Comparison of Emotional Schemas and Coping Styles in Patients With Severe and Mild Chronic Pain, With and Without Pain Acceptance
Keywords:
Chronic pain, Pain intensity, Pain acceptance, Emotional schemas, Coping stylesAbstract
Purpose: This study aimed to compare emotional schemas and coping styles among patients with chronic musculoskeletal pain based on differences in pain intensity and pain acceptance.
Methodology: A causal–comparative (ex post facto) design was employed. The population consisted of patients with chronic pain who attended the Pain Clinic of Rasoul Akram Hospital in Tehran. A purposive sample of 160 individuals was assigned into four groups of 40 based on pain intensity (severe vs. mild) and pain acceptance (with acceptance vs. without acceptance). Instruments included the Chronic Pain Questionnaire, the Pain Acceptance Questionnaire, the Emotional Schema Scale, and the Coping Styles Questionnaire. Data were analyzed using Shapiro–Wilk tests, multivariate analysis of variance (MANOVA), ANOVA, and Bonferroni post hoc tests.
Findings: Findings revealed significant main effects of pain intensity and pain acceptance on all dependent variables (p < 0.05). Patients with severe pain and low acceptance demonstrated significantly higher levels of negative emotional schemas, including greater negative emotional appraisal and negative cognitive responses to emotion. They also showed higher scores on avoidant and emotion-focused coping and lower levels of problem-focused coping. Patients with higher pain acceptance consistently reported lower negative schemas and more adaptive coping styles. A significant interaction effect (pain intensity × acceptance) indicated that pain acceptance attenuates the maladaptive emotional and coping outcomes associated with severe pain.
Conclusion: Pain intensity and pain acceptance jointly shape emotional schemas and coping strategies in individuals with chronic pain. Enhancing pain acceptance and strengthening problem-focused coping may reduce maladaptive emotional responses and improve psychological adjustment in chronic pain patients.
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Copyright (c) 2025 Sanaz Salamati (Author); Arezo Tarimoradi; Alireza Shokrgozar, Saeed Mahmoodinia, Masoumeh Zhian Bagheri (Author)
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