The Role of Social Problem-Solving in Chronic Prostatitis/Chronic Pelvic Pain Syndrome
Authors:   , Colosimo Meghan Marie , Nezu Christine M. , Nezu Arthur M. 
Published: July 2021

Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is a common and persistent urological pain condition often accompanied by lower urinary tract and sexual dysfunction symptomatology, and currently of indeterminate etiology. The condition presently lacks effective and satisfactory treatment options. Studies that have explored the characteristic symptoms and ways of coping in men diagnosed with CP/CPPS report that they experience substantial physical and psychological problems, particularly in the realms of depression, anxiety, quality of life, perceived stress, physiological stress reactivity, and pain catastrophizing. These documented biopsychosocial correlates of CP/CPPS have demonstrated significant associations with the symptomatology associated with chronic prostatitis syndromes, such as pain intensity and pain-related disability (Ullrich, Turner, Ciol, & Berger, 2005). Recent advancements aimed at improving both understanding and intervention of chronic pelvic pain syndrome have focused on psychoemotional and psychosocial facets of the development, course, and prognosis of the disorder. Social problem-solving (SPS) refers to the dynamic interplay between the affective, cognitive, and behavioral aspects of real-world problem-solving (Nezu, Nezu, & D'Zurilla, 2013). Despite evidence for the role of SPS in various adjustment outcomes of other chronic pain populations, including patients coping with migraine/tension headaches, back pain, and noncardiac chest pain, this construct has yet to be formally assessed in the CP/CPPS population (Eskin, Akyol, Celik, & Gultekin, 2013; Siemonsma, Stuive, Roorda, Vollebregt, Lankhorst, & Lettinga, 2011; Nezu, Nezu, Jain, Shepanski Xanthopoulos, Cos, Friedman, & Lee, 2007; Nezu, Maguth Nezu, & Jain, 2008). As a result, the present study examined the significance of correlations between social problem-solving (measured by the Social Problem Solving Inventory-Revised; SPSI-R), chronic prostatitis symptomatology (reported on the National Institutes of Health - Chronic Prostatitis Symptom Inventory; NIH-CPSI), the experience of daily life stress (reported on the Survey of Recent Life Experiences Scale; SRLE) and perceived stress (measured by the Perceived Stress Scale; PSS), in males diagnosed with CP/CPPS. Additionally, this investigation conducted a hierarchical multiple regression in order to assess the utility of SPS in predicting CP/CPPS symptoms, while accounting for daily life hassles and perceived stress, respectively. Finally, the potential moderating function of SPS in the relationship between daily life stress experiences and CP/CPPS symptoms and between perceived stress and CP/CPPS symptoms was explored. Significant results regarding the two distinct stress measures, the SRLE and PSS, were compared for any notable, differential associations with the variables of interest that might suggest the unique contribution of these constructs to CP/CPPS. As hypothesized, total SPS was found to be significantly associated with total CP/CPPS symptomatology on the NIH-CPSI. Additionally, SPS significantly predicted symptoms above and beyond the experience of perceived stress on the PSS, but not the experience of daily stress on the SRLE. Finally, no support was found for the hypothesis that SPS would be a significant moderator of the stress - symptom relationship for either the perception or experience of stress. However, data collection remains ongoing. In the event that the final results of this investigation highlight SPS as a promising target of treatment intervention in alleviating the symptomatology of males diagnosed with chronic pelvic pain, future research will focus on the implementation and efficacy of Problem-Solving Therapy (PST) for CP/CPPS as a viable avenue of psychosocial treatment.