The high prevalence of depression in chronic pain patient samples calls for the identification of important modifiable targets of intervention in multidisciplinary pain treatment centers. Based on previous research in the marital and chronic pain fields, the proposed study will examine the role of marital functioning as one such factor in the co-morbidity of chronic pain and depression. Two groups of chronic pain outpatients and their spouses at an urban multidisciplinary pain evaluation and treatment center will be recruited for this study. One group will consist of fifty married couples in which one spouse is a patient with a current diagnosis of Major Depression and the other group will consist of 50 married couples in which one spouse is a patient without a current diagnosis of Major Depression. All patient participants will receive a standardized diagnostic interview for Major Depression. Including this interview in the proposed study is an improvement over previous studies that have often relied on chart reviews or unstandardized diagnostic criteria to diagnose depression. In addition, patients will complete a battery of questionnaires tapping marital discord, perceived spouse responses to their pain, overall pain adjustment, and self report depressive symptoms. Spouse participants will complete similar questionnaires. Group comparisons are expected to reveal that the depressed group of patients experience more marital discord and negative marital communication than the non-depressed group. It is also expected that the depressed group will report a poorer overall pain adjustment. Overall pain adjustments also expected to mediate the association between marital functioning, and depression. Furthermore, patients' diagnostic status and overall pain adjustment are expected to be related to their spouses' marital discord and depressive symptoms, thus suggesting that the chronic pain experience not only affects the patient but the spouse as well. The results of this study are expected to have implications for marital research and clinical practice in chronic pain settings.
