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postgraduate thesis: Psychological adjustment to chronic pain : the role of pain catastrophizing, negative copingand psychological inflexibility
Title | Psychological adjustment to chronic pain : the role of pain catastrophizing, negative copingand psychological inflexibility |
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Authors | |
Issue Date | 2020 |
Publisher | The University of Hong Kong (Pokfulam, Hong Kong) |
Citation | 吳雁詞, [Ng, Ngan-chi]. (2020). Psychological adjustment to chronic pain : the role of pain catastrophizing, negative copingand psychological inflexibility. (Thesis). University of Hong Kong, Pokfulam, Hong Kong SAR. |
Abstract | Introduction: Pain intensity is not the sole determinant of adjustment outcomes in regard to
chronic pain. The processes through which pain exerts its influences via psychological
variables from different theoretical approaches have been extensively studied. The main
objectives of the present study were to study the mediating role of pain catastrophizing,
negative coping and psychological inflexibility, as well as their interrelationships, in
accounting for depression, anxiety and physical impairment in chronic pain. An integrated
model based on cognitive-behavioural and contextual-behavioural theories was proposed.
Methods: A cross-sectional study, employing validated self-report questionnaires, was used
to investigate pain intensity, pain catastrophizing, negative coping, psychological inflexibility,
psychological disturbance and physical impairment in a heterogeneous sample of 340 chronic
pain patients recruited from specialty pain clinics. Multiple mediational analyses were carried
out by structural equation model. Results: The examined psychological variables
significantly and differentially mediated the impact of pain intensity in regard to both
psychological and physical dysfunction in a multiple mediation model. From the integrated
model proposed, psychological inflexibility demonstrated non-redundant influences over all
adjustment outcomes and mediators. Analysis of specific indirect effects revealed that the
serial paths from pain to psychological inflexibility to all three adjustment outcomes, were the most influential paths of influences, compared with other indirect paths in the models. In
addition, the paths involving pain catastrophizing were relatively more influential for
psychological disturbance, while the paths involving negative coping were relatively more
influential in relation to physical dysfunction. Psychological inflexibility was shown to relate
with pain catastrophizing and negative coping in a theoretically meaningful and coherent way.
Conclusions: The relationships between pain, depression, anxiety and physical impairment
were significantly mediated by psychological variables in differential manner. The mediation
effect via psychological inflexibility was more salient, relative to catastrophizing and
negative coping. Theoretical and clinical implications, as well as future research directions,
were discussed.
|
Degree | Doctor of Psychology |
Subject | Chronic pain - Psychological aspects |
Dept/Program | Psychology |
Persistent Identifier | http://hdl.handle.net/10722/281621 |
DC Field | Value | Language |
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dc.contributor.author | 吳雁詞 | - |
dc.contributor.author | Ng, Ngan-chi | - |
dc.date.accessioned | 2020-03-19T04:50:30Z | - |
dc.date.available | 2020-03-19T04:50:30Z | - |
dc.date.issued | 2020 | - |
dc.identifier.citation | 吳雁詞, [Ng, Ngan-chi]. (2020). Psychological adjustment to chronic pain : the role of pain catastrophizing, negative copingand psychological inflexibility. (Thesis). University of Hong Kong, Pokfulam, Hong Kong SAR. | - |
dc.identifier.uri | http://hdl.handle.net/10722/281621 | - |
dc.description.abstract | Introduction: Pain intensity is not the sole determinant of adjustment outcomes in regard to chronic pain. The processes through which pain exerts its influences via psychological variables from different theoretical approaches have been extensively studied. The main objectives of the present study were to study the mediating role of pain catastrophizing, negative coping and psychological inflexibility, as well as their interrelationships, in accounting for depression, anxiety and physical impairment in chronic pain. An integrated model based on cognitive-behavioural and contextual-behavioural theories was proposed. Methods: A cross-sectional study, employing validated self-report questionnaires, was used to investigate pain intensity, pain catastrophizing, negative coping, psychological inflexibility, psychological disturbance and physical impairment in a heterogeneous sample of 340 chronic pain patients recruited from specialty pain clinics. Multiple mediational analyses were carried out by structural equation model. Results: The examined psychological variables significantly and differentially mediated the impact of pain intensity in regard to both psychological and physical dysfunction in a multiple mediation model. From the integrated model proposed, psychological inflexibility demonstrated non-redundant influences over all adjustment outcomes and mediators. Analysis of specific indirect effects revealed that the serial paths from pain to psychological inflexibility to all three adjustment outcomes, were the most influential paths of influences, compared with other indirect paths in the models. In addition, the paths involving pain catastrophizing were relatively more influential for psychological disturbance, while the paths involving negative coping were relatively more influential in relation to physical dysfunction. Psychological inflexibility was shown to relate with pain catastrophizing and negative coping in a theoretically meaningful and coherent way. Conclusions: The relationships between pain, depression, anxiety and physical impairment were significantly mediated by psychological variables in differential manner. The mediation effect via psychological inflexibility was more salient, relative to catastrophizing and negative coping. Theoretical and clinical implications, as well as future research directions, were discussed. | - |
dc.language | eng | - |
dc.publisher | The University of Hong Kong (Pokfulam, Hong Kong) | - |
dc.relation.ispartof | HKU Theses Online (HKUTO) | - |
dc.rights | The author retains all proprietary rights, (such as patent rights) and the right to use in future works. | - |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
dc.subject.lcsh | Chronic pain - Psychological aspects | - |
dc.title | Psychological adjustment to chronic pain : the role of pain catastrophizing, negative copingand psychological inflexibility | - |
dc.type | PG_Thesis | - |
dc.description.thesisname | Doctor of Psychology | - |
dc.description.thesislevel | Doctoral | - |
dc.description.thesisdiscipline | Psychology | - |
dc.description.nature | published_or_final_version | - |
dc.date.hkucongregation | 2020 | - |
dc.identifier.mmsid | 991044217192503414 | - |