title: Mental defeat predicts distress and disability in Hong Kong Chinese with chronic pain.
abstract: OBJECTIVE
  The concept of mental defeat (MD) has been applied to describe the deeper impact of pain on the person's sense of self. It describes an intense psychological reaction to pain, whereby people feel that pain has taken away their autonomy and identity. Although MD has been found to characterize Western individuals who are most distressed and disabled by CP, it is debatable whether the concept can be generalized to the experience of CP patients in other cultures. The present study examined whether MD contributed to the prediction of distress and disability among Hong Kong (HK) Chinese reporting CP.
  
  
  METHODS
  Using questionnaires, the present study assessed MD, pain, distress, and disability in a sample of HK Chinese, comprising CP patients seeking specialist treatment and community volunteers with chronic or acute pain but not seeking specialist treatment.
  
  
  RESULTS
  MD was found to be elevated in CP patients seeking specialist treatment but not in nontreatment-seeking volunteers with pain of comparable duration and severity. Hierarchical regression indicated that MD was a significant predictor of functioning and distress, over and above the effects of pain severity and other potential demographic confounds.
  
  
  CONCLUSIONS
  These findings provide further evidence that MD is a factor that differentiates treatment-seeking from nontreatment-seeking individuals with CP. They also highlight the potential value of applying this psychological concept to the understanding and treatment of CP in HK Chinese.
authors.affiliation: Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Staffordshire. n.tang@warwick.ac.uk
authors.forename: Nicole K Y
authors.initials: NK
authors.lastname: Tang
authors.forename: Siu-Hong
authors.initials: SH
authors.lastname: Shum
authors.forename: Patrick W L
authors.initials: PW
authors.lastname: Leung
authors.forename: Phoon-Ping
authors.initials: PP
authors.lastname: Chen
authors.forename: Paul M
authors.initials: PM
authors.lastname: Salkovskis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044466:Asian People; D016009:Chi-Square Distribution; D059350:Chronic Pain / Q000453:epidemiology / Q000523:psychology*; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D006723:Hong Kong; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D010147:Pain Measurement; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D057566:Self Report; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D055815:Young Adult