Chronic Pain and the Enterprise of Living: Self-regulatory and Goal Mechanisms

Of the 60 to 80 million Americans who live with one or more pain conditions, a sizeable number appear to be restricted in their ability or willingness to pursue daily goals. The proposed research seeks to investigate in a sample of adults with chronic pain the impact of changes in pain intensity on the daily pursuit of valued life goals pertaining to task achievement and lifestyle change. We contend that a comprehensive, context-sensitive analysis of the daily pain-adjustment relationship requires a careful accounting of pains capacity to derail affect, varied goal pursuit processes (such as planning and self-monitoring), and goal progress. In addition, our research highlights a set of risk and resilience factors that may moderate the relations among pain, affect, goal pursuit processes, and goal progress. Using Random Digit Dialing procedures, we will recruit 150 community-dwelling adults (75 men and 75 women) between the ages of 25 and 65 who, based upon a screening instrument, are experiencing moderate to severe chronic pain. Eligible persons will then be scheduled for a two-hour laboratory session during which we will assess self-regulatory competencies (working memory, inhibition, and task-set switching), pain catastrophizing, state orientation, and self-efficacy for their goals. Also obtained during this session are measures of psychological symptoms, pain medication and alcohol use, and demographic characteristics. Finally, during this session, participants will be trained in the use of Personal Digital Assistants (PDAs). For 21 consecutive days, participants will be interrogated via PDAs about their pain intensity, goal pursuit processes, affect, and goal progress. Our proposed study aims to (a) test a model in which changes in pain influence goal pursuit processes and affect, which, in turn, influence goal progress; and (b) examine whether resilience-related individual difference variables (self-regulatory competence and goal-based self-efficacy beliefs) and vulnerability-related individual difference variables (pain catastrophizing and state orientation) affect the linkages proposed in our model. Because several of our variables represent trainable aspects of motivation, support for our hypothesizes will provide a firm empirical basis for developing interventions designed to enhance patients resilience potential, allowing them to successfully pursue the daily enterprise of living.