The Role of Emotion Regulation in the Relationship Between Pain, Catastrophizing, Depression, and Disability in Women with Interstitial Cystitis/Bladder Pain Syndrome

Abstract

Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) is a chronic pelvic pain condition with an unknown etiology and biomedical treatment outcomes for IC/BPS are poor. Catastrophizing and depression have been implicated in negative outcomes in patients with chronic pelvic pain (e.g., diminished mental and/or physical quality of life, greater pain and disability). The literature has suggested that pain, catastrophizing, depression, and disability are associated variables, but investigations on how they are associated remain to be conducted. Linton and Bergbom (2011) have created a theoretical pathway model that can be used to connect pain, catastrophizing, depression, and disability through an emotion regulation framework. Using the biopsychosocial model, and the Örebro Model of Emotion Regulation for Pain as theoretical frameworks, the primary aim of this study is to examine whether both catastrophizing and difficulties in emotion regulation mediate the relationship between pain and depression/pain-related disability in an IC/BPS sample with serial mediation models. A total of 225 women diagnosed with IC/BPS recruited from tertiary care clinics in Canada and the U.S. completed questionnaires regarding demographics, pain, catastrophizing, emotion regulation, depression, and pain related disability across twelve months. Catastrophizing and difficulties in emotion regulation were found to mediate the relationship between pain and depression/pain-related disability. The longitudinal models were not significant, which might suggest that these psychological actions are stable over time. The relationships between pain, catastrophizing, difficulties in emotion regulation, depression, and disability are discussed in the framework of chronic pain literature, as well as clinical implications, limitations, and areas for future research.