DEPRESSION, COGNITIVE DISTORTION AND SELF-EFFICACY IN CHRONIC-PAIN PATIENTS

The purpose of this study was to investigate cognitive distortion, mood change, treatment expectancies and treatment choice in depressed and nondepressed chronic-pain outpatients, and to see whether a persuasive message could influence expectancies about treatment. Thirty patients referred for psychological assessment participated in the study. The Beck Depression Inventory (BDI), the Differential Personality Inventory (DPI), and the MMPI were used to assess depression. Mood change was measured by three administrations of the Profile of Mood States. Bandura's definitions of self-efficacy and outcome expectancy were used to design a measure of expectancies about pain-management treatment. All subjects were provided with assessment feedback having an equal number of positive and negative statements. Measures of cognitive distortion were derived from free recall and from estimation of positiveness of feedback. Half of the subjects were randomly assigned to hear a brief persuasive self-efficacy message prior to feedback. The persuasive message was not effective in changing expectancies. Depressed subjects had lower expectancies regarding treatment and were more negatively biased in the estimation (but not free recall) of feedback. The DPI was the best predictor of expectancies and bias, followed by the BDI. Subjects' moods became more positive over the course of the assessment. Those with positive expectancies were more likely to accept the pain management program.