Mental defeat is linked to interference, distress and disability in chronic pain

Mental defeat is a psychological construct that has recently been applied to characterize the experience of chronic pain. Elevated levels of mental defeat have been identified in patients with chronic pain, and while its presence distinguishes treatment seeking from non-treatment seeking individuals, the link between mental defeat and disability in chronic pain is yet to be established. The current study investigated the extent to which mental defeat is associated with pain-related interference, distress and disability. A total of 133 participants completed the Pain Self Perception Scale that assessed mental defeat in relation to pain. Moreover, the participants were asked to complete a set of questionnaires that measured pain interference, distress, disability and other demographic (age, body mass index), clinical (pain intensity) and psychological (catastrophizing, worry, rumination and health anxiety) predictors of disability. Mental defeat was found to be strongly correlated with pain interference, sleep disturbance, anxiety, depression, functional disability and psychosocial disability. These correlations remained significant even when pain intensity and demographic variables were partialled out. Relative to chronic pain patients with lower levels of mental defeat, those with higher levels of mental defeat reported greater degree of pain interference, distress and disability. In a series of regression analyses, mental defeat emerged as the strongest predictor of pain interference, depression and psychosocial disability, whereas catastrophizing was the best predictor of sleep interference, anxiety and functional disability. These findings suggest that mental defeat may be an important mediator of distress and disability in chronic pain. Theoretical and clinical implications are discussed.