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Volume 46 Number 1, 2009
   Pages 43 — 56

Abstract - Relationship between pain characteristics and pain adaptation type in persons with SCI

Eva G . Widerström-Noga, DDS, PhD;1-5* Yenisel Cruz-Almeida, MSPH;1-2,4 Elizabeth R. Felix, PhD;1-2,5 James P. Adcock, MBS1-2

1Department of Veterans Affairs Medical Center, Miami, FL; 2The Miami Project to Cure Paralysis, 3Department of Neurological Surgery, 4Neuroscience Graduate Program, and 5Department of Rehabilitation Medicine, University of Miami Leonard M. Miller School of Medicine, Miami, FL

Abstract — After a spinal cord injury (SCI), people commonly experience several types of persistent pain. Unfortunately, individuals who experience unremitting pain despite various treatments have no choice but to adapt to their pain. Although people may possess different styles of pain adaptation, one can hypothesize that the specific types of pain a person experiences are also important. The present study determined the association between pain characteristics and specific adaptational patterns to pain after SCI. Participants (N = 182) were interviewed regarding pain characteristics and the impact of pain on their psychosocial status. Based on the SCI version of the Multidimensional Pain Inventory (MPI-SCI), they were classified as Dysfunctional, with higher pain severity (PS) and life interference (LI); Interpersonally Supported, with moderately high PS, high social support levels, and less LI; or Adaptive Coper, with lower PS and LI levels. A multinomial logistic regression analysis indicated a robust model fit (chi-square = 63.6, p < 0.0005), predicting MPI-SCI subgroup membership based on a combination of pain intensity (p < 0.0005), extent of pain aggravation (p < 0.01), electric quality of pain (p < 0.01), constancy of pain (p < 0.01), and distribution of pain (p < 0.05). The results of the present study support the biopsychosocial model of pain.

Key words: adaptation, biopsychosocial, chronic pain, Multidimensional Pain Inventory, neuropathic pain, pain aggravation, pain history, psychosocial impact, rehabilitation, spinal cord injury.

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