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Scandinavian Journal of Pain

Official Journal of the Scandinavian Association for the Study of Pain

Editor-in-Chief: Breivik, Harald


CiteScore 2018: 0.85

SCImago Journal Rank (SJR) 2018: 0.494
Source Normalized Impact per Paper (SNIP) 2018: 0.427

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1877-8879
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Volume 11, Issue 1

Issues

Social Anxiety, Pain Catastrophizing and Return-To-Work Self-Efficacy in chronic pain: a cross-sectional study

Johanna Thomtén / Katja Boersma
  • Center for Health and Medical Psychology, JPS: Psychology, Örebro University, Örebro Sweden
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Ida Flink
  • Center for Health and Medical Psychology, JPS: Psychology, Örebro University, Örebro Sweden
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Maria Tillfors
  • Center for Health and Medical Psychology, JPS: Psychology, Örebro University, Örebro Sweden
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2016-04-01 | DOI: https://doi.org/10.1016/j.sjpain.2015.10.005

Abstract

Background and aims

Returning to work after periods of sick-leave due to chronic pain problems, involve a number of situations of interpersonal nature (e.g. meeting supervisors/insurance companies to adapt work setting to present functional level, receive help from colleagues, express pain, etc.). Since chronic pain has shown co-morbidity with social anxiety, it is of interest to investigate restraining factors in return to work among chronic pain sufferers from a social perspective. Catastrophizing is identified in both pain and social anxiety as a mechanism that might fuel a continuous bias in how situations are perceived (threat) and by hindering the development of functional behavior strategies. The presence of social anxiety in chronic pain patients might be seen as a stressor that limits the individuals’ ability to effectively communicate pain-related needs to colleagues, and/or employers and therefore act as a hindering factor in return-to-work. Hence, the overall aim of this study was to examine the relationship between social anxiety, pain catastrophizing, and perceived ability to communicate pain-related needs to the work environment in a clinical pain population.

Methods

The study employed a cross-sectional design and involved 247 individuals with chronic pain (82.3% women; Mage = 44 years). Measures included the Pain catastrophizing Scale, the Social Phobia Screening Questionnaire and the communication of pain-related needs-subscale of the Return-To-Work Self-efficacy Questionnaire. Analyzes were run to examine whether social anxiety moderated the relation between pain catastrophizing, and perceived ability to communicate pain-related needs while controlling for pain severity/interference and sick leave.

Results

Social anxiety and pain catastrophizing correlated positively with each other and negatively with perceived ability to communicate pain-related needs. No support was obtained for a moderating effect of social anxiety. However, social anxiety and pain interference were each significant predictors of the individual’s confidence in being able to communicate pain-related needs to the work environment.

Conclusions

In the context of pain and work-related communication, symptoms of social anxiety was identified as being of similar importance to the outcome as pain interference, while pain severity was not associated with the individual’s confidence in communicating one’s pain-related needs.

Implications

The results implicate that fears relating to pain-related social situations at work might be central in the process of return-to-work and rehabilitation in chronic pain.

Keywords: Clinical pain population; Social anxiety; Pain catastrophizing; Return to work; Communicating pain-related needs; Co-morbidity

References

  • [1]

    Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D. Survey of chronic pain in Europe: Prevalence, impact on daily life, and treatment. EurJ Pain 2006;10:287-333.PubMedCrossrefGoogle Scholar

  • [2]

    Reid KJ, Harker J, Bala MM, Truyers C, Kellen E, Bekkering G, Kleijnen J. Epidemiology of chronic non-cancer pain in Europe: Narrative review of prevalence, pain treatments and pain impact. Curr Med Res Opin 2011;272:449-62.Web of ScienceGoogle Scholar

  • [3]

    McCarberg B, Billington R. Consequences of Neuropathic Pain: Quality-of-life Issues and Associated Costs. Am J Manag Care 2006;12:263-8.Google Scholar

  • [4]

    SBU, Statens beredning for medicinsk utvardering. Sjukskrivning - orsaker, konsekvsenser och praxis: En systematisk litteraturoversikt (SBU-rapport, nr 167). Stockholm: Statens beredning for medicinsk utvardering; 2003.Google Scholar

  • [5]

    Demyttenaere K, Bruffaerts R, Lee S, Posada-Villa J, Kovess V, Angermeyer MC, Von Korff M. Mental disorders among persons with chronic back or neck pain: results from the World Mental Health Surveys. Pain 2007;129:332.PubMedCrossrefWeb of ScienceGoogle Scholar

  • [6]

    Schultz IZ, Crook J, Fraser K, Joy PW. Models of diagnosis and rehabilitation in musculoskeletal pain-related occupational disability. J Occup Rehabil 2000;10:271-93.CrossrefGoogle Scholar

  • [7]

    Turk DC, Monarch ES. Biopsychosocial perspective on chronic pain. In: Turk DC, Gatchel RJ, editors. Psychological approaches to pain management: A practitioner’s handbook. 2nd ed. New York: Guilford; 2002.Google Scholar

  • [8]

    Gatchel RJ. Psychological disorders and chronic pain: Cause and effect relationships. In: Gatchel RJ, Turk DC, editors. Psychological approaches to pain management: A practitioner’s handbook. New York: Guilford; 1996. p. 33-52.Google Scholar

  • [9]

    Jones M, Edwards I, Gifford L. Conceptual models for implementing biopsychosocial theory in Clinical practice. Manual Ther 2002;71:2-9.Google Scholar

  • [10]

    DershJ, Gatchel RJ, Kishino N. The role of tertiary gain in pain disability. Practical Pain Management 2005;Sept/Oct:13-28.Google Scholar

  • [11]

    Sullivan MJL, Feuerstein M, Gatchel RJ, Linton SJ, Pransky G. Integrating psychosocial and behavioral interventions to achieve optimal rehabilitation outcomes. J Occup Rehabil 2005;15:475-89.PubMedCrossrefGoogle Scholar

  • [12]

    Vlaeyen JWS, Linton SJ. Fear-avoidance and its consequences in chronic musculoskeletal pain: A state of the art. Pain 2000;85:317-32.CrossrefPubMedGoogle Scholar

  • [13]

    Vlaeyen JWS, Linton SJ. Fear-avoidance model of chronic musculoskeletal pain: 12 years on. Pain 2012;153:1144-7.CrossrefWeb of SciencePubMedGoogle Scholar

  • [14]

    Keefe FJ, Rumble ME, Scipio CD, Giordano LA, Perri LM. Psychological Aspects of Persistent Pain: Current State of the science. J Pain 2004;54:195-211.Google Scholar

  • [15]

    Severeijns JM, Vlayen JWS, van den Hout MA, Weber WE. Pain catastrophizing predicts pain intensity, disability, and psychological distress independent of the level of physical impairment. Clin J Pain 2001;17:165-72.CrossrefPubMedGoogle Scholar

  • [16]

    Flink IK, Boersma K, Linton SJ. Catastrophizing moderates the effect of exposure in vivo for back pain patients with pain-related fear. EurJ Pain 2010;14:887-92.PubMedCrossrefWeb of ScienceGoogle Scholar

  • [17]

    Harvey AG, Watkins E, Mansell W, Shafran R. Cognitive behavioral processes across psychological disorders: A transdiagnostic approach to research and treatment. Oxford: Oxford University Press; 2004.Google Scholar

  • [18]

    Castro M, Kraychete D, Daltro C, Lopes J, Menezes R, Oliveira I. Comorbid anxiety and depression disorders in patients with chronic pain. Arquivos de Neuro-Psiquiatria 2009;676:982-5.Web of ScienceGoogle Scholar

  • [19]

    Clark DM, Wells A. A cognitive model of social phobia. In: Heimberg R, Liebowitz M, Hope DA, Schneier FR, editors. Social phobia: Diagnosis, assessment, and treatment. New York: Guilford Press; 1995. p. 69-93.Google Scholar

  • [20]

    Schultz IZ, Stowell AW, Feuerstein M, Gatchel RJ. Models of return to work for musculo-skeletal disorders. J Occup Rehab 2007;17:327-52.CrossrefGoogle Scholar

  • [21]

    Denison E, Asenlof P, Lindberg P. Self-efficacy, fear avoidance, and pain intensity as predictors of disability in subacute and chronic musculoskeletal pain patients in primary health care. Pain 2004;111:245-52.PubMedCrossrefGoogle Scholar

  • [22]

    Shaw WS, Reme SE, Linton SJ, Huang YH, Pransky G. 3 (rd) place, premus best paper competition: Development of the return-to-work self-efficacy (RTWSE-19) questionnaire—psychometric properties and predictive validity. Scand J Work Environ Health 2011;37:109-19.Web of ScienceCrossrefGoogle Scholar

  • [23]

    SCB, Statistiska Centralbyran. nBefolkningens Utbildning 2014 (Swedish) UF37 befolkningens utbildning, (UF37SM1501). ISSN: 1654-3483 2015.

  • [24]

    Nyberg V, Sanne H, Sjolund BH. Swedish quality registry for pain rehabilitation: purpose, design, implementation and characteristics of referred patients. J Rehab Med 2011;43:50-7.CrossrefGoogle Scholar

  • [25]

    Furmark TT, Tillfors MM, Everz PO, Marteinsdottir II, Gefvert OO, Fredrikson MM. Social phobia in the general population: Prevalence and sociodemographic profile. Soc Psychiatry Psychiatric Epidem 1999;348:416-24.Google Scholar

  • [26]

    Heimberg RG, Mueller GP, Holt CS, Hope DA, Liebowitz MR. Assessment of anxiety in social interaction and being observed by others: The Social Interaction Anxiety Scale and the Social Phobia Scale. Beh Therap 1992;23:53-73.CrossrefGoogle Scholar

  • [27]

    Andersson G, Carlbring P, Holmstrom A, Sparthan E, Furmark T, Nilsson-Ihrfelt E, Ekselius L. Internet-based self-help with therapist feedback and in vivo group exposure for social phobia: a randomized controlled trial. J Consult Clin Psych 2006;74:677-86, http://dx.doi.org/10.1037/0022-006X.74A677.Crossref

  • [28]

    Sullivan MJL, Bishop SR, Pivik J. The pain catastrophizing scale: Development and validation. Psych Assess 1995;74:524-32.Google Scholar

  • [29]

    Sullivan MJL. The pain catastrophizing scale, User Manual. Montreal, Quebec: Departments of Psychology, Medicine, and Neurology, School of Physical and Occupational Therapy, McGill University; 2009.Google Scholar

  • [30]

    Osman A, Barrios FX, Kopper BA, Hauptmann W, Jones J, ONiell E. Factor structure, reliability and validity of the Pain Catastrophizing Scale. J Behav Med 1997;20:589-605.CrossrefPubMedGoogle Scholar

  • [31]

    Sullivan MJ, Stanish W, Waite H, Sullivan M, Tripp DA. Catastrophzing, pain and disability in patients with soft-tissue injuries. Pain 1998;77:253-60.CrossrefGoogle Scholar

  • [32]

    Linton SJ, Boersma K, Traczyk M, Shaw W, Nicholas M. Early workplace communication and problem solving to prevent back disability: results of a randomized controlled trial among high-risk workers and their supervisors. J Occ Rehab 2015.Google Scholar

  • [33]

    Kerns RD, Turk DC, Rudy TE. The West Haven-Yale Multidimensional Pain Inventory (WHYMPI). Pain 1985;23:345-56.PubMedCrossrefGoogle Scholar

  • [34]

    Bergstrom G, Jensen IB, Bodin L, Linton SJ, Nygren AL, Carlsson SG. Reliability and factor structure of the Multidimensional Pain Inventory—Swedish Language Version (MPI-S). Pain 1998;75:101-10.CrossrefPubMedGoogle Scholar

  • [35]

    Lousberg R, Van Breukelen GJ, Groenman NH, Schmidt AJ, Arntz A, Winter FA. Psychometric properties of the Multidimensional Pain Inventory Dutch language version (MPI-DLV). Behav Res Ther 1999;372:167-82, http://dx.doi.org/10.1016/S0005-7967(98)00137-5.

  • [36]

    Field A. Discovering statistics using SPSS. London: Sage Publications; 2013.Google Scholar

  • [37]

    Asmundson GJG, Katz J. Understanding the co-occurrence of anxiety disorders and chronic pain: state of the art. Depression and Anxiety 2009;26:888-901.CrossrefPubMedWeb of ScienceGoogle Scholar

  • [38]

    Thorn BE, Ward LC, Sullivan MJ, Boothby JL. Communal coping model of catastrophizing: conceptual model building. Pain 2003;106:1-2.CrossrefPubMedGoogle Scholar

  • [39]

    Carstens-Soderstrand JKP, Shaw WS, Boersma K, Reme SE, Pransky G, Linton SJ. When the wind goes out of the sail—declining recovery expectations in the first weeks of back pain. EurJ Pain 2013;18:269-78.Google Scholar

  • [40]

    Flink IK, Boersma K, MacDonald S, Linton SJ. Understanding catastrophizing from a misdirected problem-solving perspective. British J Health Psych 2012;172:408-19.Web of ScienceGoogle Scholar

  • [41]

    Rapee RM, Heimberg RG. A cognitive-behavioral model of anxiety in social phobia. Behav Res Ther 1997;35:741-56.CrossrefPubMedGoogle Scholar

  • [42]

    Sullivan MJL, Thorn B, Haythornthwaite JA, Keefe F, Martin M, Bradley LA, Lefebvre JC. Theoretical perspectives on the relation between catastrophizing and pain. Clin J Pain 2001;17:52-64.CrossrefPubMedGoogle Scholar

About the article

Department of Psychology, Mid Sweden University, Kunskapens vag 1,831 25 Östersund, Sweden


Received: 2015-08-12

Revised: 2015-10-12

Accepted: 2015-10-13

Published Online: 2016-04-01

Published in Print: 2016-04-01


Conflict of interest: The authors declare that they have no conflict of interest.


Citation Information: Scandinavian Journal of Pain, Volume 11, Issue 1, Pages 98–103, ISSN (Online) 1877-8879, ISSN (Print) 1877-8860, DOI: https://doi.org/10.1016/j.sjpain.2015.10.005.

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