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Pain Related Catastrophizing on Physical Limitation in Rheumatoid Arthritis Patients. Is Acceptance Important?

Published online by Cambridge University Press:  16 May 2014

Joana Costa*
Affiliation:
Universidade de Coimbra (Portugal)
José Pinto-Gouveia
Affiliation:
Universidade de Coimbra (Portugal)
João Marôco
Affiliation:
Unidade de Investigação em Psicologia e Saúde (Portugal)
*
*Correspondence concerning this article should be addressed to Joana Costa Centro de Investigação do Núcleo Cognitivo Comportamental-CINEICC. Faculdade de Psicologia e Ciências da Educação. Universidade de Coimbra. Rua do Colégio Novo, Apartado 6153. 3001–802. Coimbra (Portugal). E-mail: joanascosta@hotmail.com

Abstract

The experience of Rheumatoid Arthritis (RA) includes significant suffering and life disruption. This cross-sectional study examined the associations between pain, catastrophizing, acceptance and physical limitation in 55 individuals (11 males and 44 female; Mean age = 54.37; SD = 18.346), from the Portuguese population with (RA) 2 years after the diagnosis; also explored the role of acceptance as a mediator process between pain, catastrophizing and physical limitation. Results showed positive correlation between pain and catastrophizing (r = .544; p ≤ .001), and also between pain and 2-years’ physical limitation (r = .531; p ≤ .001) Results also showed that acceptance was negatively correlated with physical limitation 2 years after the diagnosis (r = –.476; p ≤ .001). Path-analysis was performed to explore the direct effect of pain (ß = –.393; SD = .044; Z = 3.180; p ≤ .001) and catastrophizing (n.sig.) on physical limitation and also to explore the buffer effect of acceptance in this relationship (indirect effect ß = –.080). Results showed that physical limitation is not necessarily a direct product of pain and catastrophizing but acceptance was also involved. Pain and catastrophizing are associated but the influence of catastrophizing on physical limitation is promoted by low levels of acceptance. Results emphasize the relevance of acceptance as the emotional regulation process by which pain and catastrophizing influence physical functioning and establish the basic mechanism by which pain and catastrophizing operate in a contextual-based perspective. Also the study results offer a novel approach that may help behavioral health and medical providers prevent and treat these conditions.

Type
Research Article
Copyright
Copyright © Universidad Complutense de Madrid and Colegio Oficial de Psicólogos de Madrid 2014 

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References

Alamanos, Y., Voulgari, P. V., & Drosos, A. A. (2006). Incidence and prevalence of rheumatoid arthritis, based on the 1987 american college of rheumatology criteria: A systematic review. Seminars in Arthritis and Rheumatism, 36, 182188. http://dx.doi.org/10.1016/j.semarthrit.2006.08.006 Google Scholar
Bollen, K. (1989). Structural equations with latent variables (Wiley Series in Probability and Statistics). New Jersey, NJ: John Wiley & Sons, Inc.Google Scholar
Brandão, L., Zerbini, M., & Ferraz, C. (1995). The Arthritis Impact Measurement Scales 2. Tradução e adaptação para a população brasileira [The Arthritis Impact Measurement Scales 2. Translation and adaptation for the Brazilian population]. (Unpublished manuscript) Departamento de Reumatologia da Escola Paulista, Universidade Federal de São Paulo.Google Scholar
Brown, T. (2006). Confirmatory factorial analysis for applied research. New York, NY: Guilford.Google Scholar
Burns, J., 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. Behavioral, Research and Therapy, 41, 11631182. http://dx.doi.org/10.1016/S0005-7967(03)00029-9 Google Scholar
Cano, A. (2004). Pain catastrophizong and social support in married individuals with chronic pain: The moderating role of pain duration. Pain, 110, 656664. http://dx.doi.org/10.1016/j.pain.2004.05.004 Google Scholar
Cimmino, M. A., Parisi, M., Moggiana, G., Mela, G., & Accardo, S. (1998). Prevalence of rheumatoid arthritis in Italy: The Chiavari Study. Annals Rheumatic Disorder, 57, 315318. http://dx.doi.org/10.1136/ard.57.5.315 CrossRefGoogle ScholarPubMed
Cohen, J., & Cohen, P. (1983). Applied multiple regression/correlation analysis for the behavioral sciences (2 nd Ed.). Hillsdale, NJ: Erlbaum.Google Scholar
Cook, A. J., Brawer, P. A., & Vowles, K. E. (2006). The fear-avoidance model of chronic pain: Validation and age analysis using structural equation modeling. Pain, 121, 195206. http://dx.doi.org/10.1016/j.pain.2005.11.018 Google Scholar
Costa, J., & Pinto-Gouveia, J. (2009). Aceitação da Dor. Abordagem psicométrica do Chronic Pain Acceptance Questionnaire numa amostra portuguesa com dor crónica [Acceptance of Pain. Psychometric approach of Chronic Pain Acceptance Questionnaire on a Portuguese sample of chronic pain]. Revista Psicologia, XXIII, 1.Google Scholar
Costa, J., & Pinto-Gouveia, J. (2011). Portuguese adaptation of the Pain Related Self-Statements Scale. Manuscript in preparation.Google Scholar
DeGood, D., & Tait, R. (2001) Assessment of pain beliefs and pain coping. In Turk, D. & Melzack, R.. Handbook of Pain Assessment (pp 320337). New York, NY: The Guilford Press.Google Scholar
Dixon, K. E., Thorn, B. E., & Ward, C. L. (2004). An evaluation of sex differences in psychological and physiological responses to experimentally-induced pain: A path analytic description. Pain, 112, 188196. http://dx.doi.org/10.1016/j.pain.2004.08.017 CrossRefGoogle Scholar
Duncan, T., Duncan, S., & Strycker, L. (2010). An introduction to latent variable growth curve modeling. Concepts, issues, and applications. New York, NY: Psychology Press. Taylor & Francis Group.Google Scholar
Flor, H., Behle, D. J., & Birbaumer, N. (1993). Assessment of pain-related cognitions in chronic pain patients. Behaviour Research and Therapy, 31, 6373. http://dx.doi.org/10.1016/0005-7967(93)90044-U Google Scholar
Gracely, R. H., Geisser, M. E., Giesecke, T., Grant, M. A. B., Petzke, F., Williams, D. A., & Clauw, D. J. (2004). Pain catastrophizing and neural responses to pain among persons with fibromyalgia. Brain, 127, 835843. http://dx.doi.org/10.1093/brain/awh098 Google Scholar
Hayes, S. C. (2004). Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies. Behavior Therapy, 35, 639665. http://dx.doi.org/10.1016/S0005-7894(04)80013-3 Google Scholar
Hayes, S. C., Strosahl, K., & Wilson, K. G. (1999). Acceptance and Commitment Therapy. An experiential approach to behavior change. New York, NY: The Guilford Press.Google Scholar
Helmick, C. G., Felson, D. T., Lawrence, R. C., Gabriel, S., Hirsch, R., Kwoh, C., … Stone, J. H. (2008). Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part I. Arthritis & Rheumatism, 58, 1525. http://dx.doi.org/10.1002/art.23177 CrossRefGoogle ScholarPubMed
Hu, L., & Bentler, P. (1999). Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus. Structural Equation Modeling, 6, 1.Google Scholar
Keefe, F., Smith, S., Buffington, A., Gibson, J., Studts, J., & Caldwell, D. (2002). Recent advances and future directions in the biopsychosocial assessment and treatment of arthritis. Journal of Consulting and Clinical Psychology, 70, 640655. http://dx.doi.org/10.103710022-006X.70.3.640 Google Scholar
Kline, R. (2005). Principles and practice of Structural Equation Modeling. New York, NY: The Guilford Press.Google Scholar
Marôco, J. (2010). Análise Estatística com o PASW Statistics (ex-SPSS) [Statistical Analysis with PASW STATISTICS (ex-SPSS)]. Pêro Pinheiro, Portugal: ReportNumber.Google Scholar
McCracken, L. (1998). Learning to live with pain: Acceptance of pain predicts adjustment in persons with chronic pain. Pain, 74, 2127. http://dx.doi.org/10.1016/S0304-3959(97)00146-2 CrossRefGoogle ScholarPubMed
McCracken, L. (1999). Behavioral constituents of chronic pain acceptance: Results from factor analysis of the Chronic Pain Acceptance Questionnaire. Journal of Back Musculoskeletal Rehabilitation, 13, 93100.Google Scholar
McCracken, L. (2005). Contextual cognitive-behavioral therapy for chronic pain. (Vol. 33). Seattle, WA: IASP Press.Google Scholar
McCracken, L., Carson, J., Eccleston, C., & Keefe, F. (2004). Acceptance and change in the context of chronic pain. Pain, 109, 47. http://dx.doi.org/10.1016/J.PAIN.2004.02.006 Google Scholar
McCracken, L., & Eccleston, C. (2005). A prospective study of acceptance of pain and patient functioning with chronic pain. Pain, 118, 164169. http://dx.doi.org/10.1016/j.pain.2005.08.015 CrossRefGoogle ScholarPubMed
McCracken, L., Vowles, K., & Eccleston, C. (2004). Acceptance of chronic pain: Component analysis and a revised assessment method. Pain, 107, 159166. http://dx.doi.org/10.1016/j.pain.2003.10.012 Google Scholar
McCracken, L., & Yang, S. (2006). The role of values in a contextual cognitive-behavioral approach to chronic pain. Pain, 123, 137145. http://dx.doi.org/10.1016/j.pain.2006.02.021 Google Scholar
Melzack, R. (2005). Short-form McGill Pain Questionnaire. (Unpublished manuscript). Department of Psychology, McGill University.Google Scholar
Melzack, R. (1987). The short-form McGill Pain Questionnaire. Pain, 30, 191197. http://dx.doi.org/10.1016/0304-3959(87)91074-8 Google Scholar
Monjardino, T., Lucas, R., & Barros, H. (2011). Frequency of rheumatic diseases in Portugal: A systematic review. Acta de Reumatologia Portuguesa. 36, 336363.Google Scholar
Newman, S., Fitzpatrick, R., Revenson, R., Skevington, S., & Williams, G. (1996). Understanding Rheumatoid Arthritis. London, UK: Routledge.Google Scholar
Pérez-Álvarez, M. (2012). Third-generation therapies: Achievements and challenges. International Journal of Clinical and Health Psychology, 12, 291310.Google Scholar
Preacher, K., & Hayes, A. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40, 879891. http://dx.doi.org/10.3758/BRM.40.3.879 Google Scholar
Sinclair, V. (2001). Predictors of pain catastrophizing in women with rheumatoid arthritis. Archives of Psychiatric Nursing, 15, 279288. http://dx.doi.org/10.1053/apnu.2001.28686 CrossRefGoogle ScholarPubMed
Sterne, J., & Davey, G. (2001). Sifting the evidence-what´s wrong with the significance tests? British Medical Journal, 322, 226231. http://dx.doi.org/10.1136/bmj.322.7281.261 CrossRefGoogle ScholarPubMed
Sullivan, M. (2012). The communal coping model of pain catastrophizing: Clinical and research implications. Canadian Psychology, 53, 3241. http://dx.doi.org/10.1037/a0026726 Google Scholar
Sullivan, M. J. L., Thorn, B., Haythornthwaite, J. A., Keefe, F., Martin, M., Bradley, L. A., & Lefebvre, J. C. (2001). Theoretical perspectives on the relation between catastrophizing and pain. The Clinical Journal of Pain, 17, 5264. http://dx.doi.org/10.1097/00002508-200103000-00008 Google Scholar
Tabachnick, B., & Fidell, L. (2007). Using multivariate statistics. New York, NY: Pearson Education Inc.Google Scholar
Turner, J. A., & Aaron, L. A. (2001). Pain-related catastrophizing: What is it?. The Clinical Journal of Pain, 17, 6571. http://dx.doi.org/10.1097/00002508-200103000-00009 Google Scholar
Turner, J. A., Mancl, L., & Aaron, L. A. (2004). Pain-related catastrophizing: A daily process study. Pain, 110, 103111. http://dx.doi.org/10.1016/j.pain.2004.03.014 Google Scholar
Viane, I., Crombez, G., Eccleston, C., Poppe, C., Devulder, J., van Houdenhove, B., & De Corte, W. (2003). Acceptance of pain is an independent predictor of mental well-being in patients with chronic pain: Empirical evidence and reappraisal. Pain, 106, 6572. http://dx.doi.org/10.1016/S0304-3959(03)00291-4 Google Scholar
Vlaeyen, J., & Linton, S. (2000). Fear-avoidance and its consequences in chronic musculoskeletal pain: A state of the art. Pain, 85, 317332. http://dx.doi.org/10.1016/S0304-3959(99)00242-0 Google Scholar
Vowles, K. E., McCracken, L. M., & Eccleston, C. (2007). Processes of change in treatment for chronic pain: The contributions of pain, acceptance, and catastrophizing. European Journal of Pain, 11, 779787. http://dx.doi.org/10.1016/j.ejpain.2006.12.007 Google Scholar
Vowles, K. E., McCracken, L. M., & Eccleston, C. (2008). Patient functioning and catastrophizing in chronic pain: The mediating effects of acceptance. Health Psychology, 27, 136143. http://dx.doi.org/10.1037/0278-6133.27.2(Suppl.).S136 Google Scholar
Vowles, K. E., McNeil, D. W., Gross, R. T., McDaniel, M. L., Mouse, A., Bates, M., … McCall, , , C. (2007). Effects of pain acceptance and pain control strategies on physical impairment in individuals with chronic low back pain. Behavior Therapy, 38, 412425. http://dx.doi.org/10.1016/j.beth.2007.02.001 Google Scholar
Wheaton, B., Muthen, B., Alvin, D., & Summers, G. (1977). Assessing reliability and stability in panel models. In Heise, D. R. (Ed.), Sociological methodology (Vol. 8, pp. 84136). San Francisco, CA: Jossey-Bass.Google Scholar
Wolff, B., Burns, J. W., Quartana, P. J., Lofland, K., Bruehl, S., & Chung, O. Y. (2008). Pain catastrophizing, physiological indexes, and chronic pain severity: Tests of mediation and moderation models. Journal of Behavioral Medicine, 31, 105114. http://dx.doi.org/10.1007/s10865-007-9138-z Google Scholar