Coping strategy use: does it predict adjustment to chronic back pain after controlling for catastrophic thinking and self-efficacy for pain control?

OBJECTIVE To explore whether coping strategy use predicted levels of adjustment in chronic low back pain after controlling for the influence of catastrophic thinking and self-efficacy for pain control. METHODS Eighty-four patients with chronic low back pain completed the Coping Strategies Questionnaire, a pain VAS and the Roland Disability Questionnaire. To derive composite measures of coping, the Coping Strategies Questionnaire subscales, excluding the Catastrophizing subscale and 2 single-item scales, were entered into a principal components analysis. The extent to which scores on the coping measures predicted levels of adjustment after controlling for catastrophic thinking (Catastrophizing subscale) and self-efficacy for pain control (2 single-item scales) was explored using sequential multiple regression analysis. RESULTS Two coping dimensions emerged from the principal components analysis, which were labelled Distraction and Praying or Hoping, and Denial of Pain and Persistence. Scores obtained on these coping measures explained an additional 5% and 13% of the variance in pain intensity and disability, respectively. Interestingly, however, the scores on the coping measures did not predict pain intensity or disability after controlling for the influence of catastrophic thinking and self-efficacy for pain control. CONCLUSION Coping strategy use might only be related to levels of adjustment via the effect it has on catastrophic thinking and self-efficacy for pain control.