title: Coping strategies as predictors of pain and disability in older people in primary care: a longitudinal study.
abstract: BACKGROUND
  Musculoskeletal pain in older adults is common. It is hypothesised that coping strategies may be predictive of pain intensity and pain-related disability at six months after initial consultation in primary care.
  
  
  METHODS
  Consecutive patients aged fifty years and over with musculoskeletal pain were recruited from general practice consultations. A self-completion postal questionnaire was sent to participants at baseline, with a follow-up questionnaire mailed six months later. Coping was assessed using The Coping Strategies Questionnaire (CSQ), pain and pain related disability were measured using domains of The Chronic Pain Grade (CPG). Associations between coping strategies and pain and disability were investigated using ordinary least squares regression.
  
  
  RESULTS
  Crude analysis revealed catastrophizing at baseline was predictive of higher levels of pain and disability at baseline and was predictive of disability at six months. The association between catastrophizing and pain and pain related disability at follow-up was not significant once adjustments were made for age, gender and baseline anxiety and depression. Increasing behaviour and self-statements were not associated with pain or disability at follow-up. Ignoring pain sensations was predictive of increased pain at follow-up.
  
  
  CONCLUSIONS
  This study highlights the relationship between catastrophizing in predicting pain and pain related disability may be mediated by other factors such as anxiety and depression. Ignoring sensations in those with high levels of pain may be maladaptive in older people with musculoskeletal pain.
authors.affiliation: Primary Care Sciences, Keele University, Staffordshire, ST5 5BG, UK. kaybenyon@doctors.org.uk
authors.forename: Kay
authors.initials: K
authors.lastname: Benyon
authors.forename: Sara
authors.initials: S
authors.lastname: Muller
authors.forename: Susan
authors.initials: S
authors.lastname: Hill
authors.forename: Christian
authors.initials: C
authors.lastname: Mallen
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001007:Anxiety; D059350:Chronic Pain / Q000523:psychology; D003863:Depression; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000523:psychology*; D010147:Pain Measurement; D011320:Primary Health Care; D012044:Regression Analysis; D012923:Social Class