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Impact of Pain on Daily Life Greater Threat to Mental Health than Pain Intensity, Study Finds

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Mental wellbeing for some persons with chronic pain appears to be associated with the flexibility to adjust goals and persevere despite obstacles, setbacks, note study authors.

New study findings suggest that for individuals living with chronic pain, the biggest threat to mental health is the extent to which it interferes with their daily life rather than the intensity of their pain.

“Based on our results, it would seem that people can find ways to maintain their mental wellbeing when their pain intensity is high, so long as it does not interfere with important aspects of their daily life,” researcher Joanne Dickson, PhD, professor of psychology at Edith Cowan University (ECU), in Perth, Australia, said in a university statement.

Chronic pain impacts approximately 20% of the population and can have significant medical and physical effects, as well as consequences for employment, lifestyle, and mental health. In a recent study published in the International Journal of Environmental Research and Public Health, Dickson and colleagues surveyed more than 300 individuals living with noncancer chronic pain about their mental wellbeing, pain intensity, and how much their pain interfered with their everyday pursuits and activities that mattered to them.

The findings suggest that as a result of their pain, patients may not have the psychological or physical capacity to participate in activities that help them attain their personal goals, which can have significant impacts on mental wellbeing, according to the investigators.

“The good news is that this research showed personal goal flexibility (ie, the ability to adapt and to adjust to life’s difficulties and obstacles) in how we strive to maintain or achieve the things that matter to us can provide a protective buffer in maintaining and promoting mental wellbeing,” said Dickson.

Dickson noted further that the findings were in contrast with investigators’ predictions. Pain interference in daily life was reported to be more problematic than pain intensity for patients living with chronic pain. Mental flexibility, they found, is one way for patients to manage this interference.

The study investigated how persistently pursuing valued goals and adjusting those goals in response to setbacks or obstacles may help explain how some individuals with chronic pain maintain their mental wellbeing. The findings highlight that distinct goal motivational processes seem to have a protective effect in maintaining mental wellbeing for individuals with chronic pain.

“Specifically, we found that goal flexibility and goal tenacity seem to buffer the negative emotional impacts of pain interference on mental wellbeing, and flexibility even more so than tenacity,” study coauthor Tara Swindells noted in the statement. “So, if you’re able to adjust, adapt, and find ways to still achieve what matters to you most in the face of life’s obstacles, that’s going to help protect your mental wellbeing.”

The investigators also emphasized that pain management and mental health are complex issues. Earlier research showed that physical impacts of chronic pain, such as lack of sleep, injury, or disease, and social factors such as employment, social support, and economic factors play a significant role in pain management. The new findings add to this body of knowledge and could help inform public health policy and campaigns around promoting psychological strengths rather than deficits.

“[The findings] indicate that variations in adaptive psychological processes provide another useful lens to understand the relationship between pain interference and mental wellbeing,” concluded Swindells.


Reference: Swindells T, Iddon J, Dickson JM. The role of adaptive goal processes in mental wellbeing in chronic pain. Int J Environ Res Public Health. 2023;20:1278. doi:10.3390/ijerph20021278


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