Associations among pain, pain attitudes, and pain behaviors in patients with metastatic breast cancer

Megan Johnson Shen, William H. Redd, Gary Winkel, Hoda Badr

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Metastatic breast cancer (MBC) patients often experience pain which can trigger pain behaviors, such as distorted ambulation. Psychological variables, such as individuals' attitudes toward pain, play a role in pain intervention. In this study, we used the cognitive-behavioral model of pain to examine the influence of patients' attitudes toward pain (as measured by the survey of pain attitudes or SOPA) on their pain behaviors (as measured by the pain behaviors checklist). Two hundred-one MBC patients completed surveys at treatment initiation and again 3 and 6 months later. Linear Mixed Model with repeated measures analyses showed that SOPA-solicitude, SOPA-emotions, SOPA-cure, SOPA-disability, and SOPA-medication pain attitudes were consistently significantly associated with pain behaviors at each assessment time point. Additionally, the belief that a medical cure for pain exists buffered the positive association between pain severity and pain behaviors. Our findings support and extend the cognitive-behavioral model of pain and suggest that it may be useful to target pain attitudes in pain management interventions for MBC patients.

Original languageEnglish
Pages (from-to)595-606
Number of pages12
JournalJournal of Behavioral Medicine
Issue number4
StatePublished - Aug 2014


  • Cancer
  • Cognitive-behavioral model of pain
  • Pain
  • Pain attitudes
  • Pain behaviors


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