Persistance with non-functional problem solving in chronic pain

Research has demonstrated the relationship between persistence with problem solving focussed on pain removal and increased levels of distress in the chronic pain population. It has been suggested that one factor which motivates individuals to persist with pain removal strategies, despite repeated failed attempts, is their worries about the future. This can be conceptualised as the feared-for self. The purpose of this research was to investigate the relationship between problem solving strategies and the feared-for self in individuals with chronic pain. An additional aim of this research was to develop a new measure of problem solving requiring respondents to generate novel solutions to problem vignettes.

58 participants with chronic pain were recruited from specialist pain clinics. Participants completed the feared-for selves interview, a questionnaire measure of problem solving (PaSol), the new problem solving measure (MEPSP) and measures of pain severity (VAS), psychological distress(HADS), pain acceptance (CPAQ) and pain-related disability (PDI).

Persistence with pain removal (assimilative problem solving) was significantly correlated with proximity to the feared-for self and enmeshment with the feared-for self. Multiple regression analyses found mixed results. Proximity to the feared-for self was a significant predictor of assimilative problem solving when the MEPSP was used as the outcome variable but this was not replicated with the PaSol data. Enmeshment with the feared-for self was a significant predictor of assimilative problem solving when the PaSol was the outcome variable but this was not replicated with the MEPSP data.

This study has provided initial support for the relationship between the feared-for self and assimilative problem solving in the chronic pain population. However, further research is necessary to verify these findings. Initial results for the MEPSP suggest that further development of this measure is worthwhile. The clinical implications of these results are discussed along with suggestions for future research.