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Cognitive Therapy and Research
Gepubliceerd in:

01-06-2008 | Original Article

The Impact of Goal Cognition and Pain Severity on Disability and Depression in Adults with Chronic Pain: An Examination of Direct Effects and Mediated Effects via Pain-Induced Fear

Auteurs: Paul Karoly, Morris A. Okun, Linda S. Ruehlman, John A. Pugliese

Gepubliceerd in: Cognitive Therapy and Research | Uitgave 3/2008

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Abstract

A group of 100 adults with chronic low back pain (CLBP), drawn from a larger national sample, completed a questionnaire battery that assessed (among other things) goal conflict and goal self-efficacy, pain severity, pain-induced fear, and 3 months later, two important clinical outcomes: physical disability and depression. Consistent with emerging motivation-centered models of adaptation (e.g., Ford, Humans as self-constructing living systems: A developmental perspective on behavior and personality. Erlbaum, 1987; Karoly Review of General Psychology, 3, 264–291, 1999) and cognitive-behavioral accounts of pain-specific fears (e.g., Asmundson et al. Clinical Psychology Review, 19, 97–119, 1999), structural equation analyses revealed that (a) goal self-efficacy, goal conflict, and pain severity independently predicted pain-induced fear, (b) pain-induced fear fully mediated the effects of goal conflict and goal self-efficacy on physical disability and depression, and (c) pain-induced fear partially mediated the effects of severity on disability and depression. Results suggest that clinical pain specialists should treat pain-induced fear as a means of forestalling disability and depression, and that they should also seek to modify how CLBP patients think about and organize their life goals.
vorige artikel How Do the Dimensions of Perfectionism Relate to Mental Health?
volgende artikel Social Support, Disease-Related Cognitions and Coping as Predictors of Depressed Mood in Systemic Sclerosis
Voetnoten
1
The RDD procedure involves the generation (by a survey sampling company) of a list of phone numbers, randomly drawn from across the United States to be representative of population distribution patterns. Non-working, cellular, and non-residential numbers are excluded from this original list. Calls were made throughout the day and evening on all days of the week. A working number was called a minimum of six times. Calling patterns were regulated in keeping with the time zone being called, so as to neither call too early in the morning nor too late in the evening.
 
2
To examine possible selection biases, the 643 unwilling participants were compared to the 2,407 willing subjects. A Multivariate Analysis of Variance was conducted in which willingness to participate was the between subjects factor and scores on the PCP: S were the dependent measures. The groups differed significantly (Wilks’ Lambda = .97; F (3, 3046) = 31.85, p < .001). However, the partial η 2 was .03, indicating that group differences were quite small.
 
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Metagegevens
Titel
The Impact of Goal Cognition and Pain Severity on Disability and Depression in Adults with Chronic Pain: An Examination of Direct Effects and Mediated Effects via Pain-Induced Fear
Auteurs
Paul Karoly
Morris A. Okun
Linda S. Ruehlman
John A. Pugliese
Publicatiedatum
01-06-2008
Uitgeverij
Springer US
Gepubliceerd in
Cognitive Therapy and Research / Uitgave 3/2008
Print ISSN: 0147-5916
Elektronisch ISSN: 1573-2819
DOI
https://doi.org/10.1007/s10608-007-9136-z

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