Sophie Guellati-Salcedo - April 2001 PERSONALITY, COPING STYLES AND CHRONIC PAIN Toward a structural approach to adjustment
Dec 14, 2015
Sophie Guellati-Salcedo - April 2001
PERSONALITY,COPING STYLES
AND CHRONIC PAIN
Toward a structural approach to adjustment
Sophie Guellati-Salcedo - April 2001
Outline
1. Introduction
2. Goal
3. Definitions
4. Hypotheses
5. Sample and Measures
6. Results
7. Conclusion
Sophie Guellati-Salcedo - April 2001
Outline
1. Introduction
2. Goal
3. Definitions
4. Hypotheses
5. Sample and Measures
6. Results
7. Conclusion
Sophie Guellati-Salcedo - April 2001
• The Gate Control Theory Melzack & Wall (1965)
• Multidimensional model of pain 4 components :sensory-discriminative
affective-emotionalcognitivebehavioral
• Definition of the IASP
1.1. The biopsychosocial model of pain
Sophie Guellati-Salcedo - April 2001
• Trait State Model
(Cottraux & Blackburn, 1995)
• “Big Five” Model (Digman, 1990)
• The Five-Factor Theory
(McAdams, 1996; Costa & McCrae, 1999)
1.2. Models of Personality
Sophie Guellati-Salcedo - April 2001
• Dispositional vs. Situational approach
• Coping styles vs. Coping responses
• Regulating role vs. Outcomes
• Adjustment vs. Adaptation
1.3. Coping and correlates
Sophie Guellati-Salcedo - April 2001
• Structural approach
• Postulate: Regularities in behavior
• Type of relationship between variables
• A three-level hierarchical model
1.4. Model proposed
Sophie Guellati-Salcedo - April 2001
Outline
1. Introduction
2. Goal
3. Definitions
4. Hypotheses
5. Sample and Measures
6. Results
7. Conclusion
Sophie Guellati-Salcedo - April 2001
Answer this question:
Does taking into consideration usual patterns of cognition and behavior allow a better understanding of specific cognitive-behavioral responses to the experience of chronic pain ?
2. Goal
Sophie Guellati-Salcedo - April 2001
Outline
1. Introduction
2. Goal
3. Definitions
4. Hypotheses
5. Sample and Measures
6. Results
7. Conclusion
Sophie Guellati-Salcedo - April 2001
3. Definitions
A theoretical position constrains:
the definition of concepts
the operationalization of variables
Sophie Guellati-Salcedo - April 2001
3.1. Usual patterns of behavior
Three levels of patterns… : personality dimensions (Big Five) coping styles usual coping responses to pain
… characterized by :
temporal stability
cross-situational consistency
Sophie Guellati-Salcedo - April 2001
3.2. Components of adjustment
Sensory component of pain: Sensory / affective descriptors
Functional component: Impact on everyday life
Emotional component: Depressive / Anxious states
Sophie Guellati-Salcedo - April 2001
Outline
1. Introduction
2. Goal
3. Definitions
4. Hypotheses
5. Sample and Measures
6. Results
7. Conclusion
Sophie Guellati-Salcedo - April 2001
4.1. Main Hypothesis
Chronic pain patients adopt specific pain-related behaviors that depend on their personality traits and coping styles
The components of their adjustment to pain are related to their usual patterns of behavior
Sophie Guellati-Salcedo - April 2001
4.2. Operationalization
The relationship between usual patterns of behavior and specific pain-related adjustment responses differs according to the aspect of pain experience measured:
intensity and description of pain functional status (daily activities) emotional state (depression, anxiety)
Sophie Guellati-Salcedo - April 2001
Outline
1. Introduction
2. Goal
3. Definitions
4. Hypotheses
5. Sample and Measures
6. Results
7. Conclusion
Sophie Guellati-Salcedo - April 2001
5.1. Population and Sample
• Outpatients from a multidisciplinary pain clinic
• A specific category of pain patients
• An heterogeneous sample.
• Random diversity of pathologies
• Average duration of pain: 7.8 years
Sophie Guellati-Salcedo - April 2001
5.2. Measures of usual patterns of behavior
3 degrees of “predictors” :
Personality traits
Coping styles
Coping responses to pain
D5D
CISS
CSQ
Sophie Guellati-Salcedo - April 2001
5.3. Measures of pain adjustment
4 categories of “outcome variables”:
Intensity of pain
Description of pain
Functional impact
Emotional impact
VAS
QDSA
QUOTI7 MPI IIIBDI 13HAD
Sophie Guellati-Salcedo - April 2001
Outline
1. Introduction
2. Goal
3. Definitions
4. Hypotheses
5. Sample and Measures
6. Results
7. Conclusion
Sophie Guellati-Salcedo - April 2001
6.1. Proportions of variance explained
Sensory components : intensity of pain
21% description of pain 41%
Functional impact : daily activities 30% outdoor and social activities 44%
Emotional impact : Depressive state 53% Anxious state 52%
Sophie Guellati-Salcedo - April 2001
6.3. Prediction of pain intensity
D5D
CISS
CSQ 14%
21%
OverallModel
N.S.
D5D D5D
CISS
N.S.
n.s.
Proportion of variance explained
Sophie Guellati-Salcedo - April 2001
6.2. Partial Correlations
Variables Beta p-value Variables Beta p-value
Intensity CATAS +0,232 0,027of pain PRAY +0,238 0,022
STEM -0,270 0,005 EMO +0,388 0.000TASK -0,203 0,031 CATAS +0,352 0.000
CSCX +0,234 0,016
TASK +0,276 0,006
STEM +0,369 0,001 EMO -0,373 0,002EVIT +0,348 0.000 CATAS -0,308 0,004
REINT +0,240 0,033
STEM -0,301 0,001 EMO +0,580 0.000OPEN -0,192 0,043 CATAS +0,252 0,002TASK -0,163 0,049EVIT -0,241 0,001
SELFST -0,340 0,001
STEM -0,478 0.000 EMO +0,434 0.000OPEN -0,197 0,021 BEHAV +0,221 0,031
Better Adjustment Poorer Adjustment
Anxious State
Depressive State
Outdoor and Social
Activities
Household Chores
Affective Descriptors
Sophie Guellati-Salcedo - April 2001
6.4. Prediction of affective description of pain
D5D D5D
CISS
D5D
14%
CSQ 16%
41%
OverallModel
CISS
24%
11%
Proportion of variance explained
Sophie Guellati-Salcedo - April 2001
6.2. Partial Correlations
Variables Beta p-value Variables Beta p-value
Intensity CATAS +0,232 0,027of pain PRAY +0,238 0,022
STEM -0,270 0,005 EMO +0,388 0.000TASK -0,203 0,031 CATAS +0,352 0.000
CSCX +0,234 0,016
TASK +0,276 0,006
STEM +0,369 0,001 EMO -0,373 0,002EVIT +0,348 0.000 CATAS -0,308 0,004
REINT +0,240 0,033
STEM -0,301 0,001 EMO +0,580 0.000OPEN -0,192 0,043 CATAS +0,252 0,002TASK -0,163 0,049EVIT -0,241 0,001
SELFST -0,340 0,001
STEM -0,478 0.000 EMO +0,434 0.000OPEN -0,197 0,021 BEHAV +0,221 0,031
Better Adjustment Poorer Adjustment
Anxious State
Depressive State
Outdoor and Social
Activities
Household Chores
Affective Descriptors
Sophie Guellati-Salcedo - April 2001
6.5. Prediction of functional impact of pain
On everyday life
D5D D5D
CISS
D5D
N.S.
CSQ 2%
30%
OverallModel
CISS
14%
7%
Proportion of variance explained
Sophie Guellati-Salcedo - April 2001
6.5. Prediction of functional impact of pain
On household chores
D5D D5D
CISS
D5D
N.S.
CSQ n.s.
20%
OverallModel
CISS
6%
6%
Proportion of variance explained
Sophie Guellati-Salcedo - April 2001
6.2. Partial correlations
Variables Beta p-value Variables Beta p-value
Intensity CATAS +0,232 0,027of pain PRAY +0,238 0,022
STEM -0,270 0,005 EMO +0,388 0.000TASK -0,203 0,031 CATAS +0,352 0.000
CSCX +0,234 0,016
TASK +0,276 0,006
STEM +0,369 0,001 EMO -0,373 0,002EVIT +0,348 0.000 CATAS -0,308 0,004
REINT +0,240 0,033
STEM -0,301 0,001 EMO +0,580 0.000OPEN -0,192 0,043 CATAS +0,252 0,002TASK -0,163 0,049EVIT -0,241 0,001
SELFST -0,340 0,001
STEM -0,478 0.000 EMO +0,434 0.000OPEN -0,197 0,021 BEHAV +0,221 0,031
Better Adjustment Poorer Adjustment
Anxious State
Depressive State
Outdoor and Social
Activities
Household Chores
Affective Descriptors
Sophie Guellati-Salcedo - April 2001
6.5. Prediction of functional impact of pain
On outdoor and social activities
D5D D5D
CISS
D5D
15%
CSQ 14%
44%
OverallModel
CISS
31%
16%
Proportion of variance explained
Sophie Guellati-Salcedo - April 2001
6.2. Partial correlations
Variables Beta p-value Variables Beta p-value
Intensity CATAS +0,232 0,027of pain PRAY +0,238 0,022
STEM -0,270 0,005 EMO +0,388 0.000TASK -0,203 0,031 CATAS +0,352 0.000
CSCX +0,234 0,016
TASK +0,276 0,006
STEM +0,369 0,001 EMO -0,373 0,002EVIT +0,348 0.000 CATAS -0,308 0,004
REINT +0,240 0,033
STEM -0,301 0,001 EMO +0,580 0.000OPEN -0,192 0,043 CATAS +0,252 0,002TASK -0,163 0,049EVIT -0,241 0,001
SELFST -0,340 0,001
STEM -0,478 0.000 EMO +0,434 0.000OPEN -0,197 0,021 BEHAV +0,221 0,031
Better Adjustment Poorer Adjustment
Anxious State
Depressive State
Outdoor and Social
Activities
Household Chores
Affective Descriptors
Sophie Guellati-Salcedo - April 2001
6.6. Prediction of emotional impact of pain
Depressive state (BDI 13)
D5D D5D
CISS
D5D
20%
CSQ 12%
53%
OverallModel
CISS
42%
22%
Proportion of variance explained
Sophie Guellati-Salcedo - April 2001
6.2. Partial correlations
Variables Beta p-value Variables Beta p-value
Intensity CATAS +0,232 0,027of pain PRAY +0,238 0,022
STEM -0,270 0,005 EMO +0,388 0.000TASK -0,203 0,031 CATAS +0,352 0.000
CSCX +0,234 0,016
TASK +0,276 0,006
STEM +0,369 0,001 EMO -0,373 0,002EVIT +0,348 0.000 CATAS -0,308 0,004
REINT +0,240 0,033
STEM -0,301 0,001 EMO +0,580 0.000OPEN -0,192 0,043 CATAS +0,252 0,002TASK -0,163 0,049EVIT -0,241 0,001
SELFST -0,340 0,001
STEM -0,478 0.000 EMO +0,434 0.000OPEN -0,197 0,021 BEHAV +0,221 0,031
Better Adjustment Poorer Adjustment
Anxious State
Depressive State
Outdoor and Social
Activities
Household Chores
Affective Descriptors
Sophie Guellati-Salcedo - April 2001
6.6. Prediction of emotional impact of pain
Depressive state (HAD Depression)
D5D D5D
CISS
D5D
22%
CSQ 9%
49%
OverallModel
CISS
41%
19%
Proportion of variance explained
Sophie Guellati-Salcedo - April 2001
6.6. Prediction of emotional impact of pain
Anxious state (HAD Anxiety)
D5D D5D
CISS
D5D
35%
CSQ 7%
52%
OverallModel
CISS
45%
11%
Proportion of variance explained
Sophie Guellati-Salcedo - April 2001
6.2. Partial correlations
Variables Beta p-value Variables Beta p-value
Intensity CATAS +0,232 0,027of pain PRAY +0,238 0,022
STEM -0,270 0,005 EMO +0,388 0.000TASK -0,203 0,031 CATAS +0,352 0.000
CSCX +0,234 0,016
TASK +0,276 0,006
STEM +0,369 0,001 EMO -0,373 0,002EVIT +0,348 0.000 CATAS -0,308 0,004
REINT +0,240 0,033
STEM -0,301 0,001 EMO +0,580 0.000OPEN -0,192 0,043 CATAS +0,252 0,002TASK -0,163 0,049EVIT -0,241 0,001
SELFST -0,340 0,001
STEM -0,478 0.000 EMO +0,434 0.000OPEN -0,197 0,021 BEHAV +0,221 0,031
Better Adjustment Poorer Adjustment
Anxious State
Depressive State
Outdoor and Social
Activities
Household Chores
Affective Descriptors
Sophie Guellati-Salcedo - April 2001
Outline
1. Introduction
2. Goal
3. Definitions
4. Hypotheses
5. Sample and Measures
6. Results
7. Conclusion
Sophie Guellati-Salcedo - April 2001
7. Conclusion
Usual patterns of behavior distal variables: personality proximal variables: coping
are significantly correlated with the components of pain adjustment
Different patterns of predictors with different aspects of adjustment
Sophie Guellati-Salcedo - April 2001
7. Conclusion Personality Dimensions
Neuroticism is associatedwith poorer adjustment to pain
Emotional stability, openness, and conscientiousness are associatedwith better adjustment to pain
Sophie Guellati-Salcedo - April 2001
7. Conclusion Coping Styles
Emotion-oriented coping is associated with poorer adjustment to pain
Task-oriented coping and avoidance are associated with better adjustment to pain
Sophie Guellati-Salcedo - April 2001
7. Conclusion Coping responses to pain
Catastrophizing, praying and hoping, and distraction are associated with poorer adjustment to pain
Coping self-statements and reinterpreting sensations are associated with better adjustment to pain