THE ROLE OF SOCIAL LEARNING IN THE ACQUISITION OF CHRONIC PAIN (ILLNESS BEHAVIOR)

Abstract

This study examined the possible role of vicarious learning in the acquisition of chronic illness behavior. The purpose of the investigation was to demonstrate that childhood experiences could engender a lasting cognitive-behavioral set with the potential of influencing adult behavior. Specifically, it was expected that responses to a questionnaire, relating to childhood experiences concerning issues of health and illness, would be able to predict the respondent's cognitive appraisal and behavioral reaction to bodily stimuli.;The study sample was comprised of 193 adults, who were drawn from three select subgroups: pain patients, disabled individuals, and normal controls. These three groups were chosen in order to secure a heterogeneous sample and for their predicted responses on some of the measures central to the study.;Data for this investigation were gathered via a three-part, paper and pencil questionnaire. First, the Personal Data Sheet requested basic demographic information. Second, the Childhood Experiences questionnaire, was a 45-item index used to estimate the type and quality of the respondent's early life experiences in respect to learned responses to physical discomfort. Each of the items represented one of four factors: Reinforced; Discouraged; Modeled; or Rejected. Third, the Self-Estimate Questionnaire assessed the respondent's sense of self-efficacy for coping with physical discomfort.;The hypotheses predicted that specific relationships would exist between childhood experiences and the display of illness behavior. In this study illness behavior was measured by the frequency with which painful body stimuli were experienced, the severity of these sensations, and the degree to which they interfered with daily activities. Relationships were also predicted between the four childhood experiences factors and the self-estimate score.;The data confirmed a relationship between childhood experiences and the sense of self-efficacy for coping with painful body stimuli. Individuals who scored higher on the Reinforced or Modeled factors scored lower on the Self-Estimate Questionnaire. The findings were interpreted as indicating that the display or reinforcement of illness behavior by parents lowers the child's sense of self-efficacy for dealing with illness. Further, this negative cognitive-behavioral set can be sustained into adulthood. The other hypotheses predicting relationships between childhood experiences and the reporting of pain were not confirmed.;Issues concerning the possible influence of demographic variables on the reporting of pain were explored. Finally, observations relevant to the study of pain patients were made and discussed.