Pain beliefs, coping, and adjustment to chronic pain

Pain beliefs and coping are believed to be important determinants of adjustment to chronic pain. The majority of the studies in this area have focused on the potential benefits of adaptive pain coping strategies and beliefs to improve adjustment to pain. In this Focus article, we propose a model whereby maladaptive pain beliefs and coping strategies are considered primary determinants of chronic pain adjustment, and influence the likelihood of engaging in more adaptive coping through influencing mediating factors such as perceived self-efficacy to manage pain. We (1) review data to support this model; (2) discuss evidence for the influence of maladaptive and adaptive coping and beliefs on chronic pain adjustment within the context of methodological limitations of studies in this area; (3) discuss the difficulties in assessing adaptive pain coping and beliefs; and (4) examine the implications of our proposed model for cognitive/behavioral interventions for chronic pain. We conclude that future studies on chronic pain adjustment should place more emphasis on the examination of maladaptive pain beliefs and coping strategies, examine causal relationships between adaptive and maladaptive strategies, and employ more multivariate analyses when examining the relationship between pain beliefs, coping, and adaptation to chronic pain.