Catastrophizing and Pain-Contingent Rest Predict Patient Adjustment in Men with Chronic Prostatitis/Chronic Pelvic Pain Syndrome

Published in: The Journal of Pain, v. 7, no. 10, Oct. 2006, p. 697-708

Posted on RAND.org on December 31, 2005

by Dean A. Tripp, J. Curtis Nickel, Yan Wang, Mark Litwin, Mary McNaughton-Collins, J. Richard Landis, Richard B. Alexander, Anthony J. Schaeffer, Michael P. O'Leary, Michel A. Pontari, Jackson E. Fowler, Jr., Leroy M. Nyberg, John W. Kusek

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Cognitive/behavioral and environmental variables are significant predictors of patient adjustment in chronic pain. Using a biopsychosocial template and selecting several pain-relevant constructs from physical, cognitive/behavioral, and environmental predictors, outcomes of pain and disability in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) were explored. Men (n = 253) from a North American multi-institutional NIH-funded Chronic Prostatitis Cohort Study in 6 US and 1 Canadian centers participated in a survey examining pain and disability. Measures included demographics, urinary symptoms, depression, pain, disability, catastrophizing, control over pain, pain-contingent rest, social support, and solicitous responses from a significant other. Regressions showed that urinary symptoms (B = .20), depression (B = .24), and helplessness catastrophizing (B = .29) predicted overall pain. Further, affective pain was predicted by depression (B = .39) and helplessness catastrophizing (B = .44), whereas sensory pain was predicted by urinary symptoms (B =.25) and helplessness catastrophizing (B = .37). With regard to disability, urinary symptoms (B = .17), pain (B = .21), and pain-contingent rest (B - .33) were the predictors. These results suggest cognitive/behavioral variables (ie, catastrophizing, pain-contingent rest) may have significant impact on patient adjustment in CP/CPPS. Findings support the need for greater research of such pain-related variables in CP/CPPS. Perspective: This article explores predictors of patient adjustment in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Cognitive/behavioral variables of catastrophizing and pain-contingent rest respectively predicted greater pain and disability. Catastrophic helplessness was a prominent pain predictor. These findings inform clinicians and researchers on several new variables in CP/CPPS outcomes and suggest future research.

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