Chronic pain is one of the most intractable and expensive problems in medicine. Many pain experts contend that medical treatments have a poor success rate because chronic pain is a multi-faceted problem with biological, psychological and social aspects. The purposes of the proposed study are to first, examine emotional distress in spouses of chronic pain patients, second, determine the frequency and extent of marital discord for chronic pain patients and their spouses and third, determine the association between spouse distress and marital discord and patient response to a behavioral rehabilitation program. Additionally, the relationship between spouses' and patients' levels of emotional distress and degree of marital discord will be examined. The planned methodology involves a retrospective chart review of 79 spouses and patients who completed the Minnesota Multiphasic Personality Inventory (MMPI), the Locke-Wallace Marital adjustment Scale and the Areas of Change Questionnaire. Also, a subset of 40 patients who participated in a behavioral pain rehabilitation program will complete the Sickness Impact Profile (SIP) and Pain Intensity Ratings at pre- and post-treatment. Univariate descriptive statistics, X2 frequency analysis and correlation analysis will be employed to document the prevalence of emotional distress and marital discord and determine the relationship fo emotional distress to marital discord in this sample. Multiple Regression/correlation analysis will be performed in order to determine the association between spouse distress and marital discord and treatment outcome. The results from this study will serve to further define the parameters of emotional and marital factors in the maintenance and modification of chronic pain. The study will also provide clinically important information that will improve our understanding of the relationship between chronic illness and marital discord and lead toward the development of more effective treatment strategies for chronic pain patients and their families.
