Pain-Related Coping Behavior in ALS: The Interplay between Maladaptive Coping, the Patient’s Affective State and Pain
Abstract
:1. Introduction
2. Methods
2.1. Study Design
2.2. Patient Characteristics
2.3. Patient-Reported Data and Assessment Instruments
2.4. Statistics
3. Results
3.1. Demographic and Clinical Data
3.2. Pain Characteristics, Treatment and Pain Relief
3.3. Pain-Related Coping Strategies
3.4. Relation between Demographic/Clinical Data, Pain-Related Features and the Affective State
3.5. Predictors of the Average Pain Intensity
3.6. Catastrophizing in Relation to the Patients’ Functional Status and Emotional Aspects of Health-Related Quality of Life
3.7. Predictors of Pain-Related Catastrophizing
4. Discussion
4.1. Pain-Related Coping Behavior
4.2. Interplay between Pain, Maladaptive Coping and the Patients’ Affective State
5. Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Patients with Pain | Patients without Pain | p-Value | |
---|---|---|---|
Gender (female/male) | 24/60 (28.6/71.4%) | 20/46 (30.3/69.7%) | 0.817 |
Patient age | 61.2 ± 11.8 | 66.6 ± 8.0 | 0.037 |
Disease duration from diagnosis in months | 33.5 ± 38.5 | 37.7 ± 51.3 | 0.569 |
Symptom onset | 0.135 | ||
Bulbar | 14 (16.7%) | 19 (28.8%) | |
Upper limb | 37 (44%) | 21 (31.8%) | |
Lower limb | 31 (36.9%) | 22 (33.3%) | |
Missing information | 2 (2.4%) | 4 (6.1%) | |
King’s clinical staging | 0.065 | ||
Stage 1: Symptom onset/functional involvement of first region | 0 | 0 | |
Stage 2A: Diagnosis | 7 (8.3%) | 5 (7.6%) | |
Stage 2B: Functional involvement of a second region | 8 (9.5%) | 16 (24.2%) | |
Stage 3: Functional involvement of a third region | 39 (46.4%) | 23 (34.8%) | |
Stage 4A: Need for gastrostomy | 4 (4.8%) | 7 (10.6%) | |
Stage 4B: Need for respiratory support (NIV) | 26 (31%) | 15 (22.7%) | |
ALSFRS-EX | |||
Sum score | 36.6 ± 12.9 | 42.6 ± 10.8 | 0.003 |
Bulbar subscore | 11.6 ± 4.8 | 11.23 ± 3.4 | 0.344 |
Fine motor subscore | 7.7 ± 4.3 | 10.0 ± 4.9 | 0.003 |
Gross motor subscore | 8.2 ± 5.0 | 10.2 ± 4.6 | 0.012 |
Respiratory subscore | 9.1 ± 3.2 | 10.2 ± 2.8 | 0.038 |
Disease progression rate * | 0.9 ± 1.9 | 0.75 ± 0.9 | 0.639 |
ADI-12 | |||
Sum score | 26.1 ± 7.6 | 22.2 ± 7.1 | 0.002 |
Absence of depressive symptoms (<22 points) | 25 (29.8%) | 33 (50%) | 0.029 |
Mild depressive symptoms (22–28 points) | 26 (31%) | 18 (27.3%) | |
Clinically relevant depressive symptoms (>28 points) | 31 (36.9%) | 14 (21.2%) | |
ALSAQ-40 subscale score “emotional functioning” | 41.8 ± 22.6 | 30.9 ± 20.2 | 0.003 |
Patients with Pain (n = 84) | |
---|---|
Pain interference with daily functions | |
Normal work | 5.4 ± 3.0 |
Walking ability | 4.8 ± 2.8 |
General activity | 4.5 ± 3.2 |
Sleep | 4.0 ± 3.7 |
Mood | 4.2 ± 3.1 |
Enjoyment of life | 3.6 ± 3.7 |
Relations with other people | 2.9 ± 3.1 |
Pain-related pharmacotherapy * | n = 54 (64.3%) |
Non-opioid analgesics | n = 45 (53.6%) |
Opioid analgesics | n = 16 (19.0%) |
Tricyclic antidepressants ** | n = 5 (6.0%) |
Anticonvulsants | n = 10 (12.0%) |
Unstandardized Coefficients | Standardized Coefficients | T | p-Value | VIF | ||
---|---|---|---|---|---|---|
Regression Coefficient B | Standard Error | Beta | ||||
Gender | −0.521 | 0.465 | −0.119 | −1.120 | 0.266 | 1.279 |
CSQ subscales | ||||||
Diverting attention | 0.323 | 0.170 | 0.216 | 1.899 | 0.062 | 1.471 |
Catastrophizing | 0.621 | 0.160 | 0.529 | 3.873 | <0.001 | 2.121 |
Increasing pain behaviors | 0.086 | 0.196 | 0.054 | 0.439 | 0.662 | 1.699 |
ADI-12 sum score | −0.019 | 0.033 | −0.078 | −0.593 | 0.555 | 1.973 |
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Schlichte, I.; Petri, S.; Dengler, R.; Meyer, T.; Haghikia, A.; Vielhaber, S.; Vogt, S. Pain-Related Coping Behavior in ALS: The Interplay between Maladaptive Coping, the Patient’s Affective State and Pain. J. Clin. Med. 2022, 11, 944. https://doi.org/10.3390/jcm11040944
Schlichte I, Petri S, Dengler R, Meyer T, Haghikia A, Vielhaber S, Vogt S. Pain-Related Coping Behavior in ALS: The Interplay between Maladaptive Coping, the Patient’s Affective State and Pain. Journal of Clinical Medicine. 2022; 11(4):944. https://doi.org/10.3390/jcm11040944
Chicago/Turabian StyleSchlichte, Ina, Susanne Petri, Reinhard Dengler, Thomas Meyer, Aiden Haghikia, Stefan Vielhaber, and Susanne Vogt. 2022. "Pain-Related Coping Behavior in ALS: The Interplay between Maladaptive Coping, the Patient’s Affective State and Pain" Journal of Clinical Medicine 11, no. 4: 944. https://doi.org/10.3390/jcm11040944