Jamani, Nicole; (2001) Adjustment to chronic pain: The relative importance of, and relationship between, early childhood experience, early maladaptive schemas and coping style. Doctoral thesis (D.Clin.Psy), UCL (University College London).

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Abstract

The current study aimed to investigate the link between predisposing psychological factors and adjustment to chronic pain. Based upon Young's (1990, 1994) cognitive conceptualisation of early maladaptive schemas and previous empirical research, the primary aim of the study was to examine the potential impact of early maladaptive schemas (core beliefs) and perceived quality of parenting during childhood on adjustment to chronic pain. It was anticipated that poorer perceived quality of parenting and higher ratings of early maladaptive schemas would lead to poorer adjustment to chronic pain. It was hypothesised that early maladaptive schemas would act as a mediator between perceived quality of parenting and adjustment to chronic pain. Additionally, it was hypothesised that coping style would predict adjustment to chronic pain independent of early maladaptive schemas. The study utilised a retrospective cross-sectional design. 40 people with a chronic pain diagnosis were recruited along with 32 people with type-I diabetes (the comparison group). All participants completed a range of standardised self-report questionnaires relating to present physical and psychological impairment, perceived quality of parenting during childhood, early maladaptive schemas, and coping style. The data was analysed using t-tests and multiple regression analysis. Findings indicated that both samples showed moderate physical and psychological levels of impairment. Both samples were found to have experienced relatively positive parenting and had relatively low early maladaptive schema scores. The self- sacrifice and unrelenting standards schemas were found to be the most pertinent for both groups. Perceived quality of parenting was found to predict several higher-order schema domains in both clinical samples. Findings showed that early maladaptive schemas predicted adjustment in the chronic pain sample but not in the comparison group. Perceived quality of parenting was not found to predict adjustment in either sample, and therefore a mediational model between perceived quality of parenting, early maladaptive schemas and adjustment was not established. A further finding was that coping style did not predict adjustment independent of early maladaptive schemas in the chronic pain group, but did so in the comparison group. These results highlight the potential role of early maladaptive schemas in adjustment to chronic pain, and a number of clinical and theoretical implications are discussed.

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