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J Pain. 2019 Apr 4. pii: S1526-5900(18)30596-0. doi: 10.1016/j.jpain.2019.04.001. [Epub ahead of print]

Spouse and Patient Beliefs and Perceptions about Chronic Pain: Effects on Couple Interactions and Patient Pain Behavior.

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Rush University Medical Center. Electronic address:
University of La Verne.
University of Notre Dame.
Duke University Medical Center.
Rush University Medical Center.


Patients' beliefs and perceptions about the causes and meaning of their chronic pain are related to their psychosocial functioning. Beliefs and perceptions about chronic pain held by spouses may also be related to patient functioning. We used a laboratory procedure to evaluate whether spouse beliefs about and perceptions of chronic pain were related to spouse negative responses toward chronic low back pain patients during a conflictual discussion, and to their attributions about patient pain behavior during a subsequent pain-induction task. Patients (n=71) and their spouses (n=71) participated in a 10-minute discussion followed by the patient undergoing a 10-minute structured pain behavior task (SPBT). Findings were: a) spouse perceptions that patient's pain was a mystery were significantly related to greater patient perceived spouse critical/invalidating responses toward the patient during the discussion; b) spouse perceptions that patient's pain was a mystery were related to internal and negative attributions spouses made while observing patients display pain behaviors during the SPBT. Inasmuch as both spouse critical/invalidating speech toward patients and negative attributions regarding the cause of patient behavior are related to poor patient functioning, spouse uncertainty about the source and potential legitimacy of their partner's pain may play crucial roles in affecting patient well-being. Perspective: Spouse beliefs about and perceptions of patient chronic pain were related to spouse behavior toward patients during a discussion and to attributions explaining patient pain during physical activity. If spouse confusion and doubt about patient pain is related to negative behavior and attributions, then modifying these perceptions may be a fundamental intervention target.


Chronic low back pain; couples; critical/invalidating responses; negative attributions; pain behaviors

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