Perceived entitlement to pain-related support and pain catastrophizing: associations with perceived and observed support.
Open accessAbstract
Studies on the determinants of pain-related support are needed to enhance couples-based treatments for pain. The purpose of this study was to determine the extent to which pain catastrophizing and perceived entitlement to pain-related support (i.e., support entitlement) were associated with perceived and observed social support. Participants were 106 chronic pain couples recruited from the community. They completed surveys as well as an observational discussion task. Greater support entitlement in persons with pain was correlated positively with pain catastrophizing, punishing spouse responses, and observed spousal invalidation but negatively correlated with perceived spousal support, solicitous spouse responses, and observed validation. Catastrophizing was correlated with perceptions of general spousal support but not the other support variables. Hierarchical regression analyses demonstrated that among persons with lower levels of support entitlement, catastrophizing was associated with greater solicitous spouse responses. Among those with a greater entitlement to support, catastrophizing was associated with greater punishing spouse responses and observed invalidation by the spouse. These results suggest that support entitlement plays an important role in couples' supportive interactions about pain. Continued research is needed to determine how a desire for pain-related attention and support and catastrophizing translate into behaviors that affect support provision and receipt.
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Several studies have coded validation in chronic pain patient-partner interactions using the Validation and Invalidation Behavioral Coding System (VIBCS).
“A number of studies have used the Validation and Invalidation Behavioral Coding System (VIBCS[7]) to code validation occurring in interactions between patients with chronic pain and their partners.[1–3]”
From Validating pain communication: current state of the science (2015) · cites this paper as [2]
When partners gave more validation, patients disclosed more and reported less support entitlement.
“Third, in couples where the partner provided higher levels of validation, patients were much more likely to engage in disclosure and much less likely to report a sense of support entitlement.”
From Validating pain communication: current state of the science (2015) · cites this paper as [2]
Several studies have coded validation in chronic pain patient-partner interactions using the Validation and Invalidation Behavioral Coding System (VIBCS).
“A number of studies have used the Validation and Invalidation Behavioral Coding System (VIBCS[7]) to code validation occurring in interactions between patients with chronic pain and their partners.[1–3]”
From Validating pain communication: current state of the science (2015) · cites this paper as [3]
These behaviors were distinct from other spousal responses, including partner solicitousness.
“Second, these behaviors were found to be distinct from other spousal responses such as partner solicitousness.”
From Validating pain communication: current state of the science (2015) · cites this paper as [3]
When partners gave more validation, patients disclosed more and reported less support entitlement.
“Third, in couples where the partner provided higher levels of validation, patients were much more likely to engage in disclosure and much less likely to report a sense of support entitlement.”
From Validating pain communication: current state of the science (2015) · cites this paper as [3]
Observers reliably coded both validating and invalidating behaviors.
“First, observers were able to reliably code both validating behaviors and invalidating behaviors.”
From Validating pain communication: current state of the science (2015) · cites this paper as [2]
More validation was unrelated to patients' pain reports or their anxiety or depression symptoms.
“Finally, higher levels of validation were not related to patient reports of pain or symptoms of anxiety or depression.”
From Validating pain communication: current state of the science (2015) · cites this paper as [3]
Observers reliably coded both validating and invalidating behaviors.
“First, observers were able to reliably code both validating behaviors and invalidating behaviors.”
From Validating pain communication: current state of the science (2015) · cites this paper as [3]
More validation was unrelated to patients' pain reports or their anxiety or depression symptoms.
“Finally, higher levels of validation were not related to patient reports of pain or symptoms of anxiety or depression.”
From Validating pain communication: current state of the science (2015) · cites this paper as [2]
These behaviors were distinct from other spousal responses, including partner solicitousness.
“Second, these behaviors were found to be distinct from other spousal responses such as partner solicitousness.”
From Validating pain communication: current state of the science (2015) · cites this paper as [2]
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“In a study of interpersonal validation and empathy in adults with chronic pain and their partners, higher levels of validation were linked to higher levels of disclosure about pain experiences.(51) No studies have examined the levels of validation and empathic support in parent–child conversations about pain.”
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Catastrophizing and Perceived Injustice
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“30,31 39 Additionally, the related concept of greater social connectedness (ie, a greater sense of belonging and ability to connect with others) is also correlated with lower anxiety and, consequently, lower levels of pain.”
- Authors
- Cano, A., Leong, L., Heller, J. B., & Lutz, J. R.
- Affiliations
- Wayne State University (US)
- ORCID
- Leong, Laura
- Venue
- Pain
- Published
- 2009-12
- Volume
- 147
- Issue
- 1
- Pages
- 249-254
- ISSN
- 0304-3959 (ISSN-L)
- PMC
- PMC2787815
- OpenAlex
- W2129417913
- Cited by
- 60
- References
- 31
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 1 · 2023: 4 · 2022: 2 · 2021: 1 · 2020: 1 · 2019: 2 · 2018: 1 · 2017: 5 · 2016: 7 · 2015: 9 · 2014: 1 · 2013: 6 · 2012: 7
- FWCI
- 3.83
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Pain (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Human Biology (submittedVersion)
- Funders
- National Institute of Mental Health (K01MH066975)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Social Sciences › Psychology › Social Psychology › Attachment and Relationship Dynamics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Keywords
- pain catastrophizing, chronic pain, couples, spousal support, social support
- MeSH terms
- Adaptation, Psychological, Adult, Aged, Chronic Disease, Disability Evaluation, Female, Humans, Interpersonal Relations, Male, Middle Aged, Pain, Pain Measurement, Personality Inventory, Surveys and Questionnaires, Regression Analysis, Severity of Illness Index, Social Support, Spouses
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