Effective Coping of Chronic Pain Varies With Psychosocial Resource Profiles

Chronic pain is a major public health concern. About one third of Americans report having chronic pain, and its annual treatment cost surpasses that of any other chronic illness. Individuals with equivalent levels of pain vary in the extent to which they can successfully cope with it. Hence, it is paramount to develop more effective personalized treatments for chronic pain.

Prior research has operated on the assumption that all individual difference variables are associated with pain-related experiences in the same manner across individuals. An important step forward in the development of personalized chronic pain treatment is to identify subgroups of individuals with chronic pain based on profiles of personal resources, that is, psychosocial characteristics that help preserve the ability to pursue meaningful life goals in the face of adversity.

A study by Mun and colleagues (2019) addresses this important missing element in previous research by employing person-centered analyses of two separate samples of individuals with chronic pain.

Study 1 is cross-sectional and consists of 220 individuals with fibromyalgia, whereas Study 2 is prospective and consists of 483 individuals with chronic pain associated with a neurological/neuromuscular condition.

Personal resource variables, such as sense of resilience, social support, pain acceptance, and sleep quality were included in latent profile analyses. Pain interference, one's perception of how pain interferes with performance of daily activities, was used as the primary indicator of adjustment to chronic pain.

The key findings of this study are:

• Three distinct subgroups were identified across the two unique chronic pain samples: High, Moderate, and Low Personal Resource groups.
• In both studies, individuals in the Low Personal Resource group showed significantly lower annual income levels compared to those in other two groups.
• In Study 1, after controlling for depressive symptoms as a covariate, differences between High and Moderate Personal Resource groups remained significant for pain interference measured by a 21-day daily diary report.
• In Study 2, all three subgroups differed in their levels of pain interference at baseline over and above depressive symptoms, age, and pain severity. The Low Personal Resource group reported the highest level of pain interference, whereas the High Personal Resource Group reported the lowest level at baseline. Moreover, these baseline differences remained stable over 4 years.

Implications of these findings:

• Low income may hamper individuals with chronic pain from gaining adequate personal resources needed to sustain a high level of health and function. Efforts to reduce socioeconomic disparities are likely to yield health benefits for those with chronic pain.
• More thorough assessment and treatment of depressive symptoms may prove helpful when conceptualizing and planning chronic pain treatment for individuals with fibromyalgia.
• Patterns of pain interference among individuals with neurological disease or injury and chronic pain appear to be stable over long periods. Evidence-based chronic pain interventions may be particularly helpful for those classified within the Low Personal Resource group.

Citation

• Mun, C. J., Davis, M. C., Molton, I. R., Karoly, P., Suk, H. W., Ehde, D. M.,...Jensen, M. P. (2019). Personal resource profiles of individuals with chronic pain: Sociodemographic and pain interference differences. Rehabilitation Psychology, 64(3), 245–262. https://dx.doi.org/10.1037/rep0000261

Note: This article is in the Health Psychology and Medicine topic area. View more articles in the Health Psychology and Medicine topic area.

Chung Jung Mun, PhD, is a F32 NRSA postdoctoral fellow at Johns Hopkins School of Medicine in the Department of Psychiatry and Behavioral Sciences. His research focuses on understanding the multifaceted processes that influence adjustment to and coping with chronic pain, and development and maintenance of substance use disorders.

Mary C. Davis, PhD, is professor and associate chair of the department of psychology at Arizona State University. Her research focuses on identifying psychosocial risk and resilience factors that predict adaptation to chronic pain, with the aim of developing more effective interventions.

Ivan Molton, PhD, is a clinical psychologist and associate professor in the department of rehabilitation medicine at the University of Washington. His scientific interests focus on psychosocial adjustment to chronic conditions and disability, particularly in older adults.

Paul Karoly, PhD, is professor of psychology at Arizona State University and a fellow of APA. He is a clinical-health psychologist who studies the processes of human goal-guided self-regulation as applied to acute and chronic pain and psychopathology.

Hye Won Suk, PhD, is a quantitative psychologist and assistant professor in the department of psychology at Sogang University, South Korea. Her scientific interests focus on developing and evaluating multilevel models, structural equation models, and functional data analysis methods, particularly for intensive longitudinal data analysis.

Dawn Ehde, PhD, is a clinical psychologist and professor in the department of rehabilitation medicine at the University of Washington. She is also a fellow of APA and editor of the journal Rehabilitation Psychology. She conducts research on the behavioral treatment of chronic pain and fatigue in adults with chronic neurologic conditions.

Howard Tennen, PhD, is a clinical psychologist and Board of Trustees Distinguished Professor at the University of Connecticut. His research examines stress, coping, and adjustment to threatening encounters, including the daily dynamics of chronic pain, stress and alcohol use, gene-stress interactions, and daily process methods in behavioral and pharmacological intervention studies.

Robert D. Kerns, PhD, is a clinical psychologist, professor of psychiatry, neurology, and psychology at Yale University and fellow of APA. Dr. Kerns' scholarly and scientific interests focus on psychosocial aspects of pain and pain management.

Mark P. Jensen, PhD, is a professor and vice chair for research at the department of rehabilitation medicine, University of Washington. His research program focuses on understanding the efficacy and mechanisms of psychosocial pain treatments.