Skip to main content
SpringerLink
Log in

Coping self-efficacy as a mediator between catastrophizing and physical functioning: treatment target selection in an osteoarthritis sample

  • Published:
Journal of Behavioral Medicine Aims and scope Submit manuscript

Abstract

The purpose of this study was to assess the relative effects of coping self-efficacy and catastrophizing on physical functioning. Over a 9-month period, studying changes in self-efficacy as possible mediator between catastrophizing changes and physical functioning changes might provide evidence for the most promising treatment target. Data came from a randomized, longitudinal controlled trial comparing exercise, self-management and the two combined to treat 254 individuals with early knee osteoarthritis. A secondary analysis using a bootstrapped linear mixed-effects mediational model produced estimates of both the direct and indirect effects. Results indicated that self-efficacy partially mediated the effect between catastrophizing and physical functioning suggesting that self-efficacy was the more direct treatment target compared to catastrophizing. Treatments targeting both self-efficacy and catastrophizing may have greater impact on physical functioning compared to treatments that focus on only one.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  • Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review 84(2), 191–215.

    Article  CAS  PubMed  Google Scholar 

  • Baron, R., & Kenny, D. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic and statistical considerations. Journal of Personality and Social Psychology 51, 1173–1182.

    Article  CAS  PubMed  Google Scholar 

  • Bates, D., Maechler, M., & Dai, B. (2008). lme4: Linear mixed-effects models using s4 classes. (R package version 0.999375-28).

  • Berlin, J. A., & Colditz, G. A. (1990). A meta-analysis of physical activity in the prevention of coronary heart disease. American Journal of Epidemiology 132(4), 612–628.

    CAS  PubMed  Google Scholar 

  • Biglan, A., Hayes, S. C., & Pistorello, J. (2008). Acceptance and commitment: implications for prevention science. Prevention Science 9(3), 139–152.

    Article  PubMed  Google Scholar 

  • Brenes, G. A., Rapp, S. R., Rejeski, W. J., & Miller, M. E. (2002). Do optimism and pessimism predict physical functioning?. Journal of Behavioral Medicine 25(3), 219–231.

    Article  PubMed  Google Scholar 

  • Burns, J. W., Glenn, B., Bruehl, S., Harden, R. N., & Lofland, K. (2003a). Cognitive factors influence outcome following multidisciplinary chronic pain treatment: a replication and extension of a cross-lagged panel analysis. Behaviour Research and Therapy 41(10), 1163–1182.

    Article  CAS  PubMed  Google Scholar 

  • Burns, J. W., Kubilus, A., Bruehl, S., Harden, R. N., & Lofland, K. (2003b). Do changes in cognitive factors influence outcome following multidisciplinary treatment for chronic pain? a cross-lagged panel analysis. Journal of Consulting and Clinical Psychology 71(1), 81–91.

    Article  PubMed  Google Scholar 

  • de Groot, I. B., Bussmann, J. B., Stam, H. J., & Verhaar, J. A. N. (2008). Actual everyday physical activity in patients with end-stage hip or knee osteoarthritis compared with healthy controls. Osteoarthritis Cartilage 16(4), 436–442.

    Article  PubMed  Google Scholar 

  • DeVellis, R. F., & Blalock, S. J. (1993). Psychological and educational interventions to reduce arthritis disability. Baillieres Clinical Rheumatology 7(2), 397–416.

    Article  CAS  Google Scholar 

  • Ettinger, W. H., Burns, R., Messier, S. P., Applegate, W., Rejeski, W. J., & Morgan, T. et al. (1997). A randomized trial comparing aerobic exercise and resistance exercise with a health education program in older adults with knee osteoarthritis. The fitness arthritis and seniors trial (fast). JAMA 277(1), 25–31.

    Article  PubMed  Google Scholar 

  • Focht, B.C., Rejeski, W. J., Ambrosius, W. T., Katula, J. A., & Messier, S. P. (2005). Exercise, self-efficacy, and mobility performance in overweight and obese older adults with knee osteoarthritis. Arthritis and Rheumatism 53(5), 659–665.

    Article  PubMed  Google Scholar 

  • Harrison, A. L. (2004). The influence of pathology, pain, balance, and self-efficacy on function in women with osteoarthritis of the knee. Physical Therapy 84(9), 822–831.

    PubMed  Google Scholar 

  • Hirsh, A. T., George, S. Z., Riley, J. L., & Robinson, M. E. (2007). An evaluation of the measurement of pain catastrophizing by the coping strategies questionnaire. European Journal of Pain 11(1), 75–81.

    Article  PubMed  Google Scholar 

  • Jensen, M. P., Turner, J. A., & Romano, J. M. (2001). Changes in beliefs, catastrophizing, and coping are associated with improvement in multidisciplinary pain treatment. Journal of Consulting and Clinical Psychology 69(4), 655–662.

    Article  CAS  PubMed  Google Scholar 

  • Keefe, F. J., Affleck, G., France, C. R., Emery, C. F., Waters, S., & Caldwell, D. S. et al. (2004). Gender differences in pain, coping, and mood in individuals having osteoarthritic knee pain: A within-day analysis. Pain 110(3), 571–577.

    Article  PubMed  Google Scholar 

  • Keefe, F. J., Caldwell, D. S., Baucom, D., Salley, A., Robinson, E., Timmons, K. et al. (1996). Spouse-assisted coping skills training in the management of osteoarthritic knee pain. Arthritis Care and Research 9(4), 279–291.

    Article  CAS  PubMed  Google Scholar 

  • Keefe, F. J., Caldwell D. S., Queen, K., Gil, K. M., Martinez, S., & Crisson J. E. et al. (1987a). Osteoarthritic knee pain: a behavioral analysis. PainThink u said ud email me about something. Just a reminder. Also, Ill be on campus today (wednesday) most of the afternoon and i meet with Jon at 10am. If I dont see ya then Ill be at the Shebeen Thursday 28(3):309–321

    Google Scholar 

  • Keefe, F. J., Caldwell, D. S., Queen, K. T., Gil, K. M., Martinez, S., & Crisson, J.,E. et al. (1987b). Pain coping strategies in osteoarthritis patients. Journal of Consulting and Clinical Psychology 55(2), 208–212.

    Article  CAS  PubMed  Google Scholar 

  • Keefe, F. J., Kashikar-Zuck, S., Robinson, E., Salley, A., Beaupre, P., & Caldwell, D. et al. (1997). Pain coping strategies that predict patients’ and spouses’ ratings of patients’ self-efficacy. Pain 73(2), 191–199.

    Article  CAS  PubMed  Google Scholar 

  • Keefe, F. J., Lefebvre, J. C., Egert, J. R., Affleck, G., Sullivan, M. J., & Caldwell, D. S. (2000a). The relationship of gender to pain, pain behavior, and disability in osteoarthritis patients: the role of catastrophizing. Pain 87(3), 325–334.

    Article  CAS  PubMed  Google Scholar 

  • Keefe, F. J., Lefebvre, J. C., Kerns, R. D., Rosenberg, R., Beaupre, P., & Prochaska, J. et al. (2000b). Understanding the adoption of arthritis self-management: stages of change profiles among arthritis patients. Pain 87(3), 303–313.

    Article  CAS  PubMed  Google Scholar 

  • Keefe, F. J., Smith, S. J., Buffington, A. L. H., Gibson, J., Studts, J. L., & Caldwell, D. S. (2002). Recent advances and future directions in the biopsychosocial assessment and treatment of arthritis. Journal of Consulting and Clinical Psychology 70(3), 640–655.

    Article  PubMed  Google Scholar 

  • Kellgren, J. H., & Lawrence, J. S. (1957). Radiological assessment of rheumatoid arthritis. Annals of the Rheumatic Diseases 16(4), 485–493.

    Article  CAS  PubMed  Google Scholar 

  • Kratz, A. L., Davis, M. C., & Zautra, A. J. (2007). Pain acceptance moderates the relation between pain and negative affect in female osteoarthritis and fibromyalgia patients. Annals of Behavioral Medicine 33(3), 291–301.

    Article  PubMed  Google Scholar 

  • Lakka, T. A., Venlinen, J. M., Rauramaa, R., Salonen, R., Tuomilehto, J., & Salonen, J. T. (1994). Relation of leisure-time physical activity and cardiorespiratory fitness to the risk of acute myocardial infarction. The New England Journal of Medicine 330(22), 1549–1554.

    Article  CAS  PubMed  Google Scholar 

  • Little, R., & Rubin, D. (1987) Statistical analysis with missing data. New York: John Wiley.

    Google Scholar 

  • Lorig, K., & Holman, H. (1993). Arthritis self-management studies: A twelve-year review. Health Education Quarterly 20(1), 17–28.

    CAS  PubMed  Google Scholar 

  • Lorig, K., & Holman, H. (1998). Arthritis self-efficacy scales measure self-efficacy. Arthritis Care and Research 11(3), 155–157.

    Article  CAS  PubMed  Google Scholar 

  • Lorig, K. R., & Holman, H. (2003). Self-management education: History, definition, outcomes, and mechanisms. Annals of Behavioral Medicine 26(1), 1–7.

    Article  PubMed  Google Scholar 

  • Lorig, K. R., Ritter, P., Stewart, A. L., Sobel, D. S., Brown, B. W., & Bandura, A. et al. (2001), Chronic disease self-management program: 2-year health status and health care utilization outcomes. Medical Care 39(11), 1217–1223.

    Article  CAS  PubMed  Google Scholar 

  • Lorig, K. R., Ritter, P. L., Laurent, D. D., & Fries, J. F. (2004), Long-term randomized controlled trials of tailored-print and small-group arthritis self-management interventions. Medical Care 42(4), 346–354.

    Article  PubMed  Google Scholar 

  • MacKinnon, D. P. (2008). Introduction to statistical mediation analysis. New York: Taylor & Francis Group/Lawrence Erlbaum Associates.

    Google Scholar 

  • MacKinnon, D. P., Lockwood, C. M., Hoffman, J. M., West, S. G., & Sheets, V. (2002). A comparison of methods to test the significance of the mediated effect. Psychological Methods 7, 83–104.

    Article  PubMed  Google Scholar 

  • Maly, M. R., Costigan, P. A., & Olney, S. J. (2006a). Determinants of self efficacy for physical tasks in people with knee osteoarthritis. Arthritis and Rheumatism 55(1), 94–101.

    Article  PubMed  Google Scholar 

  • Maly, M. R., Costigan, P. A., & Olney, S. J. (2006b). Determinants of self-report outcome measures in people with knee osteoarthritis. Archives of Physical Medicine and Rehabilitation 87(1), 96–104.

    Article  PubMed  Google Scholar 

  • Maly, M. R., Costigan, P. A., & Olney, S. J. (2006c). Role of knee kinematics and kinetics on performance and disability in people with medial compartment knee osteoarthritis. Clinical Biomechanics (Bristol, Avon) 21(10), 1051–1059.

    Article  Google Scholar 

  • Maly, M. R., Costigan, P. A., Olney, S. J. (2007). Self-efficacy mediates walking performance in older adults with knee osteoarthritis. The journals of gerontology. Series A, Biological sciences and medical sciences 62(10), 1142–1146.

    PubMed  Google Scholar 

  • Marks, R., Allegrante, J. P., & Lorig, K. (2005). A review and synthesis of research evidence for self-efficacy-enhancing interventions for reducing chronic disability: implications for health education practice (part i). Health Promotion Practice 6(1), 37-43.

    Article  PubMed  Google Scholar 

  • McKnight, P., Kasle, S., Going, S., Villaneuva, I., Cornett, M., & Farr, J. et al. (2010). A comparison of strength-training, self-management and the combination for early osteoarthritis of the knee. Arthritis Care and Research 62, 45–53.

    Article  PubMed  Google Scholar 

  • McKnight, P., McKnight, K., Sidani, S., & Figuredo, A. (2007). Missing data: A gentle introduction. New York: Guilford.

    Google Scholar 

  • Miller, C., & Cronan, T. (1998). The effects of coping style and self-efficacy on health status and health care costs. Anxiety, Stress and Coping 11, 311–325.

    Article  Google Scholar 

  • Oguma, Y., & Shinoda-Tagawa, T. (2004). Physical activity decreases cardiovascular disease risk in women: review and meta-analysis. American Journal of Preventive Medicine 26(5), 407–418.

    Article  PubMed  Google Scholar 

  • Oudshoorn, S. V. B. C. (2007). mice: Multivariate imputation by chained equations. (R package version 1.16)

  • Pells, J. J., Shelby, R. A., Keefe, F. J., Dixon, K. E., Blumenthal, J. A., & Lacaille, L. et al. (2008). Arthritis self-efficacy and self-efficacy for resisting eating: relationships to pain, disability, and eating behavior in overweight and obese individuals with osteoarthritic knee pain. Pain 136(3), 340–347.

    Article  PubMed  Google Scholar 

  • Potter, P. T., & Zautra, A. J. (1997). Stressful life events’ effects on rheumatoid arthritis disease activity. Journal of Consulting and Clinical Psychology 65(2), 319–323.

    Article  CAS  PubMed  Google Scholar 

  • Prior, K., & Bond, M. (2004). The roles of self-efficacy and abnormal illness behavior in osteoarthritis self-management. Psychology, Health & Medicine 9, 177–192.

    Article  Google Scholar 

  • R Development Core Team. (2008). R: A language and environment for statistical computing. Vienna, Austria (ISBN 3-900051-07-0).

  • Radloff, L. (1977). The ces-d scale: A self-report depression scale for research in the general population. Applied Psychological Measurement 1, 385–401.

    Article  Google Scholar 

  • Rejeski, W. J., Miller, M. E., Foy, C., Messier, S., & Rapp, S. (2001). Self-efficacy and the progression of functional limitations and self-reported disability in older adults with knee pain. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences 56(5), S261–S265.

    CAS  PubMed  Google Scholar 

  • Rosenstiel, A. K., & Keefe, F. J. (1983). The use of coping strategies in chronic low back pain patients: relationship to patient characteristics and current adjustment. Pain 17(1), 33–44.

    Article  CAS  PubMed  Google Scholar 

  • Rubin, D. (1996). Multiple imputation after 18+ years (with discussion). Journal of the American Statistical Association 91, 471–489.

    Google Scholar 

  • Santavirta, N., Bjrvell, H., Solovieva, S., Alaranta, H., Hurskainen, K., & Konttinen, Y. T. (2001). Coping strategies, pain, and disability in patients with hemophilia and related disorders. Arthritis and Rheumatism 45(1), 48–55.

    Article  CAS  PubMed  Google Scholar 

  • Seligman, M. E., & Csikszentmihalyi, M. (2000). Positive psychology an introduction. The American Psychologist55(1), 5–14.

    Article  CAS  PubMed  Google Scholar 

  • Sharma, L., Cahue, S., Song, J., Hayes, K., Pai, Y.-C., & Dunlop, D. (2003). Physical functioning over three years in knee osteoarthritis: role of psychosocial, local mechanical, and neuromuscular factors. Arthritis and Rheumatism 48(12), 3359–3370.

    Article  PubMed  Google Scholar 

  • Sheehan, T. J., Fifield, J., Reisine, S., & Tennen, H. (1995). The measurement structure of the center for epidemiologic studies depression scale. Journal of Personality Assessment 64(3), 507–521.

    Article  CAS  PubMed  Google Scholar 

  • Shelby, R. A., Somers, T. J., Keefe, F. J., Pells, J. J., Dixon, K. E., & Blumenthal, J. A. (2008). Domain specific self-efficacy mediates the impact of pain catastrophizing on pain and disability in overweight and obese osteoarthritis patients. The Journal of Pain 9(10), 912–919.

    Article  PubMed  Google Scholar 

  • Smarr, K. L., Parker, J. C., Wright, G. E., Stucky-Ropp, R. C., Buckelew, S. P., & Hoffman, R. W. et al. (1997). The importance of enhancing self-efficacy in rheumatoid arthritis. Arthritis Care and Research 10(1), 18–26.

    Article  CAS  PubMed  Google Scholar 

  • Smith, B. W., & Zautra, A. J. (2008). The effects of anxiety and depression on weekly pain in women with arthritis. Pain 138, 354–361.

    Article  PubMed  Google Scholar 

  • Sullivan, M. J., & D’Eon, J. L. (1990). Relation between catastrophizing and depression in chronic pain patients. Journal of Abnormal Psychology 99(3), 260–263.

    Article  CAS  PubMed  Google Scholar 

  • Sullivan, M. J., Rodgers, W. M., & Kirsch, I. (2001a). Catastrophizing, depression and expectancies for pain and emotional distress. Pain 91(1-2), 147–154.

    Article  CAS  PubMed  Google Scholar 

  • Sullivan, M. J., Thorn, B., Haythornthwaite, J. A., Keefe, F., Martin, M., & Bradley, L. A. et al. (2001b). Theoretical perspectives on the relation between catastrophizing and pain. The Clinical Journal of Pain 17(1), 52–64.

    Article  CAS  PubMed  Google Scholar 

  • Turner, J. A., Jensen, M. P., Warms, C. A., & Cardenas, D. D. (2002). Catastrophizing is associated with pain intensity, psychological distress, and pain-related disability among individuals with chronic pain after spinal cord injury. Pain 98(1–2), 127–134.

    Article  PubMed  Google Scholar 

  • Turner, J. A., Mancl, L., & Aaron, L. A. (2004). Pain-related catastrophizing: a daily process study. Pain 110(1–2), 103–111.

    Article  PubMed  Google Scholar 

  • Vowles, K. E., McCracken, L. M., & Eccleston, C. (2008). Patient functioning and catastrophizing in chronic pain: the mediating effects of acceptance. Health Psychology 27(2 Suppl), S136–S143.

    Article  PubMed  Google Scholar 

  • Ware, J., & Sherbourne, C. (1992). The mos 36-item short-form health survey (sf-36). i. conceptual framework and item selection. Medical Care 30(6), 473–483.

    Article  PubMed  Google Scholar 

  • Watkins, K. W., Shifren, K., Park, D. C., & Morrell, R. W. (1999). Age, pain, and coping with rheumatoid arthritis. Pain 82(3), 217–228.

    Article  CAS  PubMed  Google Scholar 

  • Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: the panas scales. Journal of Personality and Social Psychology 54(6), 1063–1070.

    Article  CAS  PubMed  Google Scholar 

  • Zautra, A. J., Burleson, M. H., Smith, C. A., Blalock, S. J., Wallston, K. A., & DeVellis, R. F. et al. (1995). Arthritis and perceptions of quality of life: an examination of positive and negative affect in rheumatoid arthritis patients. Health Psychology 14(5), 399–408.

    Article  CAS  PubMed  Google Scholar 

  • Zautra, A. J., Johnson, L. M., & Davis, M. C. (2005). Positive affect as a source of resilience for women in chronic pain. Journal of Consulting and Clinical Psychology 73(2), 212–220.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychology, George Mason University, MSN 3F5, 4400 University Drive, Fairfax, VA, 22030-4400, USA

    Patrick E. McKnight, Alex Afram & Todd B. Kashdan

  2. Arizona Arthritis Center, University of Arizona, Tucson, AZ, USA

    Shelley Kasle

  3. Department of Psychology, Arizona State University, Tempe, AZ, USA

    Alex Zautra

Authors
  1. Patrick E. McKnight
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alex Afram
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Todd B. Kashdan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shelley Kasle
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Alex Zautra
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Patrick E. McKnight.

Rights and permissions

Reprints and permissions

About this article

Cite this article

McKnight, P.E., Afram, A., Kashdan, T.B. et al. Coping self-efficacy as a mediator between catastrophizing and physical functioning: treatment target selection in an osteoarthritis sample. J Behav Med 33, 239–249 (2010). https://doi.org/10.1007/s10865-010-9252-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10865-010-9252-1

Keywords

Search

Navigation