Performance and nonperformance strategies for coping with acute pain: The role of perceived self-efficacy,expected outcomes,and attention

We compared several strategies for coping with acute induced pain, and examined self-efficacy perceptions, outcome expectations, and attention to pain as cognitive mediators of pain tolerance. The coping strategy of central interest was an overt performance task selected to be highly distracting. Sixty-four subjects were randomly assigned to either overt performance distraction, verbal—imaginal distraction, relaxation, or no strategy. Before and after strategy training, subjects completed measures of cold-pressor pain tolerance, subjective pain, perceived self-efficacy, anticipated painful outcomes, and attention to pain. The performance strategy enhanced pain tolerance much more than did the verbal—imaginal or relaxation strategies. Self-efficacy perceptions accurately predicted individual differences in tolerance even when anticipated pain, subjective pain, or attention to pain were held constant. With self-efficacy held constant, attention predicted tolerance but anticipated pain did not. The findings suggest that self-efficacy perceptions and attention deployment both influence individuals' pain-coping ability.This research was supported by United States Public Health Service grants 5R29MH42385 and S07RR07173.