title: Is self-efficacy and catastrophizing in pain-related disability mediated by control over pain and ability to decrease pain in whiplash-associated disorders?
abstract: Pain perception is influenced by several cognitive and behavioral factors of which some identified as mediators are important in pain management. We studied the mediating role of control over pain and ability to decrease pain in relation to functional self-efficacy, catastrophizing, and pain-related disability in patients with Whiplash-Associated Disorders, (WAD). Further, if the possible mediating impact differs over time from acute to three and 12 months after an accident, cross-sectional and prospective design was used, and 123 patients with WAD were included. Regression analyses were conducted to examine the mediating effect. The results showed that control over pain and ability to decrease pain were not mediators between self-efficacy, catastrophizing, and disability. Self-efficacy had a larger direct effect on pain-related disability compared to catastrophizing. Thus, healthcare staff should give priority to increase patients' self-efficacy, decrease catastrophic thinking, and have least focus on control over pain or ability to decrease pain.
authors.affiliation: a Department of Physiotherapy , Mälardalen University , Västerås , Sweden.
authors.forename: Anne
authors.identifier: http://orcid.org/0000-0002-4537-030X
authors.initials: A
authors.lastname: Söderlund
authors.affiliation: a Department of Physiotherapy , Mälardalen University , Västerås , Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Sandborgh
authors.affiliation: a Department of Physiotherapy , Mälardalen University , Västerås , Sweden.
authors.forename: Ann-Christin
authors.initials: AC
authors.lastname: Johansson
mesh_terms: D000223:Adaptation, Psychological; D058443:Catastrophization; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D006801:Humans; D019547:Neck Pain / Q000175:diagnosis / Q000523:psychology*; D010147:Pain Measurement; D058748:Pain Perception; D011379:Prognosis; D011446:Prospective Studies; D020377:Self Efficacy; D013997:Time Factors; D014911:Whiplash Injuries / Q000175:diagnosis / Q000523:psychology*
keywords: Ability to decrease pain; Whiplash-Associated Disorders; catastrophizing; control over pain; self-efficacy