Perceived Early Childhood Family Influence, Perceived Pain Self-Efficacy, and Chronic Pain Disability: An Exploratory Study

The authors examined, with adult participants, the relationship between perceived early childhood family influence, pain self-efficacy beliefs, and pain-related disability. Perceived pain self-efficacy explained 37% of the variance in chronic pain disability, but perceived early childhood family influence was not a statistically significant predictor of chronic pain disability. ********** Chronic pain is an exponentially increasing issue for aging adults in the United States and has stretched the limits of technology and the ability of health care professionals to provide adequate care (Aronoff & Feldman, 2000; Gloth, 2001; Trunks, 2008). Chronic pain deprives individuals of their independence, confidence, quality of life, and often their primary support groups while leaving them with depression, anxiety, and uncertainty regarding a cure or a treatment for their pain condition (Dewar, White, Posade, & Dillon, 2003; Lame, Peters, Vlaeyen, Kleef, & Patijn, 2005; Paulson, Danielson, Larsson, & Norberg, 2001; Sullivan & Stanish, 2003). When chronic pain leads to disability, individuals with such pain become dependent on others for their care (Dewar et al., 2003; Gloth, 2001; Paulson et al., 2001). Technologies exist to treat chronic pain; however, they are often expensive, and the low success rate and expensive follow-up care make the technologies helpful for only a few individuals who experience chronic pain (Pizzi et al., 2005). Research results have consistently indicated, however, that therapies dealing with the psychosocial issues of chronic pain patients as a part of a multidisciplinary program, including physical and medical modalities, are cost-effective and have been shown to (a) improve outcomes for individuals with a wide range of diagnoses, (b) reduce distress resulting from a chronic pain condition, (c) improve return-to-work status, and (d) decrease the individual's reliance on the medical and social services system (American Academy of Pain Medicine, 2005; Gatchel et al., 2003; Lemstra & Olszynski, 2005; Loeser, 1999; Pizzi et al., 2005; Sullivan & Stanish, 2003; Trunks, 2008; Turk, 2005). In particular, multidisciplinary programs that address self-efficacy have been associated with reductions in disability for patients with chronic pain (Arnstein, 2000; Flor & Turk, 1988; Keefe et al., 2000; Wells-Federman, Arnstein, & Caudill, 2002). PERCEIVED SELF-EFFICACY BELIEFS AND CHRONIC PAIN As the emphasis on improving outcomes for individuals with pain shifted from a biomedical model to a biopsychosocial model, research concentrated on the influence of psychosocial factors, including self-efficacy beliefs, in the progression of acute pain to chronic pain and disability (Kongstvedt, 1987). Bandura (1989) postulated that self-efficacy beliefs and performance are highly correlated and that self-efficacy beliefs can be predictive of behavior. According to Bandura (1997), stronger perceptions of self-efficacy result in the individual setting higher personal goals and even cultivating healthy behaviors. Data from chronic pain research indicate that the level of perceived self-efficacy is a significant contributor of the extent to which an individual is disabled by chronic pain (Arnstein, 2000). Individuals with chronic pain who have higher scores on perceived self-efficacy scales were more likely to cultivate health behaviors and less likely to become disabled because of their chronic pain (Arnstein, 2000; Bandura, 1997; Keefe, Rumble, Scipio, Giordano, & Perri, 2004; Novy, Nelson, Hetzel, Squitieri, & Kennington, 1997; Woby, Watson, Roach, & Urmston, 2005). These results were consistent regardless of diagnosis or location of the pain and are consistent with Bandura's (1986) definition of perceived self-efficacy as an individual's judgment of what he or she can do with his or her actual skills, rather than whether or not the skills exist. …