The effects of perceived versus enacted social support on the discriminative cue function of spouses for pain behaviors.

Abstract

This study examined the effects of spouse social support on patient displays of pain behaviors. A standardized behavioral observation method was used to record pain behaviors in 110 chronic pain patients while the spouse was present and while the spouse was absent. Patients and their spouses also completed paper and pencil measures of spouse-provided social support as well as a demographic questionnaire. Results indicated that pain behaviors varied as a function of spouse presence and the type, or dimension, of support considered. Patients reporting higher levels of enacted support displayed a greater number of pain behaviors irrespective of spouse presence, consistent with the operant theory. When a measure of perceived support was used, the pain behaviors displayed differed, depending upon the level of support and spouse presence. Results are consistent with support-seeking and cognitive-behavioral models of the effects of social support on outcome. We discuss our findings within the context of a multidimensional model of support and pain and we caution against strict application of the operant model in treatment programs. Additional research is warranted to better understand the impact of support on the rehabilitation of patients with chronic pain.