Work

Impact of Pain Self-Efficacy on Health Outcomes in High-Impact Chronic Pain

Year: 2025

Type: article

Abstract: OBJECTIVES: High-impact chronic pain (HICP), affecting 36.4% of individuals with chronic pain, significantly limits work, social, and self-care activities. Effective treatments for HICP remain elusive. In addition to pain catastrophizing (PC), growing evidence suggests that pain self-efficacy (PSE) may be a treatment target for HICP. Our study examines the relative contributions of pain self-efficacy and catastrophizing to health outcomes in patients with HICP. METHODS: A total of 259 patients with chronic pain (154 with HICP; 105 without HICP) completed validated measures at baseline and 3 months later. These included the Chronic Pain Self-Efficacy Scale (CPSS), the Pain Catastrophizing Scale (PCS), and Patient-Reported Outcomes Measurement Information System (PROMIS) domains for physical health (ie, pain interference, physical function, fatigue, and sleep disturbance) and psychosocial health (ie, depression, anxiety, anger, and social isolation). RESULTS: Repeated measures MANOVA showed a significant group effect (HICP vs. No-HICP), but no significant time or group by time interaction. The HICP group reported significantly lower CPSS scores and higher PCS scores than the No-HICP group, alongside worse physical and psychosocial health outcomes (η²=0.076 to 0.445). PSE explained a greater proportion of group differences in health outcomes (52.9% to 71.7%) compared with PC (10.1% to 43.3%). Especially, SE in activity engagement accounted for the largest health disparities between the groups. DISCUSSION: Findings highlight PSE as a critical treatment target for HICP, with greater predictive utility than PC. Enhancing SE through tailored interventions may reduce the burden of HICP. Future studies should prioritize SE-based interventions and explore their scalability and long-term impact.

Source: Clinical Journal of Pain

DOI: 10.1097/ajp.0000000000001295