Factors Associated With Depressed Mood in Chronic Pain Patients: The Role of Intrapersonal Coping Resources

The purpose of this study was to examine processes through which chronic pain can result in depressed mood and to determine whether intrapersonal coping resources, namely high self-esteem and optimism, affect these processes. We hypothesized that pain severity contributes to depressed mood largely because pain interferes with involvement in important pursuits. We then examined whether intrapersonal resources are directly associated with pain severity, interference, and depressed mood and whether resources moderate associations between pain and interference or between interference and depressed mood. Structured interviews containing psychometrically robust measures were conducted with 141 outpatients of a university hospital-affiliated chronic pain center. As predicted, interference mediated much of the association between pain severity and depressed mood, and high resources were associated with less severe pain, less interference, and lower depressed mood. The association between pain severity and interference was stronger for people with high than people with low intrapersonal resources. The pattern of results that emerged from this study illustrates that intrapersonal coping resources may affect chronic pain patients through a variety of differentiated mechanisms. Pain severity appears to have greater adverse impact on the activity of people who possess highly positive self-views and outlook, but these resources are also associated with better emotional status. Perspective: Pain had greater adverse impact on the activity of people with highly positive self-views and outlook, but these coping resources were also associated with better emotional status. Chronic pain sufferers with few resources may require different interventions than those with more positive views of themselves and the world around them.