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Psychological functioning of people living with chronic pain: a meta-analytic review
- Authors:
- BURKE Anne L.J., MATHIAS Jane L., DENSON Linley A.
- Journal article citation:
- British Journal of Clinical Psychology, 54(3), 2015, pp.345-360.
- Publisher:
- Wiley
Objectives: This meta-analysis synthesised the literature from a general chronic pain (CP) perspective to systematically identify and compare the psychological problems most commonly associated with CP. Methods: Four databases were searched from inception to December 2013 (PsychINFO, The Cochrane Library, Scopus, and PubMed) for studies comparing the psychological functioning of adults with CP to healthy controls. Data from 110 studies were meta-analysed and Cohen's d effect sizes calculated. Results: The CP group reported experiencing significant problems in a range of psychological domains (depression, anxiety, somatisation, anger/hostility, self-efficacy, self-esteem and general emotional functioning), with the largest effects observed for pain anxiety/concern and somatisation; followed by anxiety and self-efficacy; and then depression, anger/hostility, self-esteem and general emotional functioning. Conclusions: This study demonstrates that individuals with CP are more likely to experience physically focussed psychological problems than other psychological problems and that, unlike self-efficacy, fear of pain is intrinsically tied to the CP experience. This challenges the prevailing view that, for individuals with CP, problems with depression are either equal to, or greater than, problems with anxiety, thereby providing important information to guide therapeutic targets. (Edited publisher abstract)