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Spousal Responses Are Differentially Associated With Clinical Variables in Women and Men With Chronic Pain

Fillingim, Roger B. PhD*; Doleys, Daniel M. PhD; Edwards, Robert R. MA, MSPH; Lowery, Daniel MA

The Clinical Journal of Pain: July 2003 - Volume 19 - Issue 4 - p 217–224

Objectives: Spousal responses have been related to clinical variables in patients with chronic pain. For example, solicitous responses from spouses have been associated with greater levels of pain and disability among patients with chronic pain. However, few investigators have determined whether spousal solicitousness produces different effects in women versus men with chronic pain. The present study examined pain reports, medication use, psychosocial factors, functional measures, and pain tolerance in patients with chronic pain.

Methods: Subjects included 114 female and 213 male chronic pain patients, who described their spouses as either high or low in solicitousness on the Multidimensional Pain Inventory. Measures of pain severity, affective distress, physical function, medication use, and pain tolerance were examined in women and men with high versus low scores on spousal solicitousness.

Results: Among males only, high spousal solicitousness was associated with greater numerical ratings of pain and greater self-reported disability compared with patients with low solicitous spouses. Among females only, the high spousal solicitousness patients showed lower pain tolerance, greater pain-related interference, poorer performance on functional tasks (eg, timed walking, lifting, and carrying tasks), and greater use of opioid medications. In both women and men, spousal solicitousness was associated with higher scores on the MPI pain severity scale.

Discussion: These results extend previous findings demonstrating a relationship between spousal responses and patients' adjustment to pain; however, the pattern of these effects appears to be moderated by the sex of the patient. Implications for assessment and treatment of chronic pain are discussed.

*University of Florida College of Dentistry and North Florida South Georgia VA Health System, Gainesville, Florida; †Pain and Rehabilitation Institute, Birmingham, Alabama; and ‡University of Alabama at Birmingham, Birmingham, Alabama

Received June 17, 2002; accepted June 17, 2002.

Supported by NIH/NINDS grant NS41670. This material is also the result of work supported with resources and the use of facilities at the Malcom Randall VA Medical Center, Gainesville, FL.

Corresponding author: Roger B. Fillingim, PhD, University of Florida College of Dentistry Public Health Services and Research, 1600 SW Archer Road, Room D8-44A, P.O. Box 100404, Gainesville, FL 32610. E-mail:

© 2003 Lippincott Williams & Wilkins, Inc.