2,3
1 Doctoral School Evidence-based assessment and psychological interventions; Babes-Bolyai University, Cluj-Napoca
2 Department of Clinical Psychology and Psychotherapy, Babeş-Bolyai University of Cluj-Napoca, Romania
3 The International Institute for the Advanced Studies of Psychotherapy
and Applied Mental Health, Babeş-Bolyai University of Cluj-Napoca, Romania
Objective: Cognitive-behavioral models of chronic pain point out the importance of cognitive mechanisms that amplify the intensity of pain (Keffe, Dunsmore, & Burnett 1992). This study aims to investigate the role of cognitive and emotional characteristics on pain intensity and distress in a sample of patients diagnosed with coxarthrosis, namely a chronic pain condition.
Research method: Correlational and regression analyses were conducted. The data were collected during two meeting-sessions, two days before surgery and nine days after surgery.
Results: A total of 31 patients diagnosed with coxarthrosis participated in this study. We found significant positive correlation among pre-surgery distress, fear of pain, pain catastrophizing, and automatic thoughts. Fear of pain and pain catastrophizing explained pre-surgery emotional distress variance. Post-surgery distress was positively correlated with fear of pain, pain catastrophizing, automatic thoughts, and optimism. Also, a positive correlation was found between pre-surgery pain and emotional distress. Post-surgery pain was positively correlated with pain catastrophizing, fear of pain, automatic thoughts, and distress.
Implications: Pain catastrophizing and fear of pain may still be the key to understanding the persistence of pain among patients who suffer from a chronic condition.
Keywords: chronic pain, pain catastrophizing, fear of pain, emotional distress, hip replacement surgery
Published online: 2018/03/01
Published print: 2018/03/01
Arntz, A., & Claassens, L. (2004). The meaning of pain inﬂuences its experienced intensity, Pain, (109), 20-25.
Beck, A. T, Rush, A., & Shaw, B. F. (1984). Cognitive Therapy of Depression. An Overview. 1st ed. New York, NY: Guilford Press; 1-33.
Borkum, J. M. (2010). Maladaptive Cognitions and Chronic Pain: Epidemiology, Neuro¬biology, and Treatment, Rational-Emotional and Cognitive-Behavioral Therapy, 28:4–24.
Burns, J. W., Glenn, B., Bruehl, S., Harden, R. N., & Lofland, K. (2003). Cognitive factors influence outcome following multidisciplinary chronic pain treatment: a replication and extension of a cross-lagged panel analysis. Behavior Research and Therapy, 41(10), 1163-1182.
Crombez, G., Vlaeyen, J. W., Heuts, P. H., & Lysens, R. (1999). Pain-related fear is more disabling than pain itself: evidence on the role of pain-related fear in chronic back pain disability. Pain, 80(1-2), 229-239.
David, D., Lynn, S. J., & Ellis, A. (Eds.). (2009). Rational and irrational beliefs: Research, theory, and clinical practice. Oxford University Press.
David, D., & Hofmann, S. G. (2013). Another error of Descartes? Implications for the “third wave” cognitive-behavioral therapy. Journal of Cognitive and Behavioral Psychotherapies, 13(1), 115-124.
Duivenvoorden T, Vissers MM, Verhaar JA, Busschbach JJ, Gosens T, Bloem RR, et al. Anxiety and depressive symptoms before and after total hip and knee arthroplasty: a pros¬pective multicentre study. Osteoarthritis Cartilage 2013;21: 1834–1840. pmid:24012622
De Peuter, S., Jong, J., Crombez, G., & Vlaeyen, J. W. (2009). The Nature and Treatment of Pain-Related Fear in Chronic Musculoskeletal Pain. Journal of Cognitive Psychotherapy, 85-101. 69.
Dilorenzo, T. A., Bovbjerg, D. H., Montgomery, G. H., Valdimarsdottir, H., & Jacobsen, P. B. (1999). The application of a shortened version of the profile of mood states in a sample of breast cancer chemotherapy patients. British Journal of Health Psychology, 4(4), 315-325.
Endrighi R, Hamer M, Steptoe A (2012). Associations of trait optimism with diurnal neuroendocrine activity, cortisol responses to mental stress, and subjective stress measures in healthy men and women. Psychosomatic Medicine, 73: 672-678.
Feuerstein M, Beattie P. (1995). Biobehavioral factors affecting pain and disability in low back pain: Mechanisms and assessment. Physical Therapy; 75:267–79.
Fordyce, W. E., Lansky, D., Calsyn, D. A., Shelton, J. L., Stolov, W. C., & Rock, D. L. (1984). Pain measurement and pain behavior. Pain, 18(1), 53-69.
Hazlett A, Molden D. C, Sackett A. M (2011). Hoping for the best or preparing for the worst? Regulatory focus and preferences for optimism and pessimism in predicting personal
outcomes. Social Cognition 29: 74-96.
Hollon, S., & Kendall, P. (2007). Chestionarul Gandurilor Automate (Automatic Thoughts Questionnaire-ATQ). In D. David, Scale de evaluare clinical (R. Moldovan, Trad.). Cluj- Napoca: RTS.
Keefe, F. J., Dunsmore, J., & Burnett, R. (1992). Behavioral and cognitive-behavioral approaches to chronic pain: Recent advances and future directions. Journal of Consulting and Clinical Psychology, 60(4), 528.
Leeuw, M., Goossens, M. E., Linton, S. J., Crombez, G., Boersma, K., & Vlaeyen, J. W. (2007). The fear-avoidance model of musculoskeletal pain: current state of scientific evidence. Journal of behavioral medicine, 30(1), 77-94.
Luthar S. S, Cicchetti D, Becker B. (2000). The construct of resilience: a critical evaluation and guidelines for future work. Child Dev. 71:543–62.
Loeser, J. D., & Melzack, R. (1999). Pain: an overview. The Lancet, 353, 1607-1609.
Meevissen Y. M. C, Peters M. L, Alberts H. J. E.M (2011). Become more optimistic by imagining a best possible self: Effects of a two week intervention. J Behav Ther & Exp Psychiat 42:371-378.
McCraken, L. M., Zayfert, C., & Gross, R. T. (1992). The pain anxiety symptoms scale: development and validation of a scale to measure fear of pain. Pain, 50 (1), 67-73.
Nilsdotter, A. K., Peterson, I. F., Ross, E. M., & Lohmander, L. S. (2003). Predictors of patient relevant outcome after total hip replacement for osteoarthritis: A prospective study. Annals of Rheumatic Diseases, 62(10), 923-930.
Picavet, S. J., Vlaeyen, J. W., & Schouten, J. S. (2002). Pain Catastrophizing and Kinesiophobia: Predictors of Chronic Low Back Pain. American Journal of Epidemiology, 156(11), 1028-1034.
Pakarinen M, Vanhanen S, Sinikallio S, Aalto T, Lehto S. M, Airaksinen O (2014). Depressive burden is associated with a poorer surgical outcome among lumbar spinal stenosis patients: a 5-year follow-up study. Spine Journal, 14: 2392–2396.
Rutter M. (1987). Psychosocial resilience and protective mechanisms. Am J Orthopsychiat. 57:316–31.
Scheier, M. F., Carver, C. S., Michael W. B. (1994). Distinguishing optimism from neuroti¬cism (and trait anxiety, self-mastery, and self-esteem: A reevaluation of the Life Orientation Test. Journal of Personality and Social Psychology, Vol 67(6), Dec 1994, 1063.
Sturgeon, J. A., & Zautra, A. J. (2013). Psychological resilience, pain catastrophizing, and positive emotions: perspectives on comprehensive modeling of individual pain adaptation. Current Pain and Headache Reports, 17(3), 317.
Sullivan, M., Tanzer, M., Stanish, W., Fallaha, M., Keefe, F. J., Simmonds, M., & Dunbar, M. (2009). Psychological determinants of problematic outcomes following total knee arthroplasty. Pain, 143(1-2), 123-129.
Sullivan, M. J., Bishop, S. R., & Pivik, J. (1995). The pain catastrophizing scale: development and validation. Psychological assessment, 7(4), 524.
Turk, D. C., & Okifuji, A. (2002). Psychological factors in chronic pain: Evolution and revolution. Journal of consulting and clinical psychology, 70(3), 678.
Vlaeyen, J. W., Kole-Snijders, A. M., Rotteveel, A. M., Ruesink, R., & Heuts, P. H. (1995). The role of fear of movement/(re) injury in pain disability. Journal of occupational rehabilitation, 5(4), 235-252.1078.
Vlaeyen, J. W., & Linton, S. J. (2000). Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain, 85(3), 317-332.
World Health Organization, World Organization of National Colleges, Academies, & Academic Associations of General Practitioners/Family Physicians. (2008). Integrating mental health into primary care: a global perspective. World Health Organization.