The role of social constraints and catastrophizing in pelvic and urogenital pain.
OBJECTIVE
Pelvic and urogenital pain is complex and highly prevalent in women, and increased attention to psychosocial influences can guide more effective treatments. This study tested the hypothesis that social constraints (the perception that close others inhibit, discourage, or dissuade a person from disclosing one's feelings or talking about one's problems) would be associated with distress, pain, and problems with functioning, beyond the influence of the widely recognized risk factor of pain catastrophizing.


METHODS
A total of 122 women completed psychosocial and pain questionnaires during an initial evaluation at a multidisciplinary urology center. Correlational and multiple regression analyses examined pain catastrophizing and social constraints in association with general distress, general pain severity, urogenital pain, and pain interference with functioning.


RESULTS
In zero-order correlations, pain catastrophizing and social constraints were significantly associated with all pain measures (p < 0.05) and distress. In regressions, both pain catastrophizing and social constraints were simultaneously independent predictors of general distress (β = 0.48 and 0.33, p < 0.001 respectively), general pain severity (β = 0.55 and 0.21, p < 0.001 and 0.01 respectively), and pain interference with functioning (β = 0.65, p < 0.001, and β = 0.16, p < 0.05 respectively), and together explained a moderate portion of the variance in outcome variables. Pain catastrophizing (but not social constraints) also significantly predicted urogenital pain (β = 0.43, p < 0.001).


CONCLUSIONS
Both pain catastrophizing and social constraints are important to the experience of pelvic and urogenital pain, and effective pain treatment should include attention to these psychological and social factors.
Beaumont Hospital, Beaumont Health, Royal Oak, MI, USA. Janice.Tomakowsky@beaumont.edu.|Women's Urology Center - 2 South, Beaumont Hospital, 3601 W. 13 Mile Road, Royal Oak, MI, 48073, USA. Janice.Tomakowsky@beaumont.edu.
Janice
J
Tomakowsky
Wayne State University, Detroit, MI, USA.
Jennifer N
JN
Carty
Wayne State University, Detroit, MI, USA.
Mark A
MA
Lumley
Beaumont Hospital, Beaumont Health, Royal Oak, MI, USA.|Oakland University William Beaumont School of Medicine, Rochester, MI, USA.
Kenneth M
KM
Peters
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D058443:Catastrophization / Q000523:psychology*; D005260:Female; D052776:Female Urogenital Diseases / Q000523:psychology*; D006801:Humans; D008875:Middle Aged; D017699:Pelvic Pain / Q000523:psychology*; D012044:Regression Analysis; D057545:Social Stigma; D013315:Stress, Psychological / Q000523:psychology; D011795:Surveys and Questionnaires; D055815:Young Adult
Catastrophizing; Pelvic/urogenital pain; Psychological; Social constraints