title: Catastrophizing and pain-contingent rest predict patient adjustment in men with chronic prostatitis/chronic pelvic pain syndrome.
abstract: Cognitive/behavioral and environmental variables are significant predictors of patient adjustment in chronic pain. Using a biopsychosocial template and selecting several pain-relevant constructs from physical, cognitive/behavioral, and environmental predictors, outcomes of pain and disability in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) were explored. Men (n = 253) from a North American multi-institutional NIH-funded Chronic Prostatitis Cohort Study in 6 US and 1 Canadian centers participated in a survey examining pain and disability. Measures included demographics, urinary symptoms, depression, pain, disability, catastrophizing, control over pain, pain-contingent rest, social support, and solicitous responses from a significant other. Regressions showed that urinary symptoms (beta = .20), depression (beta = .24), and helplessness catastrophizing (beta = .29) predicted overall pain. Further, affective pain was predicted by depression (beta = .39) and helplessness catastrophizing (beta = .44), whereas sensory pain was predicted by urinary symptoms (beta = .25) and helplessness catastrophizing (beta = .37). With regard to disability, urinary symptoms (beta = .17), pain (beta = .21), and pain-contingent rest (beta = .33) were the predictors. These results suggest cognitive/behavioral variables (ie, catastrophizing, pain-contingent rest) may have significant impact on patient adjustment in CP/CPPS. Findings support the need for greater research of such pain-related variables in CP/CPPS.
  
  
  CONCLUSIONS
  This article explores predictors of patient adjustment in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Cognitive/behavioral variables of catastrophizing and pain-contingent rest respectively predicted greater pain and disability. Catastrophic helplessness was a prominent pain predictor. These findings inform clinicians and researchers on several new variables in CP/CPPS outcomes and suggest future research.
authors.affiliation: Department of Psychology, Anesthesiology and Urology, Queen's University, Kingston, Ontario, Canada. dean.tripp@queensu.ca
authors.forename: Dean A
authors.initials: DA
authors.lastname: Tripp
authors.forename: J Curtis
authors.initials: JC
authors.lastname: Nickel
authors.forename: Yanlin
authors.initials: Y
authors.lastname: Wang
authors.forename: Mark S
authors.initials: MS
authors.lastname: Litwin
authors.forename: Mary
authors.initials: M
authors.lastname: McNaughton-Collins
authors.forename: J Richard
authors.initials: JR
authors.lastname: Landis
authors.forename: Richard B
authors.initials: RB
authors.lastname: Alexander
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Schaeffer
authors.forename: Michael P
authors.initials: MP
authors.lastname: O'Leary
authors.forename: Michel A
authors.initials: MA
authors.lastname: Pontari
authors.forename: Jackson E
authors.initials: JE
authors.lastname: Fowler
authors.forename: Leroy M
authors.initials: LM
authors.lastname: Nyberg
authors.forename: John W
authors.initials: JW
authors.lastname: Kusek
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000786:Anger; D002170:Canada; D002908:Chronic Disease / Q000523:psychology; D015331:Cohort Studies; D003866:Depressive Disorder / Q000209:etiology / Q000523:psychology*; D004185:Disability Evaluation; D006801:Humans; D008297:Male; D008875:Middle Aged; D017699:Pelvic Pain / Q000150:complications / Q000503:physiopathology / Q000523:psychology*; D010817:Physician-Patient Relations; D011472:Prostatitis / Q000150:complications / Q000503:physiopathology / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D012146:Rest / Q000523:psychology*; D012944:Social Support; D013315:Stress, Psychological / Q000209:etiology / Q000503:physiopathology / Q000523:psychology; D011795:Surveys and Questionnaires; D014481:United States; D014555:Urination Disorders / Q000150:complications / Q000503:physiopathology / Q000523:psychology