Running head: SELF-CONSCIOUS EMOTIONS IN CHRONIC PAIN

Objective The role of self-conscious emotions (SCEs) including shame, guilt, humiliation, embarrassment and pride are of increasing interest within health. Yet little is known about SCEs in the experience of chronic pain. This study explored the prevalence and experience of SCEs in chronic pain patients compared to controls and assessed the relationship between SCEs and disability in pain patients. Design and measures Questionnaire assessment comparing musculoskeletal pain patients (n=64) and pain free control participants (n=63). Pain was assessed using the McGill Pain Questionnaire (SFMPQ); disability using the Roland-Morris Disability Questionnaire (RMDQ); and six SCEs derived from three measures (i)Test of Self-Conscious Affect-3 (TOSCA-3) yielding subscales of shame, guilt, externalisation and detachment (ii) The Brief Fear of Negative Evaluation Scale (FNEB) and (iii) The Pain Self Perception Scale (PSPS) assessing mental defeat. Results Significantly greater levels of shame, guilt, fear of negative evaluation and mental defeat were observed in chronic pain patients compared to controls. In the pain group, SCE variables significantly predicted affective pain intensity; only mental defeat was significantly related to disability. Conclusion Findings highlight the prevalence of negative SCEs in the chronic pain experience and demonstrate the importance of considering SCEs in assessment and management of chronic pain. Future research may examine the role of mood, such as negative affect or depression, in these relations between SCE and chronic pain