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PERSONALITY, COPING STYLES AND CHRONIC PAIN

PERSONALITY, COPING STYLES AND CHRONIC PAIN. Toward a structural approach to adjustment. Outline. 1. Introduction 2. Goal 3. Definitions 4. Hypotheses 5. Sample and Measures 6. Results 7. Conclusion. Outline. 1. Introduction 2. Goal 3. Definitions 4. Hypotheses

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PERSONALITY, COPING STYLES AND CHRONIC PAIN

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  1. PERSONALITY,COPING STYLES AND CHRONIC PAIN Toward a structural approach to adjustment

  2. Outline 1. Introduction 2. Goal 3. Definitions 4. Hypotheses 5. Sample and Measures 6. Results 7. Conclusion

  3. Outline 1. Introduction 2. Goal 3. Definitions 4. Hypotheses 5. Sample and Measures 6. Results 7. Conclusion

  4. 1.1. The biopsychosocial model of pain • The Gate Control Theory Melzack & Wall (1965) • Multidimensional model of pain 4 components : sensory-discriminative affective-emotional cognitive behavioral • Definition of the IASP

  5. 1.2. Models of Personality • Trait  State Model (Cottraux & Blackburn, 1995) • “Big Five” Model (Digman, 1990) • The Five-Factor Theory (McAdams, 1996; Costa & McCrae, 1999)

  6. 1.3. Coping and correlates • Dispositional vs. Situational approach • Coping styles vs. Coping responses • Regulating role vs. Outcomes • Adjustment vs. Adaptation

  7. 1.4. Model proposed • Structural approach • Postulate: Regularities in behavior • Type of relationship between variables • A three-level hierarchical model

  8. Outline 1. Introduction 2. Goal 3. Definitions 4. Hypotheses 5. Sample and Measures 6. Results 7. Conclusion

  9. 2. Goal 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 ?

  10. Outline 1. Introduction 2. Goal 3. Definitions 4. Hypotheses 5. Sample and Measures 6. Results 7. Conclusion

  11. 3. Definitions A theoretical position constrains: • the definition of concepts • the operationalization of variables

  12. 3.1. Usual patterns of behavior Three levels of patterns… : • personality dimensions (Big Five) • coping styles • usualcopingresponses to pain … characterized by : • temporal stability • cross-situational consistency

  13. 3.2. Components of adjustment • Sensory component of pain: Sensory / affective descriptors • Functional component: Impact on everyday life • Emotional component: Depressive / Anxious states

  14. Outline 1. Introduction 2. Goal 3. Definitions 4. Hypotheses 5. Sample and Measures 6. Results 7. Conclusion

  15. 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

  16. 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)

  17. Outline 1. Introduction 2. Goal 3. Definitions 4. Hypotheses 5. Sample and Measures 6. Results 7. Conclusion

  18. 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

  19. 5.2. Measures of usual patterns of behavior 3 degrees of “predictors” : • Personality traits • Coping styles • Coping responses to pain • D5D • CISS • CSQ

  20. VAS • QDSA • QUOTI7 • MPI III • BDI 13 • HAD 5.3. Measures of pain adjustment 4 categories of “outcome variables”: • Intensity of pain • Description of pain • Functional impact • Emotional impact

  21. Outline 1. Introduction 2. Goal 3. Definitions 4. Hypotheses 5. Sample and Measures 6. Results 7. Conclusion

  22. 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%

  23. CSQ 21% N.S.  14% CISS CISS N.S.  n.s. D5D D5D Overall Model 6.3. Prediction of pain intensity Proportion of variance explained D5D

  24. 6.2. Partial Correlations

  25. CSQ 41% 24%  16% CISS CISS 14%  11% D5D D5D Overall Model 6.4. Prediction of affective description of pain Proportion of variance explained D5D

  26. 6.2. Partial Correlations

  27. CSQ 30% 14%  2% CISS CISS N.S.  7% D5D D5D Overall Model 6.5. Prediction of functional impact of painOn everyday life Proportion of variance explained D5D

  28. CSQ 20% 6%  n.s. CISS CISS N.S.  6% D5D D5D Overall Model 6.5. Prediction of functional impact of painOn household chores Proportion of variance explained D5D

  29. 6.2. Partial correlations

  30. CSQ 44% 31%  14% CISS CISS 15%  16% D5D D5D Overall Model 6.5. Prediction of functional impact of painOn outdoor and social activities Proportion of variance explained D5D

  31. 6.2. Partial correlations

  32. CSQ 53% 42%  12% CISS CISS 20%  22% D5D D5D Overall Model 6.6. Prediction of emotional impact of painDepressive state (BDI 13) Proportion of variance explained D5D

  33. 6.2. Partial correlations

  34. CSQ 49% 41%  9% CISS CISS 22%  19% D5D D5D Overall Model 6.6. Prediction of emotional impact of painDepressive state (HAD Depression) Proportion of variance explained D5D

  35. CSQ 52% 45% 7% CISS CISS 35%  11% D5D D5D Overall Model 6.6. Prediction of emotional impact of painAnxious state (HAD Anxiety) Proportion of variance explained D5D

  36. 6.2. Partial correlations

  37. Outline 1. Introduction 2. Goal 3. Definitions 4. Hypotheses 5. Sample and Measures 6. Results 7. Conclusion

  38. 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

  39. 7. ConclusionPersonality Dimensions Neuroticism is associated with poorer adjustment to pain Emotional stability, openness, and conscientiousness are associated with better adjustment to pain

  40. 7. ConclusionCoping Styles Emotion-oriented coping is associated with poorer adjustment to pain Task-oriented coping and avoidance are associated with better adjustment to pain

  41. 7. ConclusionCoping 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

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