The Influence of Perceived Control and Helplessness on Chronic Pain
Chronic pain , Helplessness , Perceived control
The present dissertation includes three empirical studies (Chapters 2-4) examining the relationships between perceived control constructs and chronic pain related outcomes. Study One (Chapter 2) examined whether low self-efficacy and heightened perceived stress were associated with dyspareunia at two timepoints during the COVID-19 pandemic among sixty-two participants (31 with and 31 without dyspareunia) who completed a longitudinal online survey. This survey demonstrated that during the COVID-19 pandemic, individuals with dyspareunia experienced more stress and less general-self-efficacy across the time points. In addition, this study did not find that decreases in perceived stress were associated with decreases in sexual distress, suggesting other factors may be contributing to, and maintaining, sexual distress. Study Two (Chapter 3) aimed to further our understanding of pain characteristics and the role of control cognitions and sexual flexibility in those with anodyspareunia (recurrent or persistent anal pain during receptive anal penetration) in an online survey. Results indicated that as participants reported more cognitions related to a loss of control, pain symptoms and sexual distress worsened, as predicted. Although flexibility did not significantly moderate the relationships between control cognitions and pain or distress, greater sexual flexibility was significantly associated with less sexual distress. In a sample of 350 individuals on MTurk with chronic pain, the Chronic Disease Helplessness Scale (CDHS), a measure of the motivational/motor, cognitive, and emotional deficits that have been previously observed to occur in people who experience learned helplessness, was developed and validated (Study Three, Chapter 4). The CDHS total score was significantly associated with greater pain intensity and interference, lower perceived pain control, and lower general self-efficacy. Individuals with diabetes displayed significantly lower CDHS scores compared to individuals with chronic pain, demonstrating discriminant validity. The results of these studies have yielded a psychometrically sound and conceptually valid measure of helplessness for future assessments of control constructs and further illuminated the influence of control constructs that may uniquely influence individuals who live with pain.