Perceived competence and trait anxiety as determinants of pain coping strategies

Our previous research suggests the importance of perceived competence for coping with chronic pain indicating that perceived competence determines how intensely persons experience pain, how much they are disturbed by pain, and whether they engage in adaptive or maladaptive coping behavior. The present study was designed to test the validity of our pain regulation model expanded by trait anxiety using 201 persons suffering from various types of chronic pain. Structural equation model analyses revealed that maladaptive behavior was affected by trait anxiety only indirectly through pain emotions (pain-related anxiety and depression), whereas perceived competence had an indirect effect on maladaptive pain coping through its effect on pain emotions as well as pain intensity. Adaptive pain coping behavior, on the other hand, was directly affected only by perceived competence, that is, neither trait anxiety nor pain intensity or pain emotions contributed to adaptive behavior. Our results confirm the central importance of perceived competence in determining coping behavior and indicate that perceived competence has a more pronounced effect on pain coping processes than trait anxiety. Persons with high anxiety; however, suffer more from chronic pain that persons with low anxiety; Finally, we discuss implications of our findings for pain management programs. Copyright (C) 1997 Elsevier Science Ltd.