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Education and social functioning buffer the effects of catastrophizing on pain and disability in RA patients
S68 (374) Perceived control moderates the influence of active coping on salivary cortisol response to acute pain among women but not men S Bier, B Goodin, L Mayes, G Page, L McGuire; University of Maryland, Baltimore County, Baltimore, MD Attenuated cortisol production in response to stress has been linked with poor health outcomes, such as fatigue, depression, and chronic pain. It is generally established that active-coping strategies and greater perceived control over pain are associated with improved pain-related outcomes; however it remains unclear whether these factors independently or interactively influence adrenocortical function in reaction to a painful stimulus. Previous studies have also noted sex differences in psychological and physiological responses to pain. The present study examined whether active coping predicted magnitude cortisol response to acute pain, and whether perceived control over pain moderated this association among men and women. Young, healthy adults (N = 80, 50% women) completed a cold pressor task (CPT) and provided salivary cortisol samples before and after pain. The Survey of Pain Attitudes (SOPA) was used to assess perceived control over pain, and active coping was assessed by the Coping Strategies Questionnaire-Short Form (CSQ-SF). After adjustment for pain tolerance and pain unpleasantness ratings, results of a hierarchical regression analysis showed a significant active coping X perceived control X sex three-way interaction for total release of salivary cortisol following the CPT (DR2 = .059, p = .029). Simple slope analyses revealed that active coping was positively related to total release of salivary cortisol only among women with greater perceived control (t = 2.86, p < .01). Conversely, this pattern of results was opposite for men, although none of the simple slopes was significant. Our findings suggest that perceived control moderates the active coping-adrenocortical relation among women such that active coping may augment the release of cortisol in response to a painful stimulus only in the presence of greater perceived control over pain. Taken together, active coping and perceived control may potentiate an adaptive neuroendocrine response to an acute painful stressor.
Abstracts (376) Education and social functioning buffer the effects of catastrophizing on pain and disability in RA patients R Edwards; Johns Hopkins, Baltimore, MD Pain is among the most frequently-reported, bothersome, and disabling symptoms described by patients with rheumatoid arthritis (RA). To date, dozens of studies document the deleterious effects of catastrophizing in RA patients; catastrophizing is positively related to enhanced pain severity, affective distress, and pain-related disability. However, the impact of catastrophizing on pain-related outcomes appears to show some variability across patient subgroups. That is, certain factors may moderate the effects of catastrophizing on pain, either buffering or facilitating catastrophizing’s association with pain-related outcomes. In the present study, we assessed 197 patients with RA (60% female) using measures of catastrophizing, depression, pain, and disability. Multiple moderators of catastrophizing’s effects were then evaluated, including demographic and social factors. Overall, catastrophizing was strongly associated with high pain severity and with reduced physical functioning, even after controlling for levels of depression (p’s< .01). However, several significant moderators emerged from these analyses; among RA patients with high levels of education and among RA patients who reported above-average social functioning, minimal relationships of catastrophizing with pain and disability were observed (p’s> .10), while these associations were highly significant (p’s< .01) among patients with lower levels of education or social functioning. Collectively, educational achievement and positive social interactions may protect against, or buffer, the deleterious effects of catastrophizing. The design of future interventions to reduce catastrophizing, or ameliorate its impact on pain outcomes, may benefit from further study of these subgroups of patients.
(375) Dispositional optimism buffers the negative influence of catastrophizing on pain response
(377) Differences in pain coping strategies and alcohol use among persons with spinal cord injuries
B Goodin, S Bier, L McGuire; University of Maryland, Baltimore County, Baltimore, MD It is generally accepted that the tendency to catastrophize during painful stimulation contributes to more intense pain and increased emotional distress. Conversely, dispositional optimism has been shown to serve as a buffer to the effects of stress on health and it has been suggested that optimism may positively influence the course and experience of pain. However, it is not currently known whether optimism affects the relation between catastrophizing and pain response. The current study examined the cross-sectional associations of optimism, catastrophizing, and their interaction with pain response. A total of 150 (50% women) healthy, ethnically diverse young adults were subjected to a cold pressor task (CPT) and completed the Life Orientation Test-Revised (LOT-R) and an in vivo version of the Pain Catastrophizing Scale (PCS). Pain response was assessed by the Short Form-McGill Pain Questionnaire (SF-MPQ). After adjustment for sex, pain tolerance, and depressive symptoms, we detected a modest yet significant optimism X catastrophizing interaction for pain response (DR2 = .016, p = .04) using regression analyses. Although the relation between catastrophizing and pain response remained positive and significant, simple slope analyses revealed that the magnitude of this relation was less severe among individuals with greater optimism (Beta = .517, p<.001) compared to those with intermediate optimism (Beta = .614, p<.001) or low optimism (Beta = .771, p<.001). Similar to previous reports, our results show that greater catastrophizing is a potent predictor of more severe pain responses. However, to our knowledge, these results are the first to suggest that the catastrophizing-pain relation may be moderated by optimism such that greater dispositional optimism may attenuate the deleterious influence of catastrophizing on pain response during and immediately following the cold pressor task.
T Dillworth, A Hirsh, D Ehde, M Jensen; University of Washington, Seattle, WA Pain has been found to be a common occurrence among individuals with spinal cord injuries (SCI), and various strategies for managing pain have been evaluated in the literature. Research has also found alcohol use to be associated with coping with stressful situations, such as pain. Currently there is little research evaluating the role of alcohol use in pain coping strategies in SCI populations. The current study evaluated pain coping strategies and alcohol use in persons with spinal cord injuries. One-hundred sixty three participants (74% male, 89% White) were recruited as part of a larger mailed survey. Frequency of alcohol use and frequency of pain coping strategies, including catastrophizing (Coping Strategies Questionnaire Catastrophizing subscale), guarding, resting, asking for assistance, relaxation, task persistence, seeking social support, and using coping self-statements (Chronic Pain Coping Inventory) were assessed. Results found 65.6% of participants reported consuming alcohol. No differences were found between drinkers and nondrinkers on the presence of pain, current and worst pain in the past week, or average pain severity in the past three months. Differences were found between drinkers and abstainers on use of coping strategies. Specifically, abstainers reported higher frequency of resting, F(1,125) = 5.13, p = .03, coping self-statements, F(1, 126) = 11.96, p<.001, and pacing, F(1,126) = 4.01, p<.05, as coping strategies. Additionally, abstainers were less likely to use catastrophizing, F(1,127) = 7.88, p<.01, to cope with pain. These results suggest alcohol use may play a role in the strategies individuals use to cope with pain. Implications and future research directions will be discussed. (Supported by grant PO1HD/NS33988 from National Institute of Child Health and Human Development (NICHHD) and National Institute of Neurological Disorders and Stroke, and grant R01HD057916 from NICHHD.)
Abstracts (376) Education and social functioning buffer the effects of catastrophizing on pain and disability in RA patients R Edwards; Johns Hopkins, Baltimore, MD Pain is among the most frequently-reported, bothersome, and disabling symptoms described by patients with rheumatoid arthritis (RA). To date, dozens of studies document the deleterious effects of catastrophizing in RA patients; catastrophizing is positively related to enhanced pain severity, affective distress, and pain-related disability. However, the impact of catastrophizing on pain-related outcomes appears to show some variability across patient subgroups. That is, certain factors may moderate the effects of catastrophizing on pain, either buffering or facilitating catastrophizing’s association with pain-related outcomes. In the present study, we assessed 197 patients with RA (60% female) using measures of catastrophizing, depression, pain, and disability. Multiple moderators of catastrophizing’s effects were then evaluated, including demographic and social factors. Overall, catastrophizing was strongly associated with high pain severity and with reduced physical functioning, even after controlling for levels of depression (p’s< .01). However, several significant moderators emerged from these analyses; among RA patients with high levels of education and among RA patients who reported above-average social functioning, minimal relationships of catastrophizing with pain and disability were observed (p’s> .10), while these associations were highly significant (p’s< .01) among patients with lower levels of education or social functioning. Collectively, educational achievement and positive social interactions may protect against, or buffer, the deleterious effects of catastrophizing. The design of future interventions to reduce catastrophizing, or ameliorate its impact on pain outcomes, may benefit from further study of these subgroups of patients.
(375) Dispositional optimism buffers the negative influence of catastrophizing on pain response
(377) Differences in pain coping strategies and alcohol use among persons with spinal cord injuries
B Goodin, S Bier, L McGuire; University of Maryland, Baltimore County, Baltimore, MD It is generally accepted that the tendency to catastrophize during painful stimulation contributes to more intense pain and increased emotional distress. Conversely, dispositional optimism has been shown to serve as a buffer to the effects of stress on health and it has been suggested that optimism may positively influence the course and experience of pain. However, it is not currently known whether optimism affects the relation between catastrophizing and pain response. The current study examined the cross-sectional associations of optimism, catastrophizing, and their interaction with pain response. A total of 150 (50% women) healthy, ethnically diverse young adults were subjected to a cold pressor task (CPT) and completed the Life Orientation Test-Revised (LOT-R) and an in vivo version of the Pain Catastrophizing Scale (PCS). Pain response was assessed by the Short Form-McGill Pain Questionnaire (SF-MPQ). After adjustment for sex, pain tolerance, and depressive symptoms, we detected a modest yet significant optimism X catastrophizing interaction for pain response (DR2 = .016, p = .04) using regression analyses. Although the relation between catastrophizing and pain response remained positive and significant, simple slope analyses revealed that the magnitude of this relation was less severe among individuals with greater optimism (Beta = .517, p<.001) compared to those with intermediate optimism (Beta = .614, p<.001) or low optimism (Beta = .771, p<.001). Similar to previous reports, our results show that greater catastrophizing is a potent predictor of more severe pain responses. However, to our knowledge, these results are the first to suggest that the catastrophizing-pain relation may be moderated by optimism such that greater dispositional optimism may attenuate the deleterious influence of catastrophizing on pain response during and immediately following the cold pressor task.
T Dillworth, A Hirsh, D Ehde, M Jensen; University of Washington, Seattle, WA Pain has been found to be a common occurrence among individuals with spinal cord injuries (SCI), and various strategies for managing pain have been evaluated in the literature. Research has also found alcohol use to be associated with coping with stressful situations, such as pain. Currently there is little research evaluating the role of alcohol use in pain coping strategies in SCI populations. The current study evaluated pain coping strategies and alcohol use in persons with spinal cord injuries. One-hundred sixty three participants (74% male, 89% White) were recruited as part of a larger mailed survey. Frequency of alcohol use and frequency of pain coping strategies, including catastrophizing (Coping Strategies Questionnaire Catastrophizing subscale), guarding, resting, asking for assistance, relaxation, task persistence, seeking social support, and using coping self-statements (Chronic Pain Coping Inventory) were assessed. Results found 65.6% of participants reported consuming alcohol. No differences were found between drinkers and nondrinkers on the presence of pain, current and worst pain in the past week, or average pain severity in the past three months. Differences were found between drinkers and abstainers on use of coping strategies. Specifically, abstainers reported higher frequency of resting, F(1,125) = 5.13, p = .03, coping self-statements, F(1, 126) = 11.96, p<.001, and pacing, F(1,126) = 4.01, p<.05, as coping strategies. Additionally, abstainers were less likely to use catastrophizing, F(1,127) = 7.88, p<.01, to cope with pain. These results suggest alcohol use may play a role in the strategies individuals use to cope with pain. Implications and future research directions will be discussed. (Supported by grant PO1HD/NS33988 from National Institute of Child Health and Human Development (NICHHD) and National Institute of Neurological Disorders and Stroke, and grant R01HD057916 from NICHHD.)