title: Forgiveness and chronic low back pain: a preliminary study examining the relationship of forgiveness to pain, anger, and psychological distress.
abstract: Clinical observations suggest that many patients with chronic pain have difficulty forgiving persons they perceive as having unjustly offended them in some way. By using a sample of 61 patients with chronic low back pain, this study sought to determine the reliability and variability of forgiveness assessments in patients and to examine the relationship of forgiveness to pain, anger, and psychological distress. Standardized measures were used to assess patients' current levels of forgiveness, forgiveness self-efficacy, pain, anger, and psychological distress. Results showed that forgiveness-related constructs can be reliably assessed in patients with persistent pain, and that patients vary considerably along dimensions of forgiveness. Furthermore, correlational analyses showed that patients who had higher scores on forgiveness-related variables reported lower levels of pain, anger, and psychological distress. Additional analyses indicated that state anger largely mediated the association between forgiveness and psychological distress, as well as some of the associations between forgiveness and pain. These findings indicate that forgiveness can be reliably assessed in patients with persistent pain, and that a relationship appears to exist between forgiveness and important aspects of living with persistent pain.
  
  
  CONCLUSIONS
  This preliminary study suggests there is a relationship between forgiveness and pain, anger, and psychological distress in patients with chronic low back pain. Patients who report an inability to forgive others might be experiencing higher pain and psychological distress that are mediated by relatively higher levels of state anger.
authors.affiliation: Pain Prevention & Treatment Research Program, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27708, USA. jim.carson@duke.edu
authors.forename: James W
authors.initials: JW
authors.lastname: Carson
authors.forename: Francis J
authors.initials: FJ
authors.lastname: Keefe
authors.forename: Veeraindar
authors.initials: V
authors.lastname: Goli
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Fras
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Lynch
authors.forename: Steven R
authors.initials: SR
authors.lastname: Thorp
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Buechler
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D000786:Anger; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D017116:Low Back Pain / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D020377:Self Efficacy