Psychosocial Subgroups in Persons With Spinal Cord Injuries and Chronic Pain
Abstract
Widerström-Noga EG, Felix ER, Cruz-Almeida Y, Turk DC. Psychosocial subgroups in persons with spinal cord injuries and chronic pain.
Objectives
To define adaptational subgroups in people with chronic pain and spinal cord injury (SCI), and to compare these subgroups with respect to demographic factors, level of injury, functional independence, pain disability, depressed mood, social support, and life satisfaction.
Design
Interviews.
Setting
Veterans Affairs medical center and The Miami Project to Cure Paralysis.
Participants
Persons with SCI and chronic pain (N=190).
Interventions
Not applicable.
Main Outcome Measure
The Multidimensional Pain Inventory, SCI version.
Results
Cluster analysis revealed 3 subgroups: (1) dysfunctional (34.6% of all participants), characterized by higher pain severity, life interference, and affective distress scores, and lower levels of life control and activities scores; (2) interpersonally supported (33.0% of participants), characterized by moderately high pain severity, and higher life control, support from significant others, distracting responses, solicitous responses, and activities scores; and (3) adaptive copers (32.4% of participants), characterized by lower pain severity, life interference, affective distress, support from significant others, distracting responses, solicitous responses, activities and higher life control scores. Compared with the dysfunctional subgroup, the interpersonally supported subgroup reported significantly greater social support and life satisfaction and less pain disability and emotional distress, despite moderately high pain severity.
Conclusion
Three subgroups, independent of sex, pain duration, and functional status, were identified. Although severe pain significantly decreases life satisfaction after SCI, its impact is moderated by perceived social support.
bMiami Project to Cure Paralysis, University of Miami, Miller School of Medicine, Miami, FL
cDepartment of Neurological Surgery, University of Miami, Miller School of Medicine, Miami, FL
dDepartment of Anesthesiology, University of Washington School of Medicine, Seattle, WA.
Reprint requests to Eva G. Widerström-Noga, DDS, PhD, University of Miami, Miller School of Medicine, Miami Project to Cure Paralysis, Lois Pope Life Center, PO Box 016906 (R-48), Miami, FL 33101
Supported by the Department of Veterans Affairs Rehabilitation Research and Development (grant nos. B3070R, B26566C) and The Miami Project to Cure Paralysis.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.
ABSTRACT