TY - JOUR
T1 - Pain catastrophizing, pain intensity, and dyadic adjustment influence patient and partner depression in metastatic breast cancer
AU - Badr, Hoda
AU - Shen, Megan J.
N1 - Publisher Copyright:
Copyright © 2014 by Lippincott Williams & Wilkins.
PY - 2014
Y1 - 2014
N2 - Objective: Metastatic breast cancer can be challenging for couples given the significant pain and distress caused by the disease and its treatment. Although the use of catastrophizing (eg, ruminating, exaggerating) as a pain coping strategy has been associated with depression in breast cancer patients, little is known about the effects of pain intensity on this association. Moreover, even though social relationships are a fundamental resource for couples coping with cancer, no studies have examined whether the quality of the spousal relationship affects the association between catastrophizing and depression. This study prospectively examined these associations. Methods: Couples (N=191) completed surveys at the start of treatment for metastatic breast cancer (baseline), and 3 and 6 months later. Results: Multilevel models using the couple as the unit of analysis showed patients and partners (ie, spouses or significant others) who had high levels (+1 SD) of dyadic adjustment (DAS-7) experienced fewer depressive symptoms than those who had low levels (-1 SD) of dyadic adjustment (P's<0.01). Moreover, at low levels of dyadic adjustment, when patients engaged in high levels of catastrophizing and had high levels of pain, both patients and partners reported significantly (P=0.002) higher levels of depression than when patients engaged in high levels of catastrophizing but had low levels of pain. Discussion: Findings showed that catastrophizing and pain exacerbate depression in couples experiencing marital distress. Programs that seek to alleviate pain and depressive symptoms in metastatic breast cancer may benefit from targeting both members of the couple, screening for marital distress, and teaching more adaptive pain coping strategies.
AB - Objective: Metastatic breast cancer can be challenging for couples given the significant pain and distress caused by the disease and its treatment. Although the use of catastrophizing (eg, ruminating, exaggerating) as a pain coping strategy has been associated with depression in breast cancer patients, little is known about the effects of pain intensity on this association. Moreover, even though social relationships are a fundamental resource for couples coping with cancer, no studies have examined whether the quality of the spousal relationship affects the association between catastrophizing and depression. This study prospectively examined these associations. Methods: Couples (N=191) completed surveys at the start of treatment for metastatic breast cancer (baseline), and 3 and 6 months later. Results: Multilevel models using the couple as the unit of analysis showed patients and partners (ie, spouses or significant others) who had high levels (+1 SD) of dyadic adjustment (DAS-7) experienced fewer depressive symptoms than those who had low levels (-1 SD) of dyadic adjustment (P's<0.01). Moreover, at low levels of dyadic adjustment, when patients engaged in high levels of catastrophizing and had high levels of pain, both patients and partners reported significantly (P=0.002) higher levels of depression than when patients engaged in high levels of catastrophizing but had low levels of pain. Discussion: Findings showed that catastrophizing and pain exacerbate depression in couples experiencing marital distress. Programs that seek to alleviate pain and depressive symptoms in metastatic breast cancer may benefit from targeting both members of the couple, screening for marital distress, and teaching more adaptive pain coping strategies.
KW - Catastrophizing
KW - Couples
KW - Dyadic adjustment
KW - Metastatic breast cancer
KW - Pain
UR - http://www.scopus.com/inward/record.url?scp=84927785759&partnerID=8YFLogxK
U2 - 10.1097/AJP.0000000000000058
DO - 10.1097/AJP.0000000000000058
M3 - Article
C2 - 24402001
AN - SCOPUS:84927785759
SN - 0749-8047
VL - 30
SP - 923
EP - 933
JO - Clinical Journal of Pain
JF - Clinical Journal of Pain
IS - 11
ER -