QUALITY OF LIFE IN CHRONIC PAIN PATIENTS: IMPORTANCE OF PERSONALITY, RESILIENCE, AND COPING.

Patricia Gmez-Carretero (1), Jos Soriano (2), Vicente Monsalve (3), Lorena Toms (2), Jos De Andrs (3).
1. Fundation of the Valencian Comunity for the study and treatment of pain. Spain. 2. Faculty of Psychology. University of Valencia. Spain. 3. Pain Unit. Anaesthesia, Resuscitation and Pain Therapy Service. General Hospital of Valencia. (CHGUV). Spain.
Results funded by Education and Science Ministry of Spain (REF: SEJ2004-05439/PSIC and SEJ2007-61288/PSIC9) and with collaboration of FUNDOLOR.

1. Introducction and Aims.

At present, resilience is considered a multidimensional construct in which variables as personality or specific skills (problem solving, for example), can help people to cope adequately with traumatic situations. Campbell-Sills et al. (1), found relations between resilience and the five-factor model of personality in their study, in which resilience keep a strong negative relation with Neuroticism (N), a positive relation with Extraversion (E) and Conscientiousness (C) and a small but significant relation with Openness (O) to the experience, showing no relation with Agreeableness (A). Regarding the contributions of coping in the prediction of resilience, problem-focused coping is related to resilience and mediates the relation between conscientiousness and resilience, and emotion-focused coping is associated with low levels of resilience. Similar outcomes have been found by other authors (2). In addition, relations were obtained between resilience and increased perceived quality of life (QoL) in patients with chronic pain (3). The aim of the this study is to assess the role of personality, resilience, and pain coping in quality of life in chronic pain patients.

2. Material and methods.

A consecutive series of 131 chronic pain patients of the Multidisciplinary Pain Unit of CHGUV were evaluated by psychology service by means of:
SOCIODEMOGRAPHIC DATA NEO-FFI (4) Personality CAD-R(5) Coping SF-36 (6) Quality of Life CD-RISC (7) Resilience High QoL 54,56 (13,01) 53,3 46,7 8,9 48,9 33,3 8,9 2,2 73,3 24,4 0 28,9 4,4 51,1 2,2 13,3

A cluster analysis (k-means) was made to classify patients as high or low in QoL according to their SF-36 scores:
1. Low QoL Physical Functioning 37,67 Role-Physical 8,14 Bodily Pain 20,49 General Health 30,12 Vitality 22,33 Social Functioning 38,98 Role-Emotional 3,87 Mental Health 34,94 N 86 2. High QoL 44 21,11 31,22 43,44 50,78 64,17 85,93 67,56 45

3. Sample.

Low QoL Age - Years (SD) 55,28 (12,10) Male 41,9 Gender (%) Female 58,1 Unfinished 9,3 Primary Education 62,8 Educational Status (%) Secondary Education 17,4 University Education 10,5 Vascular 4,7 Neurophatic 65,1 Pain Type (%) Somatic 24,4 Fibromialgya 5,8 Active 7 Unemployed 11,6 Laboral Status (%) Inactive 62,8 Student 1,2 Housewife 17,4

4. Results.
The discriminant analysis with CAD-R, NEO-FFI and CD-RISC scales as predictor variables and high/low QoL as criterion variables showed that 82,6% low QoL patients and 77,8% high QoL patients were correctly classified in the groups.
1. Eigenvalues Function Eigenvalue % variance % accumulated Canonical correlation 1 ,695 100 100 ,640 2. Wilks lambda Contrast functions Wilks Lambda Chi-square Degrees of freedom Sig. 1 ,590 64,876 12 ,000 5. Classification results Count Original % Predicted group Initial number belonging Total of cases Low QoL High QoL Low QoL 71 15 86 High QoL 10 35 45 Low QoL 82,6 17,4 100 High QoL 22,2 77,8 100 3. Standardized coefficients of canonical Function discriminant functions 1 Neuroticism ,896 Extraversion -,374 Openess ,065 Agreableness -,129 Conscientiousness ,074 Resilience ,277 Distraction ,218 Search for info -,245 Religion ,091 Catharsis ,362 Mental Self-Control -,150 Self-Assertion -,027 Function 4. Matrix Structure 1 Neuroticism ,883 Extraversion -,503 Resilience -,404 Conscientiousness -,283 Catharsis ,233 Self-Assertion -,218 Religion ,172 Agreableness -,163 Mental Self-Control -,087 Openess -,059 Search for info -,058 Distraction ,017

The Wilks Lambda score was used as an inclusion criterion for discriminant analysis

5. Conclusions.
Results of the study show the importance of personality, resilience en coping pain on chronic pain patients QoL. That is, QoL depends largely on the above mentioned variables. Moreover, the results show that Low or High QoL is predicted by Neuroticism, Extraversion and Resilience.
6. References.
1. 2. 3. 4. 5. 6. 7. Campbell-Sills L, Cohan S, Stein M. Relationship of resilience to personality, coping, and psychiatric symptoms in young adults. Behaviour Research and Therapy .2006; 44: 585-599. Soriano, J., Monsalve, V., Ibez, E. y Gmez, P. Personalidad y afrontamiento en dolor crnico neuroptico: un divorcio previsible. 2010; Psicothema, 22, 537-542. Gmez-Carretero P, Toms L, Monsalve V, Soriano J, Lpez MD, De Andrs J. Resiliencia, afrontamiento y calidad de vida: anlisis de correlaciones en pacientes con dolor crnico. Poster presented at XIII Virtual Congress of Psychiatry . www.psiquiatria.com. 2012. Costa, P; McCrae, R. Inventario de Personalidad NEO Revisado. 1999. Madrid: TEA. Soriano JF y Monsalve V. Validacin del cuestionario de afrontamiento al dolor crnico reducido (CAD-R). Rev Soc Esp Dolor. 2004; 11(7): 407-414. Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992; 30(6): 473-483. Campbel-Sills L, Stein MB. Psychometric analysis and refinement of the Connor-Davidson Resilience Scale (CD-RISC): validation of a 10-Item Measure of Resilience. Journal of Traumatic Stress. 2007; 20: 1019-1028. Patri.gomez80@gmail.com