THE FAMILY ENVIRONMENT IN CHRONIC PAIN PATIENTS - COMPARISON TO CONTROLS AND RELATIONSHIP TO PATIENT FUNCTIONING

Operant and cognitive-behavioral models of chronic pain have called at tention to the importance of examining the marital and family environm ents of chronic pain patients. In this study, 50 chronic pain patients and their spouses and 33 control participants and their spouses compl eted measures of the family environment, marital satisfaction, and pat ient physical and psychological functioning. Patients' overt pain beha viors were coded from videotapes of patient-spouse interactions. Compa red to controls, pain patients and their spouses rated their family en vironments as lower in cohesion and higher in control, and there was a trend for spouses to report more marital dissatisfaction. Chronic pai n patient depression was associated negatively with patient-rated fami ly cohesion and expressiveness and spouse-rated family organization an d positively with patient-rated family conflict. Overt patient pain be haviors and spouse-rated patient disability were related negatively to spouse-rated family cohesion. Spouse marital satisfaction was associa ted negatively with patient depression and with spouse ratings of pati ent disability and pain behaviors.