Circumstances of pain onset, blame and adjustment in chronic pain

Abstract

Research has found that chronic pain patients who perceive their pain to have originally resulted from a specific event are more poorly adjusted than patients who perceive their pain to have arisen for no apparent reason. The first paper of this thesis explores these relationships and notes the lack of investigation into the possible reasons for such findings. It shows that research deriving mainly from the non-chronic pain literature indicates that blame for negative events may play a role in explaining the relationship between circumstances of pain onset and adjustment. Blaming others is more consistently related to poor adjustment. Therefore, the likelihood of other-blame in patients whose pain arises from a specific event, and the association between other-blame and poor adjustment in chronic pain patients is explored in more detail. Implications for research and clinical practice are considered.

The second paper of the thesis describes a study which aimed to explore the role of other-blame as a mediator between circumstances of pain onset and adjustment. It also aimed to explore the relationship between different types of blame and adjustment given the lack of previous research into such relationships in a chronic pain population. The mediating role of other-blame was not supported. However, other-blame for initial pain onset was much more common in the event-related pain onset group and was associated with post-traumatic stress symptoms. In addition, self-blame was associated with anxiety and the use of maladaptive coping strategies.

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