The Mechanistic Role of Pain Appraisals and Behavioural Coping Strategies between Pain and Quality of Life in Chronic Prostatitis/ Chronic Pelvic Pain Syndrome (CP/CPPS)

Abstract

Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is a prevalent, refractory pelvic pain condition characterized by pain in the pelvic area and urinary frequency, largely unresponsive to medical interventions. This study used multiple mediations to test the associations of validated pain appraisal and behavioural coping strategies between pain and quality of life. Patients (N = 175) were recruited from tertiary care urology clinics and completed questionnaires. Exploratory factor analyses were conducted on four individual measures (Chronic Pain Coping Inventory, Survey of Pain Attitudes – Control subscale, Center for Epidemiologic Studies Depression Scale, and Pain Catastrophizing Scale), then on the empirically derived factors that produced four factors to be used in regression and multiple mediation models: illness-focused behavioural coping, catastrophizing, wellness-focused behavioural coping, and depression. In regressions, CP/CPPS patient symptoms (p < .01), illness-focused behavioural coping (p < .01) and wellness-focused behavioural coping (p < .05) predicted physical quality of life, while catastrophizing (p < .01) and illness-focused behavioural coping (p < .05) predicted mental quality of life. Mediation analyses showed that illness-focused behavioural coping strategies partially mediated the relationship between pain and physical quality of life, whereas catastrophizing and illness-focused behavioural coping strategies both fully mediated the relationship between pain and mental quality of life. These results identify catastrophizing and illness-focused coping as key psychosocial targets for interventions for patient quality of life in CP/CPPS.