Coping with chronic pain: flexible goal adjustment as an interactive buffer against pain-related distress.

In the present study, Brandtstädter's (1992) distinction between assimilation and accommodation as two fundamental means of coping is applied to the field of chronic pain. Assimilative coping involves active attempts (e.g. instrumental activities, self-corrective actions, compensatory measures) to alter unsatisfactory life circumstances and situational constraints in accordance with personal preferences. Conversely, accommodative coping (e.g. downgrading of aspirations, positive reappraisal, self-enhancing comparisons) is directed towards a revision of self-evaluative and personal goal standards in accordance with perceived deficits and losses. Our research is based on the assumption that chronic pain can be described as a major source of threat or impediment to personal goals. When goals are no longer perceived to be attainable through active-assimilative coping efforts, accommodative coping should become increasingly important in dealing with chronic pain. In a study of 120 chronic pain patients, dispositional differences in assimilative (tenacious goal pursuit) and accommodative coping tendencies (flexible goal adjustment), as well as measures of pain-related coping and adjustment (depression, pain-related disability, pain intensity) were assessed. The results suggest that accommodative coping functions as a protective resource by preventing global losses in the psychological functioning of chronic pain patients and maintaining a positive life perspective. Most important, the ability to flexibly adjust personal goals attenuated the negative impact of the pain experience (pain intensity, pain-related disability) on psychological well-being (depression). Furthermore, pain-related coping strategies led to a reduction of disability only when accompanied by a high degree of flexible goal adjustment. The theoretical and clinical implications of these findings for coping research and the treatment of chronic pain patients are discussed.