title: Daily verbal and nonverbal expression of osteoarthritis pain and spouse responses.
abstract: The current study applied a model of pain communication to examine the distinction between verbal and nonverbal pain expression in their prediction of punishing, empathic, and solicitous spouse responses to patient pain. It was hypothesized that on days when patients engaged in more nonverbal expression, spouses would respond more positively (ie, with less punishing and more solicitous and empathic behavior). The same pattern was predicted for verbal expression. In addition, it was expected that associations between patient nonverbal pain expression and positive spouse responses would be strengthened, and that the association with punishing responses would be weakened, on days when levels of verbal pain expression were higher than usual, regardless of daily pain severity. In a 22-day diary study, 144 individuals with knee osteoarthritis and their spouses completed daily measures of pain expression, spouse responses, health, and affect. The predicted positive main effect of nonverbal expression on empathic and solicitous responses was supported by the data, as was the positive main effect for verbal pain expression. Results from moderation analyses partially supported our hypothesis in that patients' nonverbal pain expression was even more strongly related to empathic and solicitous spouse responses on days of high verbal pain expression, and patients were buffered from spouse punishing responses on days when both nonverbal and verbal expression were high. These findings suggest that pain expression in both verbal and nonverbal modes of communication is important for positive and negative spousal responses.
authors.affiliation: Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA Department of Psychology, Kent State University, Kent, OH, USA Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Wilson
authors.forename: Lynn M
authors.initials: LM
authors.lastname: Martire
authors.forename: Francis J
authors.initials: FJ
authors.lastname: Keefe
authors.forename: Jacqueline A
authors.initials: JA
authors.lastname: Mogle
authors.forename: Mary Ann Parris
authors.initials: MAP
authors.lastname: Stephens
authors.forename: Richard
authors.initials: R
authors.lastname: Schulz
mesh_terms: D000368:Aged; D034201:Computers, Handheld / Q000706:statistics & numerical data; D004645:Empathy / Q000502:physiology; D005149:Facial Expression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D010146:Pain / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D010147:Pain Measurement / Q000379:methods / Q000523:psychology*; D018454:Spouses; D014705:Verbal Behavior / Q000502:physiology
keywords: Daily; Osteoarthritis; Pain expression; Spouse responses