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. KeywordsAmputation; Pain; Psychological adaptation Reprint requests to Mark P. Jensen, PhD, Department of Rehabilitation Medicine, Box 359612, Harborview Medical Center, 325 Ninth Avenue, Seattle, mjensen@uw.edu. No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated. NIH Public Access Author ManuscriptArch Phys Med Rehabil. Author manuscript; available in PMC 2012 January 1. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptPain is a significant problem for many persons with physical disabilities, 1 including persons with SCI, 2 MS, 3 acquired amputation, 4,5 CP, 6 and MD. 7 Although physiologic changes associated with trauma or with the disability itself may play a primary causal role in the presence and severity of pain in persons with disabilities, psychosocial factors have long be...

Objective To examine the influence of sex and disability on catastrophizing, pain intensity, and pain interference in individuals with a spinal cord injury (SCI) or multiple sclerosis (MS). Design A cross-sectional survey design was employed. 248 community-dwelling adults with a physical disability (SCI=124; MS=124) and chronic pain completed measures of demographic and clinical characteristics, pain intensity and interference, psychological functioning, and pain catastrophizing. Results Men reported marginally greater catastrophizing (p<.10) than women across both disability groups; however, there was no significant difference in catastrophizing between disability groups. Catastrophizing was the only significant predictor of pain intensity in the multivariate regression analysis, with greater catastrophizing associated with greater pain. Pain intensity and catastrophizing were the only significant variables in the regression analyses predicting pain interference and psychological functioning; as hypothesized, greater pain intensity and catastrophizing were associated with more pain interference and poorer psychological functioning. There was also a trend (p<.10) for females, relative to males, to have a stronger association between catastrophizing and pain interference. Conclusions These findings are consistent with a biopsychosocial conceptualization of pain and functioning in individuals with chronic pain secondary to a physical disability. In addition, these data suggest that assessment and treatment (when indicated) of catastrophizing should be a regular part of the clinical management of these patients.