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01-06-2008 | Original Article

The Impact of Goal Cognition and Pain Severity on Disability and Depression in Adults with Chronic Pain: An Examination of Direct Effects and Mediated Effects via Pain-Induced Fear

Auteurs: Paul Karoly, Morris A. Okun, Linda S. Ruehlman, John A. Pugliese

Gepubliceerd in: Cognitive Therapy and Research | Uitgave 3/2008

Abstract

A group of 100 adults with chronic low back pain (CLBP), drawn from a larger national sample, completed a questionnaire battery that assessed (among other things) goal conflict and goal self-efficacy, pain severity, pain-induced fear, and 3 months later, two important clinical outcomes: physical disability and depression. Consistent with emerging motivation-centered models of adaptation (e.g., Ford, Humans as self-constructing living systems: A developmental perspective on behavior and personality. Erlbaum, 1987; Karoly Review of General Psychology, 3, 264–291, 1999) and cognitive-behavioral accounts of pain-specific fears (e.g., Asmundson et al. Clinical Psychology Review, 19, 97–119, 1999), structural equation analyses revealed that (a) goal self-efficacy, goal conflict, and pain severity independently predicted pain-induced fear, (b) pain-induced fear fully mediated the effects of goal conflict and goal self-efficacy on physical disability and depression, and (c) pain-induced fear partially mediated the effects of severity on disability and depression. Results suggest that clinical pain specialists should treat pain-induced fear as a means of forestalling disability and depression, and that they should also seek to modify how CLBP patients think about and organize their life goals.

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Titel: The Impact of Goal Cognition and Pain Severity on Disability and Depression in Adults with Chronic Pain: An Examination of Direct Effects and Mediated Effects via Pain-Induced Fear
Auteurs: Paul Karoly
Morris A. Okun
Linda S. Ruehlman
John A. Pugliese
Publicatiedatum: 01-06-2008
Uitgeverij: Springer US
Gepubliceerd in: Cognitive Therapy and Research / Uitgave 3/2008
Print ISSN: 0147-5916
Elektronisch ISSN: 1573-2819
DOI: https://doi.org/10.1007/s10608-007-9136-z

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