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Reported Pain and Fatigue Behaviors Mediate the Relationship Between Catastrophizing and Perceptions of Solicitousness in Patients with Chronic Fatigue
Joan M. Romano, Ivan P. Molton, Kevin N. Alschuler, Karen B. Schmaling, Dedra S. Buchwald
1Mark P. Jensen, PhD, Department of Rehabilitation Medicine, University of Washington, Harborview Medical Cente, 325 Ninth Avenue, Seattle, WA 98104-2499.
DOI: http://dx.doi.org/10.1016/j.jpain.2015.10.020
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Article Info
Publication History
Published Online:November 29, 2015Accepted:October 30, 2015Received in revised form:October 13, 2015Received:June 4, 2015
Highlights
- •Communal coping and behavioral models of catastrophizing make different predictions
- •This study tested mediational paths from these models in chronic fatigue patients
- •Catastrophizing’s effects on solicitousness occurred through pain/fatigue behavior
- •Solicitousness did not mediate the path of catastrophizing to pain/fatigue behavior
- •Results were more consistent with a cognitive behavioral than communal coping model
Abstract
Catastrophizing is associated with negative outcomes in chronic pain and illness.
The Communal Coping Model (CCM) and cognitive-behavioral (CB) formulations provide differing accounts of the function of catastrophizing in these contexts.
The present study examined predictions from CCM and CB theoretical models in a sample of 116 patients with chronic fatigue to test:
(1) whether patient-reported solicitous responses from significant others mediate the relationship of catastrophizing with patient-reported pain and fatigue behaviors, as predicted by the CCM,
and
(2) whether pain and fatigue behaviors mediate the relationship of catastrophizing with solicitous responses, consistent with a CB model.
This work is a secondary data analysis that examined the strength of the indirect (i.e., mediating) effects among study variables.
Consistent with CB models, pain and fatigue behaviors were associated with both catastrophizing and solicitous responses, and there was a significant indirect effect of catastrophizing on solicitous responses through pain and fatigue behaviors.
Results were inconsistent with the CCM; catastrophizing was not significantly associated with solicitous responses, nor did solicitous responses mediate the relationship between catastrophizing and pain/fatigue behaviors.
Findings highlight the importance of behavioral expressions of pain and fatigue in understanding the relationship of catastrophizing to solicitous responses in chronic fatigue.
Perspective
This study of chronic fatigue patients tested cognitive-behavioral and communal coping models of catastrophizing, pain and fatigue behaviors, and solicitous responses by significant others.
Results were more consistent with CB formulations, highlighting the importance of behavioral expressions of pain and fatigue in understanding the relationship of catastrophizing to solicitous responses.
Keywords:
Catastrophizing, chronic fatigue, solicitousness, partner responses, pain and fatigue behavior