Psychosocial Predictors of Spinal Cord Injury Pain: The Canadian Spinal Cord Injury Pain Survey.

OBJECTIVE

To examine the relationships between sociodemographics, injury characteristics, personality traits, and emotions with pain severity and interference using data from the Canadian Spinal Cord Injury (SCI) Pain Survey.

DESIGN

Cross-sectional community-based survey.

SETTING

An online survey.

PARTICIPANTS

A total of 200 English-speaking adults (≥18 years old) with noncongenital SCI living in Canada (mean age ± SD, 51±14 years; 51% men) were recruited through the SCI community and research organizations.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Pain severity and interference were measured using the Brief Pain Inventory-Short Form subscales. Hierarchical blocks of predictor variables included: (1) sociodemographics; (2) injury characteristics; and psychosocial variables comprising (3) personality traits and (4) emotions.

RESULTS

For pain severity, age was the only significant predictor in the final model (β=0.04; 95% CI, 0.008, 0.072; P=.015). Psychosocial variables (blocks 3 and 4 combined) contributed additional variance (ΔR²=0.02-0.05) but did not significantly improve model fit (P>.05), indicating that psychosocial factors did not meaningfully predict pain severity. The final model explained 19.7% of the variance in pain severity (adjusted R²=0.09, P=.03), corresponding to a small to medium effect size (Cohen's f²≈.10). For pain interference, age (β=0.05; 95% CI, 0.018, 0.081; P=.002), anger (β=0.05; 95% CI, 0.005, 0.099; P=.029), and depression (β=0.07; 95% CI, 0.010, 0.123; P=.022) were statistically significant predictors. Psychosocial variables explained additional variance (ΔR²≈0.11, P<.05), supporting the hypothesis that psychosocial factors meaningfully contribute to pain interference. The final model explained 38.2% of the variance in pain interference (adjusted R²=0.30, P<.001), reflecting a very large effect size (Cohen's f²≈0.62).

CONCLUSIONS

Psychosocial variables, particularly emotions, are associated with pain interference but not severity in people with SCI. These factors appear more important than injury-related characteristics and highlight potentially modifiable targets for intervention and self-management, and support the integration of psychosocial treatment in SCI pain care.