1. Sophie Guellati-Salcedo - April 2001 PERSONALITY, COPING STYLES AND CHRONIC PAIN Toward a structural approach to adjustment

2. Sophie Guellati-Salcedo - April 2001 Outline 1. Introduction 2. Goal 3. Definitions 4. Hypotheses 5. Sample and Measures 6. Results 7. Conclusion

3. Sophie Guellati-Salcedo - April 2001 Outline 1. Introduction 2. Goal 3. Definitions 4. Hypotheses 5. Sample and Measures 6. Results 7. Conclusion

4. Sophie Guellati-Salcedo - April 2001 The Gate Control Theory Melzack & Wall (1965) Multidimensional model of pain 4 components :sensory-discriminative affective-emotional cognitive behavioral Definition of the IASP 1.1. The biopsychosocial model of pain

5. Sophie Guellati-Salcedo - April 2001 Trait  State Model (Cottraux & Blackburn, 1995) “Big Five” Model (Digman, 1990) The Five-Factor Theory ( McAdams, 1996; Costa & McCrae, 1999 ) 1.2. Models of Personality

6. Sophie Guellati-Salcedo - April 2001 Dispositional vs. Situational approach Coping styles vs. Coping responses Regulating role vs. Outcomes Adjustment vs. Adaptation 1.3. Coping and correlates

7. Sophie Guellati-Salcedo - April 2001 Structural approach Postulate: Regularities in behavior Type of relationship between variables A three-level hierarchical model 1.4. Model proposed

8. Sophie Guellati-Salcedo - April 2001 Outline 1. Introduction 2. Goal 3. Definitions 4. Hypotheses 5. Sample and Measures 6. Results 7. Conclusion

9. Sophie Guellati-Salcedo - April 2001 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 ? 2. Goal

10. Sophie Guellati-Salcedo - April 2001 Outline 1. Introduction 2. Goal 3. Definitions 4. Hypotheses 5. Sample and Measures 6. Results 7. Conclusion

11. Sophie Guellati-Salcedo - April 2001 3. Definitions A theoretical position constrains: the definition of concepts the operationalization of variables

12. Sophie Guellati-Salcedo - April 2001 3.1. Usual patterns of behavior Three levels of patterns… :  personality dimensions (Big Five)  coping styles  usual coping responses to pain … characterized by :  temporal stability  cross-situational consistency

13. Sophie Guellati-Salcedo - April 2001 3.2. Components of adjustment  Sensory component of pain: Sensory / affective descriptors  Functional component: Impact on everyday life  Emotional component: Depressive / Anxious states

14. Sophie Guellati-Salcedo - April 2001 Outline 1. Introduction 2. Goal 3. Definitions 4. Hypotheses 5. Sample and Measures 6. Results 7. Conclusion

15. Sophie Guellati-Salcedo - April 2001 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. Sophie Guellati-Salcedo - April 2001 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. Sophie Guellati-Salcedo - April 2001 Outline 1. Introduction 2. Goal 3. Definitions 4. Hypotheses 5. Sample and Measures 6. Results 7. Conclusion

18. Sophie Guellati-Salcedo - April 2001 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. Sophie Guellati-Salcedo - April 2001 5.2. Measures of usual patterns of behavior 3 degrees of “predictors” : Personality traits Coping styles Coping responses to pain  D5D  CISS  CSQ

20. Sophie Guellati-Salcedo - April 2001 5.3. Measures of pain adjustment 4 categories of “outcome variables”: Intensity of pain Description of pain Functional impact Emotional impact  VAS  QDSA  QUOTI7  MPI III  BDI 13  HAD

21. Sophie Guellati-Salcedo - April 2001 Outline 1. Introduction 2. Goal 3. Definitions 4. Hypotheses 5. Sample and Measures 6. Results 7. Conclusion

22. Sophie Guellati-Salcedo - April 2001 6.1. Proportions of variance explained Sensory components : intensity of pain21% description of pain41% Functional impact : daily activities30% outdoor and social activities44% Emotional impact : Depressive state53% Anxious state52%

23. Sophie Guellati-Salcedo - April 2001 6.3. Prediction of pain intensity D5D CISSCSQ  14% 21% Overall Model N.S. D5D CISS N.S.  n.s. Proportion of variance explained

24. Sophie Guellati-Salcedo - April 2001 6.2. Partial Correlations

25. Sophie Guellati-Salcedo - April 2001 6.4. Prediction of affective description of pain D5D CISS D5D 14% CSQ  16% 41% Overall Model CISS 24%  11% Proportion of variance explained

26. Sophie Guellati-Salcedo - April 2001 6.2. Partial Correlations

27. Sophie Guellati-Salcedo - April 2001 6.5. Prediction of functional impact of pain On everyday life D5D CISS D5D N.S. CSQ  2% 30% Overall Model CISS 14%  7% Proportion of variance explained

28. Sophie Guellati-Salcedo - April 2001 6.5. Prediction of functional impact of pain On household chores D5D CISS D5D N.S. CSQ  n.s. 20% Overall Model CISS 6%  6% Proportion of variance explained

29. Sophie Guellati-Salcedo - April 2001 6.2. Partial correlations

30. Sophie Guellati-Salcedo - April 2001 6.5. Prediction of functional impact of pain On outdoor and social activities D5D CISS D5D 15% CSQ  14% 44% Overall Model CISS 31%  16% Proportion of variance explained

31. Sophie Guellati-Salcedo - April 2001 6.2. Partial correlations

32. Sophie Guellati-Salcedo - April 2001 6.6. Prediction of emotional impact of pain Depressive state (BDI 13) D5D CISS D5D 20% CSQ  12% 53% Overall Model CISS 42%  22% Proportion of variance explained

33. Sophie Guellati-Salcedo - April 2001 6.2. Partial correlations

34. Sophie Guellati-Salcedo - April 2001 6.6. Prediction of emotional impact of pain Depressive state (HAD Depression) D5D CISS D5D 22% CSQ  9% 49% Overall Model CISS 41%  19% Proportion of variance explained

35. Sophie Guellati-Salcedo - April 2001 6.6. Prediction of emotional impact of pain Anxious state (HAD Anxiety) D5D CISS D5D 35% CSQ 7% 52% Overall Model CISS 45%  11% Proportion of variance explained

36. Sophie Guellati-Salcedo - April 2001 6.2. Partial correlations

37. Sophie Guellati-Salcedo - April 2001 Outline 1. Introduction 2. Goal 3. Definitions 4. Hypotheses 5. Sample and Measures 6. Results 7. Conclusion

38. Sophie Guellati-Salcedo - April 2001 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. Sophie Guellati-Salcedo - April 2001 7. Conclusion Personality Dimensions Neuroticism is associated with poorer adjustment to pain Emotional stability, openness, and conscientiousness are associated with better adjustment to pain

40. Sophie Guellati-Salcedo - April 2001 7. Conclusion Coping Styles Emotion-oriented coping is associated with poorer adjustment to pain Task-oriented coping and avoidance are associated with better adjustment to pain

41. Sophie Guellati-Salcedo - April 2001 7. Conclusion Coping 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