Resilience and vulnerability in individuals with chronic pain and physical disability.
Open accessAbstract
OBJECTIVE: To examine the independent contributions of vulnerability and resilience factors to pain interference, self-efficacy for managing pain, global mental health, and global physical health. RESEARCH METHOD/DESIGN: Secondary analysis of baseline data from individuals with a spinal cord injury (n = 73), amputation (n = 33), or multiple sclerosis (n = 82) and chronic pain who participated in a randomized controlled trial comparing 2 chronic pain interventions. Participants completed a comprehensive battery of pain-related outcomes that assessed for both psychosocial assets and maladaptive cognitions and behaviors. RESULTS: Results suggested that vulnerability and resilience factors together account for a considerable amount of variance in the physical outcomes, but that neither set of factors was able to make a substantial contribution above and beyond the other. In contrast, for mental health related outcomes, results indicated that resilience factors did make a meaningful contribution above and beyond vulnerability factors, suggesting the important contribution of resilience factors to the psychological experience of chronic pain. CONCLUSIONS: The present study suggested a valuable contribution of both resilience and vulnerability factors to pain outcomes, with the additional caveat that resilience factors uniquely impact specific outcomes-particularly those that are more psychosocially focused-above and beyond vulnerability factors. Taken together, this highlights the importance of considering resilience factors in addition to vulnerability factors for individuals with chronic pain. Additional research is needed to explore other factors that could be considered representative of the resilience construct and more attention should be focused on evaluating the effects of interventions that seek to build an individual's assets.
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Resilience factors mostly act on psychologically focused factors and should be evaluated in CP patients to provide adequate treatment and support.
“However, resilience factors mostly act on psychologically focused factors,140 and therefore they should be evaluated in CP patients to provide adequate treatment and support to promote better outcomes.”
From <p>Pain and Evil: From Local Nociception to Misery Following Social Harm</p> (2020) · cites this paper as [140]
Vulnerability factors such as depressed mood, catastrophic thinking, and maladaptive pain beliefs contribute to suffering in CP individuals and decrease their quality of life.
“The first dimension has focused on how “vulnerability factors”, such as depressed mood, catastrophic thinking, and maladaptive pain beliefs, contribute to suffering in CP individuals,138,139 and decrease their quality of life,140”
From <p>Pain and Evil: From Local Nociception to Misery Following Social Harm</p> (2020) · cites this paper as [140]
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<p>Pain and Evil: From Local Nociception to Misery Following Social Harm</p>
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- Authors
- Alschuler, K. N., Kratz, A. L., & Ehde, D. M.
- Affiliations
- University of Washington (US)
- University of Michigan (US)
- Venue
- Rehabilitation Psychology
- Published
- 2016-02
- Volume
- 61
- Issue
- 1
- Pages
- 7-18
- ISSN
- 0090-5550 (ISSN-L)
- 1939-1544
- PMC
- PMC4758368
- OpenAlex
- W2298846341
- Cited by
- 97
- References
- 83
- Citations by year
- 2026: 5 · 2025: 8 · 2024: 11 · 2023: 7 · 2022: 6 · 2021: 9 · 2020: 13 · 2019: 13 · 2018: 9 · 2017: 14 · 2016: 2
- FWCI
- 16.94
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Rehabilitation Psychology (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Child Health and Human Development (R01 HD057916 and HD057916-03 S1)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (1K01AR064275)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Resilience and Mental Health
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Social Sciences › Psychology › Applied Psychology › Optimism, Hope, and Well-being
- Keywords
- resilience, vulnerability factors, chronic pain, physical disability, spinal cord injury, amputation, multiple sclerosis, pain interference, self-efficacy, mental health, physical health, maladaptive cognitions
- MeSH terms
- Amputation, Surgical, Mental Disorders, Female, Persons with Disabilities, Health Status, Humans, Male, Middle Aged, Multiple Sclerosis, Spinal Cord Injuries, Self Efficacy, Resilience, Psychological, Chronic Pain, Pain Management
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