Comparison of Emotional Schemas and Suicidal Ideation in Patients with Severe and Mild Chronic Pain, With and Without Pain Acceptance
Keywords:
Chronic pain, Pain intensity, Pain acceptance, Emotional schemas, Suicidal ideationAbstract
Objective: This study aimed to compare emotional schemas and suicidal ideation among patients with chronic musculoskeletal pain based on pain intensity and pain acceptance levels.
Methodology: A causal-comparative (ex post facto) design was used. The statistical population consisted of patients with chronic pain visiting Rasoul Akram Hospital Pain Clinic in Tehran during spring 2024. A total of 160 participants were selected via purposive sampling and classified into four groups of 40 based on pain intensity (severe/mild) and pain acceptance (with/without acceptance). Data collection tools included the Chronic Pain Questionnaire (Mohammadian, 1995), Chronic Pain Acceptance Questionnaire (Mesgarian, 2011), Emotional Schema Questionnaire (Leahy et al., 2019), and Beck Scale for Suicidal Ideation (Mohammadifar et al., 2017). Data were analyzed using multivariate analysis of variance (MANOVA) and Bonferroni post hoc tests.
Findings: Results indicated significant main effects of pain intensity and pain acceptance on emotional schemas and suicidal ideation (p < 0.01). Patients with severe pain and low acceptance reported higher negative emotional schemas and suicidal ideation than those with mild pain and high acceptance. The interaction between pain intensity and acceptance was significant, showing that higher acceptance mitigates the negative impact of severe pain on emotional-cognitive outcomes. Suicidal ideation prevalence was 40% in the severe/no-acceptance group and 10% in other groups.
Conclusion: Pain intensity and acceptance are critical determinants of emotional regulation and suicidal ideation in chronic pain patients. Enhancing pain acceptance and implementing interventions targeting maladaptive emotional schemas can improve psychological adjustment and reduce suicidal risk in this population.
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