Marital satisfaction and pain severity mediate the association between negative spouse responses to pain and depressive symptoms in a chronic pain patient sample

Objective. The current study investigated marital satisfaction and pain severity as mediators of the relationship between spouse responses to pain and depressive symptoms. The study also investigated possible gender differences in these relationships. Patients and Setting. This study included 165 married patients with chronic pain who were evaluated and treated at a comprehensive pain and rehabilitation center. Design. Patients completed several questionnaires, including the West Haven-Yale Multidimensional Pain Inventory, Beck Depression Inventory, and the Marital Adjustment Test. Results. Analyses were conducted separately for male and female patients. Correlational analyses revealed several gender differences in the associations among marital functioning, pain severity, and depressive symptoms. In addition, path analyses suggested that more frequent negative spouse responses to pain were associated with increased pain severity and decreased marital satisfaction, which were linked to increased depressive symptoms. Similar results were found for male and female chronic pain patients in terms of multivariate relationships. Conclusions. The current results suggest that marital therapy aimed at improving communication and coping skills may be an appropriate treatment for depression and pain in married chronic pain patients, regardless of sex.