Psychosocial factors and adjustment to chronic pain in persons with physical disabilities: a systematic review

Jensen, Mark P.; Moore, Michael R.; Bockow, Tamara B.; Ehde, Dawn M.; Engel, Joyce M.

doi:10.1016/j.apmr.2010.09.021

Cited by 300Musculoskeletal pain and rehabilitationPediatric Pain Management TechniquesPain Management and Treatment

Psychosocial factors and adjustment to chronic pain in persons with physical disabilities: a systematic review

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Jensen, Mark P., Moore, Michael R., Bockow, Tamara B., Ehde, Dawn M., Engel, Joyce M.·2011·Archives of Physical Medicine and Rehabilitation

DOI 10.1016/j.apmr.2010.09.021PMC PMC3028590

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Abstract

Objective To systematically review the research findings regarding the associations between psychosocial factors and adjustment to chronic pain in persons with physical disabilities.Data sources A key word literature search was conducted using articles listed in PubMed, PsychInfo, and CINAHL up to March 2010, and manual searches were made of all retrieved articles to identify published articles that met the review inclusion criteria.Study selection To be included in the review, articles needed to (1) be written in English, (2) include adults with a physical disability who report having pain, (3) include at least 1 measure of a psychosocial predictor domain, (4) include at least 1 criterion measure of pain or patient functioning, and (5) report the results of associations between the psychosocial factors and criterion measures used in the study. Twenty-nine studies met the inclusion criteria.Data extraction Three reviewers tabulated study details and findings.Data synthesis The disability groups studied included spinal cord injury (SCI), acquired amputation, cerebral palsy (CP), multiple sclerosis (MS), and muscular dystrophy (MD). Psychosocial factors were shown to be significantly associated with pain and dysfunction in all disability groups. The psychosocial factors most closely associated with pain and dysfunction across the samples included (1) catastrophizing cognitions; (2) task persistence, guarding, and resting coping responses; and (3) perceived social support and solicitous responding social factors. Pain-related beliefs were more strongly associated with pain and dysfunction in the SCI, CP, MS, and MD groups than in the acquired amputation group.Conclusions The findings support the importance of psychosocial factors as significant predictors of pain and functioning in persons with physical disabilities. Clinical trials to test the efficacy of psychosocial treatments for pain and dysfunction are warranted, as are studies to determine whether psychosocial factors have a causal influence on pain and adjustment in these populations.

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Resilience factors such as pain acceptance, positive affect, and adaptive pain beliefs relieve pain-related distress and improve functioning and social integration.
“A second dimension has focused on how “resilience factors”, such as pain acceptance, positive affect, and adaptive pain beliefs relieve pain-related distress and improve functioning and social integration.145–147”
From <p>Pain and Evil: From Local Nociception to Misery Following Social Harm</p> (2020) · cites this paper as [146]
The Discussion (Coping) associates acceptance-oriented coping with less pain and improved functioning, and the Results (Associations Between Psychosocial Factors and Adjustment) links belief in pain control with less interference and better psychological functioning in people with physical disabilities. The copy does not establish the claimed benefits of positive affect or social integration. The Discussion (Treatment Implications) also cautions that these associations do not establish a causal role, so saying the factors “relieve” distress and “improve” functioning overstates the evidence. (LLM, conf=0.86)
Experimental — accuracy not yet measured
Several studies indicate that the DNIC response is more pronounced in males than females, suggesting better endogenous pain inhibition in males.
“Several studies indicate the DNIC response is more pronounced in males than females, suggesting better functioning of the endogenous pain inhibitory system among males 176–178.”
From Evaluating psychosocial contributions to chronic pain outcomes (2018) · cites this paper as [178]

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Authors: Jensen, M. P., Moore, M. R., Bockow, T. B., Ehde, D. M., & Engel, J. M.
Affiliations: University of Washington (US)
Willamette University (US)
University of Pennsylvania (US)
University of Wisconsin–Milwaukee (US)
Corresponding author: Jensen, Mark P.
ORCID: Jensen, Mark P.
Ehde, Dawn M.
Engel, Joyce M.
Venue: Archives of Physical Medicine and Rehabilitation
Publisher: Elsevier BV
Published: 2011-01
Volume: 92
Issue: 1
Pages: 146-160
ISSN: 0003-9993 (ISSN-L)
DOI: 10.1016/j.apmr.2010.09.021
PMC: PMC3028590
OpenAlex: W2079088857
Cited by: 300
References: 83
Citations by year: 2026: 14 · 2025: 7 · 2024: 20 · 2023: 61 · 2022: 17 · 2021: 21 · 2020: 23 · 2019: 20 · 2018: 15 · 2017: 21 · 2016: 13 · 2015: 17 · 2014: 12 · 2013: 14 · 2012: 16
FWCI: 1.41
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Archives of Physical Medicine and Rehabilitation (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: Eunice Kennedy Shriver National Institute of Child Health and Human Development (P01HD033988, P01 HD 33988)
Topics: Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
Keywords: chronic pain, physical disability, psychosocial factors, pain catastrophizing, coping responses, social support, pain beliefs, spinal cord injury, cerebral palsy, multiple sclerosis, muscular dystrophy, functional disability
MeSH terms: Activities of Daily Living, Adaptation, Psychological, Chronic Disease, Disabled Persons, Persons with Disabilities, Humans, Mental Health, Pain, Social Support, Socioeconomic Factors

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Psychosocial factors and adjustment to chronic pain in persons with physical disabilities: a systematic review

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