Spousal congruence on disability, pain, and spouse responses to pain

Abstract

We examined congruence between chronic pain patients and their spouses on their reports of patient pain severity, patient disability, and spouse responses to pain. Patients reported that they were more physically and psychosocially disabled than their spouses reported them to be. However, spouses reported that the patients' pain was more severe than patients reported. Depressive disorders in the patient and gender interacted with patient-spouse ratings. For physical and psychosocial disability, depressed patient couples reported significantly larger differences in disability ratings than non-depressed patient couples. In addition, female patients' disability was rated as more severe by the female patients than by their husbands. Male patient couples did not report differences on physical disability. Findings relating to other forms of disability and to spouse responses are also described. The results are discussed in the context of an interpersonal perspective of chronic pain and have implications for the assessment of pain and disability.

A biopsychosocial formulation of pain communication.

“…Much of this research has examined partners' responses to pain communication (Romano, Jensen, Turner, Good, & Hops, 2000;Romano, Turner, Friedman, & Bulcroft, 1991;Romano et al, 1992;Romano et al, 1995). Spouses often make errors when estimating the pain and disability of persons with pain (Cano, Johansen, & Franz, 2005;Cano, Johansen, & Geisser, 2004b;Clipp & George, 1992;Miaskowski, Zimmer, Barrett, Dibble, & Wallhagen, 1997). The assumption in the pain field has been that each spouse shares the same symbol system, which may not always be the case as in a husband who values visual symbols of pain and a wife who primarily uses verbal symbols.…”

Chronic Pain in a Couples Context: A Review and Integration of Theoretical Models and Empirical Evidence

“…Empathy might also account for why spouses often underestimate and overestimate pain and disability in ICPs. 13,16,24,66 Issues discussed and avoided during interactions might be just as important. One study showed that although most patients with chronic pain verbally communicated with their families about pain, they found it inappropriate to talk about the pain unless asked.…”

Perceived Spouse Responses to Pain: The Level of Agreement in Couple Dyads and the Role of Catastrophizing, Marital Satisfaction, and Depression

“…Researchers have found that patients perceive fewer spouse solicitous responses or that there are no patient-spouse differences in perceptions of solicitousness (Cano et al, 2004b;Lousberg et al, 1992;Williamson et al, 1997). Further, the literature reports that patients perceive greater punishing respsonses than spouses perceive, or that there are no mean differences in perceptions of punishing responses (Cano et al, 2004b;Williamson et al, 1997).…”