Cognitive Coping Predicts Pain Intensity and Disability in Patients with Upper Extremity Musculoskeletal Pain

Abstract

Abstract Objective: The Negative Pain Thoughts Questionnaire [NPTQ], Pain Catastrophizing Scale [PCS], and Pain Self-Efficacy Questionnaire [PSEQ] are validated measures of cognitive coping with pain. The objective of this study was to assess their individual and combined interrelation with pain intensity and disability, and determine the amount of overlap variance among these coping measures. Methods: One hundred and nineteen patients presenting to a hand practice completed validated questionnaires assessing pain intensity [an 11-point ordinal scale], and disability [the Disabilities of the Arm, Shoulder and Hand Questionnaire; DASH] along with the three cognitive coping questionnaires. Results: Regression models with NPTQ controlling for covariates explained 24% of variance in pain intensity, of which NPTQ alone explained 10%, and 32% in DASH, of which NPTQ alone explained 16%. Regression models with PCS controlling for covariates explained 24% of variance in pain intensity, of which PCS alone explained 10% and 46% in DASH, of which PCS alone explained 29%. Regression models with PSEQ controlling for covariates explained 29% of variance in pain intensity, of which PSEQ alone explained 16% and 56% in DASH, of which PSEQ alone explained 39%. Models including all variables explained 31% of the variance in pain intensity and 61% of the variance in DASH. Pain self-efficacy alone accounted for five percent of the variance in pain intensity and 14% of the variance in DASH scores. The three cognitive coping measures shared a large amount of overlapping variance. Conclusion: Pain self-efficacy may be most useful for understanding variations in arm pain and disability.