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Expression of Pain Behaviors and Perceived Partner Responses in Individuals With Chronic Pain

The Mediating Role of Partner Burden and Relationship Quality

Mohammadi, Somayyeh, PhD*,†; Chambers, Christine T., PhD*,†,‡; Rosen, Natalie O., PhD‡,§

doi: 10.1097/AJP.0000000000000610
Original Articles

Objective: Expressions of pain by individuals with chronic pain may encourage solicitous and distracting responses from some partners and punishing responses from others. Partners’ responses can impact the well-being of individuals with chronic pain. Yet information about factors that can explain the link between expression of pain behaviors and different partners’ responses is scarce. The objective of this study was to investigate the role of perceived partner burden and relationship quality in the link between expressions of pain behaviors and perceived partner responses (ie, solicitous, distracting, and punishing responses).

Materials and Methods: Participants were 158 individuals with chronic pain (ie, experiencing pain on most days for at least 6 months before participating in the study) who completed questionnaires about pain behaviors, as well as perceptions of partner burden, relationship quality, and partners’ solicitous, distracting, and punishing responses. The link between expressing pain and each type of partner response was investigated by serial mediation analysis. Partner burden and relationship quality were entered into all analyses as the first and the second mediator, respectively.

Results: Expressing more pain was related to higher levels of perceived partner burden, which in turn, was associated with poorer relationship quality. Poorer relationship quality was associated with reporting fewer solicitous and distracting partner responses and more punishing responses.

Discussion: Enhanced partner burden and reduced relationship quality may be one pathway through which pain behaviors relate to partner responses.

*Centre for Pediatric Pain Research, IWK Health Centre

Department of Pediatrics

Department of Psychology and Neuroscience

§Department of Obstetrics and Gynecology, Dalhousie University, Halifax, Canada

S.M. was supported by a John J. Bonica Trainee Fellowship awarded from the International Association for the Study of Pain (IASP), Washington, DC and a Scotia Support Grant awarded to C.T.C. from the Nova Scotia Health Research Foundation (NSRHF), Halifax, Nova Scotia, Canada during the completion of this research. This research was supported by an operating grant awarded to N.O.R. from the Canadian Institutes of Health Research (CIHR; FRN#: 135870) Ottawa, ON, Canada and a New Investigator Award from the CIHR. C.T.C. is supported by a Canada Research Chair, Ottawa, ON, Canada. The authors declare no conflict of interest.

Reprints: Natalie O. Rosen, PhD, Departments of Psychology and Neuroscience and Obstetrics and Gynaecology, Dalhousie University, 1355 Oxford Street, P.O. Box 15000, Halifax, Nova Scotia, Canada, B3H 4R2 (e-mail:

Received November 5, 2017

Received in revised form February 3, 2018

Accepted March 9, 2018

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