Coping with chronic pain - assessment of coping strategies and distress

The study examined the reliability and validity of scales that assess coping with pain. Previous exploratory and confirmatory analyses revealed a model of 9 correlated but distinctive dimensions, which were significantly correlated with external criteria. One domain (pain-related distress) consisted of helplessness/depression, anxiety, and anger, another domain (cognitive coping strategies) comprised action-oriented coping, cognitive restructuring, and self-efficacy, the third domain (behaviorally oriented strategies) included mental distraction, counter-activities, and relaxation. On the basis of these dimensions, the Pain Coping Questionnaire was constructed and was tested in 4 samples (N = 401, N = 162, N = 83, N = 248) of chronic pain patients. Homogenity and test-retest reliability were good. Pain-related distress showed significant positive correlations with pain experience, but not with duration of pain. Patients who had no pain medication showed more adaptive patterns of coping compared to patients who were on medication. Patients with ineffective medications had the least adaptive skills. Patients with multiple pain symptoms or headache/migraine coped worse than patients with back pain or inflammatory pain-syndromes. All variables of coping with pain proved to be sensitive to psychological pain treatment. Age and gender exerted no substantial effects on the coping variables.