Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-22T07:47:51.817Z Has data issue: false hasContentIssue false
  • English
  • Français

Personality, Cognitive Appraisal and Adjustment in Chronic Pain Patients

Published online by Cambridge University Press:  10 April 2014

Ana Mª Herrero ,
Carmen Ramírez-Maestre  and
Vanessa González
Ana Mª Herrero
Affiliation:
Universidad de Málaga(Spain)
Carmen Ramírez-Maestre*
Affiliation:
Universidad de Málaga(Spain)
Vanessa González
Affiliation:
Universidad de Málaga(Spain)
*
Correspondence concerning this article should be addressed to Carmen Ramírez-Maestre, Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología, Universidad de Málaga, Campus de Teatinos, 29071 Málaga (Spain). Phone: +34 952-132430. Fax: +34 952-131101. Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

This study investigated the relationship between clinical personality patterns and cognitive appraisal as well as their repercussions on adjustment to chronic pain in a sample of 91 patients. It was predicted that clinical personality patterns would be related to adjustment and cognitive appraisal processes, whereas cognitive appraisals would be related to anxiety, depression and levels of perceived pain. The instruments used were as follows: the Millon Clinical Multiaxial Inventory, the Cognitive Appraisal Questionnaire, the Hospital Anxiety and Depression Scale, and the McGill Pain Questionnaire. Multiple regression analyses, the Kruskal-Wallis test, and the Mann Whitney U-test were used to analyse the data obtained. The results show that certain clinical personality patterns were associated with poor adjustment to chronic pain. The use of cognitive appraisal of harm predicted higher anxiety levels and greater perceived pain in chronic pain patients. The use of cognitive appraisals of challenge predicted lower depression levels.

Este estudio investigó la relación entre los patrones clínicos de personalidad y la evaluatión cognitiva y sus repercusiones sobre la adaptación al dolor crónico en una muestra de 91 pacientes. Se predijo que los patrones de personalidad se relacionarían con los procesos de ajuste y de evaluación cognitiva, mientras que las evaluaciones cognitivas se relacionarían con la ansiedad, la depresión y los niveles de dolor percibido. Se emplearon los siguientes instrumentos: el Inventario Clínico Multiaxial de Millon, el Cuestionario de Evaluación Cognitiva, las Escalas de Ansiedad y Depresión Hospitalarias y el Cuestionario de Dolor de McGill. Se emplearon el análisis de regresión múltiple y los tests de Kruskal-Wallis y de Mann Whitney para analizar los datos obtenidos. Los resultados muestran que ciertos patrones clínicos de personalidad se asociaban con baja adaptación al dolor crónico. El uso de la evaluación cognitiva del daño predijo niveles más altos de ansiedad y mayor dolor percibido en los pacientes de dolor crónico. El uso de la evaluación cognitiva de retos predijo niveles más bajo de depresión.

Keywords

chronic painMillon Inventorycognitive appraisalanxietydepressiondolor crónicoInventario Millonevaluación cognitivaansiedaddepresión
Type
Articles
Information
The Spanish Journal of Psychology , Volume 11 , Issue 2 , November 2008 , pp. 531 - 541
Copyright
Copyright © Cambridge University Press 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Anarte, M.T., Ramírez-Maestre, C., López, A.E., & Esteve, R. (1999, October). Evaluación de estrategias de afrontamiento, nivel de funcionamiento y edad en personas con dolor crónico oncológico y benigno. IV Congreso de la Sociedad Española del Dolor. Benalmádena (Spain).Google Scholar
Asghari, M. A. (1997). The relative contribution of personality and pain related beliefs: Coping strategies in adjustment to chronic pain. Dissertion Abstract International Section B: The Sciences and Engineering, 58, 1586.Google Scholar
Avila, A., Jiménez, F., et al. (1998). MCMI-II. Inventario Clínico Multiaxial del Millon-II. Madrid: TEA.Google Scholar
Barrowclough, C., & Parle, M. (1997). Appraisal, psychological adjusment and expressed emotion in relatives of patients suffering from schizophrenia. British Journal of Psychiatry, 171, 26–30.CrossRefGoogle Scholar
Bockian, N., Meager, S., & Millon, T. (2000). Assessing personality with the Millon Behavioral Health Inventory, the Millon Behavioral Medicine Diagnostic, and the Millon Clinical Multiaxial Inventory. In Gatchel, R. J. & Weisberg, J. N., (Eds.), Personality characteristic of patients with pain (pp. 61–88). Washington, DC: American Psychological Association.CrossRefGoogle Scholar
BenDebba, M., Torgerson, W. S., & Long, D. M. (1997). Personality traits, pain duration and severity, functioanl impairment and psychological distress in patient with persistent low back pain. Pain, 72, 115–125.CrossRefGoogle Scholar
Carver, C. S., & Scheier, M. F. (1994). Situational coping and coping dispositions in a stressful transaction. Journal of Personality and Social Psychology, 66, 184–195.CrossRefGoogle Scholar
Compas, B. E., Worsham, N.L., Sydney, E. & Howell, D.C. (1996). When mom or dad has cancer: II. Coping, cognitive appraisals and psychological distress in childrens of cancer patients. Health Psychology, 15, 161–175.CrossRefGoogle ScholarPubMed
Costa, P. T. Jr., & McCrae, R. R. (1990). Personality: Another “hidden factor” in stress research. Psychological Inquiry, 1, 22–24.CrossRefGoogle Scholar
Cruzado, J. A., Labrador, F. J., De la Puente, M. L. & Vallejo, M. A. (1990). In Fuentenebro, F. & Vázquez, C. (Eds.), Psicología médica, psicopatología y psiquiatría. Madrid: McGraw-Hill.Google Scholar
Chang, E. D. (1998). Dispositional optimism and primary and secondary appraisal of stress: Controlling for confounding influences and relations to coping and psychological and physical adjusment. Journal of Personality and Social Psychology, 74, 1109–1120.CrossRefGoogle Scholar
Choca, J., Shanley, A., & Van Denburg, E. (1992). Interpretative Guide to the Millon Clinical Multiaxial Inventory. Washington, DC: American Psychological Association.CrossRefGoogle Scholar
Dersh, J. J. (2000). A comprehensive evaluation of psychopatology in chronic musculoskeletal pain disability patients. Dissertion Abstract International Section B: The Sciences and Engineering, 61(6B), 3273.Google Scholar
Dersh, J., Polantin, P. B., & Gatchel, R. J. (2002). Chronic pain and psychopathology: Research findings and theoretical considerations. Psycosomatic Medicine, 64, 733–786.Google ScholarPubMed
Doleys, D. M., Crocket, M. F., & Patton, D. (1982). Response of patients with chronic pain to exercise quotas. Physician Therapy, 63, 1111–1114.CrossRefGoogle Scholar
Elliot, T. R., Jackson, W. T., Layfield, M., & Kendall, D. (1996). Personality disorder and response to outpatient treatment of chronic pain. Journal of Clinical Psychology and Medical Setting, 3, 219–234.CrossRefGoogle Scholar
Endler, N. S., & Parker, J. D. A. (1990). Multidimensional assessment of coping: A critical evaluation. Journal of Personality and Social Psychology, 58, 844–854.CrossRefGoogle ScholarPubMed
Ericsson, M., Paston, W. S. C. II, Linder, J., Taylor, J., Haddock, C. K., & Foreyt, J. P. (2002). Depression predicts disability in long-term chronic pain patients. Disability and Rehabilitation: An International Multidisciplinary Journal, 24, 334–340.CrossRefGoogle ScholarPubMed
Folkman, S., Lazarus, R. S., Dunkel-Schetter, C., DeLongis, A., & Gruen, R. J. (1986). Dynamics of a stressful encounter: Cognitive appraisal, coping, and encounter outcomes. Journal of Personality and Social Psychology, 50, 992–1003.CrossRefGoogle ScholarPubMed
Folkman, S., & Lazarus, R. S. (1980). An analysis of coping in a middle-aged community sample. Journal of Health and Social Behavior, 21, 219–239.CrossRefGoogle Scholar
Garofalo, J. P. (2000). Perceived optimism and chronic pain. In Gatchel, R. J. & Weisberg, J. N. (Eds.), Personality characteristics of patients with chronic pain (pp. 61–88). Washington, DC: American Psychological Association.Google Scholar
Gatchel, R. J. (2000). How practitioners should evaluate personality to help manage patients with chronic pain. In Gatchel, R. J.. & Weisberg, J. N., (Eds.), Personality characteristics of patients with chronic pain (pp. 241–257). Washington DC: American Psychological Association.CrossRefGoogle Scholar
Gittes, M. G. (1996). Vulnerability to depression: Personality styles and coping strategies in response to rejection and failure. Dissertation Abstract International Section B: The Sciences and Engineering, 56 (2B), 7078.Google Scholar
Hewitt, P. L., & Flett, G. L. (1996). Personality traits and the coping process. In Zeidner, M. & Endler, N. S. (Eds.), Handbook of coping (pp. 410–433). New York: Wiley.Google Scholar
Holmes, D. S., & Houston, B. K. (1974). Effectiveness of situational redefinition and affective isolation in coping with stress. Journal of Personality and Social psychology, 29, 212–218.CrossRefGoogle ScholarPubMed
IASP. (1986). Recent developments in the classifaction of pain. Psychosomatic, 26, 637–645.Google Scholar
Jay, G. W., Grove, R. N., & Grove, K. S. (1987). Differentation of chronic headache from nonheadache pain patients using the Millon Clinical Multiaxial Inventory (MCMI). Headache, 27, 124–129.CrossRefGoogle Scholar
Kimble, L. P. (1998). Cognitive appraisal and cardiac risk reduction behavior following coronary angioplasty. Western Journal of Nursing Research, 20, 733–744.CrossRefGoogle ScholarPubMed
Kobasa, S. C. (1979). Stressful life events, personality, and health inquiry into hardiness. Journal of Personality and Social Psychology, 37, 1–11.CrossRefGoogle ScholarPubMed
Lázaro, C., Bosch, F., Torrubia, R., & Baños, J. E. (1994). The development of a Spanish questionnaire for assessing pain: Preliminary data concerning reliability and validity. European Journal of Psychological Assessment, 10, 145–151.Google Scholar
Lazarus, R. S., & Folkman, S. (1984a). Coping and adaptation. In Gentry, W. D. (Ed.),. The handbook of behavioral medicine (pp. 282–325). New York: Guilford Press.Google Scholar
Lazarus, R. S., & Folkman, S. (1984b). Stress, appraisal and coping. New York: Springer. [Spanish translation: Estrés y procesos cognitivos. Barcelona: Martín Roca, 1986.]Google Scholar
Linder, J., Poston, W. S. C. II., Haddock, C. K., Foreyt, J. P., & Ericsson, M. (2000). Does personality or psychopathology predict disability in chronic pain patients? Disability and Rehabilitation: An International Multidisciplinary Journal, 22, 281–187.CrossRefGoogle ScholarPubMed
Melzack, R. (1975). The McGill Pain Questionnaire: Major properties and scoring methods. Pain, 1, 277–299.CrossRefGoogle ScholarPubMed
McCrae, R. S. (1984). Situational determinants of coping responses: Loss, threat and challenge. Journal of Personality and Social Psychology, 46, 919–928.CrossRefGoogle ScholarPubMed
McCrae, R. R., & Costa, P. T. (1986). Personality, coping, and coping effectiveness in an adult sample. Journal of Personality, 54, 385–405.CrossRefGoogle Scholar
Miller, K. S. (1998). Coping, cognitive appraisals, optimism, gender and age as correlates of depression and anxiety in myocardial infarction patients. Dissertation Abstracts International Section B: The Sciences and Engineering, 58(9B), 5132.Google Scholar
Millon, T. (1981). Disorders of personality: DSM-III. Axis II. New York: Wiley.Google Scholar
Millon, T. (1994). Millon Index of Personality Styles. San Antonio, TX: The Psychological Corporation. [Translation: MIPS: Inventario Millon de Estilos de Personalidad. Buenos Aires: Paidós, 1997.]Google Scholar
Millon, T. (1997). The Millon inventories: Clinical and personality assessment. New York: Guilford Press.Google Scholar
Monti, D. A., Herring, C. L., Schwartzman, R. J., & Marchese, M. (1998). Personality assessment of patients with complex regional pain syndrome Type I. Clinical Journal of Pain, 14, 295–302.CrossRefGoogle ScholarPubMed
Morasso, P., Costantini, M., Baracco, G., Borreani, C., & Capelli, M. (1996). Assessing psychological distress in cancer patients: Validation of a self-administered questionnaire. Oncology, 53, 295–302.CrossRefGoogle ScholarPubMed
Mukulincer, M., & Florian, V. (1995). Appraisal of and coping with a real-life stressful situations: The contribution of attachment styles. Personality and Social Psychology Bulletin. 21, 406–414.CrossRefGoogle Scholar
Oliver, J., & Brough, P. (2002). Cognitive appraisal, negative affectivity and psychological well-being. New Zeland Journal of Psychology, 31, 2–7.Google Scholar
Pattnoff, J. G. (1995). Pesonality, life stressors and depressive symptoms: An exploratory model. Dissertation Abstracts International Section B: The Sciences and Engineering. 58, 1586.Google Scholar
Ptacek, J. T., Smith, R. E., & Dodge, K. L. (1994). Gender differences in coping with stress: When stressor and appraisals do not differ. Personality and Social Psychology Bulletin, 20, 421–430.CrossRefGoogle Scholar
Quintana, J. M., Padierna, A., Esteban, C., Arostegui, I., Bilbao, A., & Ruiz, I. (2003). Evaluation of the psychometric characteristics of the Spanish version of the Hospital Anxiety and Depression Scale. Acta Psychyatrica Scandinava, 107, 216–221.CrossRefGoogle ScholarPubMed
Ramírez-Maestre, C., Valdivia, Y., Anarte, M. T., & Masedo, A. I. (2000, February). Diferencias individuales en las evaluaciones cognitivas de pacientes con dolor crónico. V Jornadas Nacionales de la SEIDI, Barcelona.Google Scholar
Ramírez-Maestre, C., López, A. E., & Esteve, M. R. (2004). Personality characteristics as differential variables of the pain experience. Journal Behavioral Medicine, 27, 147–165.CrossRefGoogle ScholarPubMed
Ramírez-Maestre, C., Esteve, R., & López, A. E. (2005, September). Development of an inventory to assess cognitive appraisal in patients with chronic pain. Budapest: 8th European Conference on Psychological Assessment. Rodríguez C., Cebriá, J., Corbella, S., Segura, J., & Sobreques, J. (2003). Rasgos de personalidad y malestar psíquico asociados a los pacientes hiperfrecuentadores de consultas de Atención Primaria. Medifam, 13, 143–150.Google Scholar
Rodríguez, C., Cebriá, J., Corbella, S., Segura, J., & Sobreques, J. (2003). Rasgos de personalidad y malestar psíquico asociados a los pacientes hiperfrecuentadores de consultas de Atención Primaria. Medifam, 13, 143–150.Google Scholar
Sánchez Cánovas, J., & Sánchez López, M. P. (1994). Psicología diferencial: diversidad e individualidad humanas. Madrid: Ramón Areces.Google Scholar
Scheier, M. F., & Carver, C. S. (1985). Optimism, coping and health: Assessment and implications on generalized outcome expectancies. Health Psychology, 4, 219–247.CrossRefGoogle ScholarPubMed
Scheier, M. F., & Carver, C. S. (1992). Effects of optimism on psychological and physical well-being: Theoretical overview and empirical update. Cognitive Therapy and Research, 16, 201–228.CrossRefGoogle Scholar
Skinner, N., & Brewer, N. (2002). The dymanics of threat and challenge appraisal prior to stressful achivement events. Journal of Personality and Social Psychology, 83, 678–692.CrossRefGoogle Scholar
Smith, C. A., & Ellsworth, P. C. (1984). Patterns of cognitive appraisal in emotion. Journal of Personality and Social Psychology, 52, 813–838.Google Scholar
Soriano, J., & Monsalve, V. (1999). Valoración, afrontamiento y emoción en pacientes con dolor crónico. Boletín de Psicologia, 62, 43–64.Google Scholar
Stone, A. A., & Neale, J. M. (1984). New measure of daily coping: Development and preliminary results. Journal of Personality and Social Psychology, 46, 892–906.CrossRefGoogle Scholar
Tejero, A., Guimerá, E. M., & Farré, J. M. (1996). Uso clínico del HADS (Hospital Anxiety and Depression Scale) en población psiquiátrica: un estudio de su sensibilidad, fiabilidad y validez. Revista del Departamento de Psiquiatría de la Facultad de Medicina de Barcelona, 13, 133–238.Google Scholar
Turk, D. C., Okifuji, A., & Scharff, L. (1995). Chronic pain and depression: Role of perceived impact and perceived control in different age cohorts. Pain, 61, 93–101.CrossRefGoogle ScholarPubMed
Turk, D., & Rudy, T. (1986). Assessment of cognitive factors in chronic pain: A worth-while enterprise. Journal of Consulting, and Clinical Psychology, 54, 760–768.CrossRefGoogle Scholar
Weisberg, J. N. (2000). Studies investigating the prevalence of personality disorders in patients with chronic pain. In Gatchel, R. J. & Weisberg, J. N., (Eds.), Personality characteristics of patients with chronic pain (pp. 221–239). Washington, DC: American Psychological Association.CrossRefGoogle Scholar
Wade, J. B., Dougherty, L. M., Hart, R. P., & Cook, D. B. (1992). Patterns of normal personality structure among chronic pain patients. Pain, 48, 37–43.CrossRefGoogle ScholarPubMed
Zigmond, A. S., & Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandavica, 67, 361–370.CrossRefGoogle ScholarPubMed