Self-discrepancy in chronic low back pain: relation to pain, depression, and psychological distress.

Self-discrepancies occur when patients' evaluations of their actual self differ from their views of who they ideally would like to be (ideal self) or feel they ought to be (ought self), or from patients' perceptions of how significant others wish they could be (ideal-other self) or ought to be (ought-other self). These self-discrepancies may be related to psychological functioning and adjustment to pain. This study sought to: 1) determine the reliability of self-discrepancy assessments in patients; 2) determine whether each of the four types of self-discrepancies (actual self vs. ideal self, actual self vs. ought self, actual self vs. ideal-other self and actual self vs. ought-other self) measure a distinct type of self-discrepancy; and, 3) examine the relationship of self-discrepancies to pain intensity, depression, and psychological distress in 93 chronic low back pain patients. A semi-structured questionnaire assessed self-discrepancies. Standardized measures were used to assess pain intensity, depression, and psychological distress. Results showed that self-discrepancies can be reliably assessed in patients with persistent pain. Furthermore, data analyses showed that patients who had large ought-other self-discrepancies reported more severe pain and higher levels of psychological distress. Patients who had large ideal self-discrepancies reported higher levels of depression and psychological distress. Taken together, these findings suggest that self-discrepancy can be reliably assessed in patients with persistent pain and demonstrate that self-discrepancies are related in meaningful ways to measures of pain, depression, and psychological distress in chronic low back pain patients.