THE COPING STRATEGIES QUESTIONNAIRE AND CHRONIC PAIN ADJUSTMENT - A CONCEPTUAL AND EMPIRICAL REANALYSIS

Objective: Some studies have found significant relations between both the factor scores and subscales of the Coping Strategies Questionnaire (CSQ) and various measures of adjustment to chronic pain. In their re view of the literature on coping with chronic pain, Jensen et al. (Pai n 1991;47:249-83) suggest that conceptual overlap between the subscale s may inflate these observed correlations. In the present study, we ex amine the factor structure of the CSQ subscales which reflect coping, excluding the CSQ subscales which measure appraisal or activity. We th en examine the relationship between the CSQ factors and subscales and pain adjustment, while controlling for selected variables. Design and Subjects: One hundred fifty-two chronic pain patients were administere d the CSQ. Seventy-three were also administered the Multidimensional P ain Inventory (MPI). Adjustment to chronic pain was defined based on p atients' cluster membership on the MPI and responses to the Interferen ce, Pain Severity, and Negative Affect subscales. Setting: Tertiary ca re center. Results: Multiple regression analyses revealed that the Pai n Avoidance factor was positively related to pain severity, interferen ce, and MPI cluster membership. In addition, the catastrophizing subsc ale was positively related to negative affect and MPI cluster membersh ip even when controlling for level of depression, ability to decrease pain was related to lower levels of pain severity, and ability to cont rol pain was related to MPI cluster membership. Neither the Conscious Cognitive Coping factor nor the Increasing Activities subscale was rel ated to the adjustment measures. Follow-up analyses revealed that the Praying/Hoping subscale appeared to account for the relationship betwe en pain avoidance and adjustment. Conclusion: The results suggest that praying/hoping and catastrophizing are related to poorer adjustment t o chronic pain, that ability to control and decrease pain are related to better adjustment, and that catastrophizing appears to be a separat e construct from depression. The results also suggest that the individ ual CSQ subscales may have greater utility in terms of examining copin g, appraisals, and pain adjustment compared to the composite scores.