(PS6-B47) Disentangling the Underlying Mechanisms of Chronic Pain: The Protective Role of Positive Body Image and Positive Embodiment

Chronic pain is a complex and distressing health condition affecting a large percentage of the global population, being among the first leading cause of disability worldwide. Recently, a cognitive-behavioral model of chronic pain has been proposed (Sunderaman et al., 2020), in which the role of body image (BI) (e.g., body dissatisfaction) in the experience of pain is highlighted. However, this model neglects the variables involved in positive BI (i.e., body appreciation and body functionality appreciation) and positive embodiment (i.e., trust in the body), which have stood out as protective variables in several psychopathological conditions (e.g., eating disorders). The current study aims at analyzing the effect of positive BI (i.e., functionality appreciation and body appreciation) and positive embodiment (i.e., body trusting) on buffering the interference and intensity of pain, through the mediational role of two well-known maladaptive coping strategies (i.e., catastrophizing and kinesiophobia) in chronic pain. A cross-sectional design was conducted in a sample of 82 Spanish participants suffering from different chronic pain conditions, such as musculoskeletal or neuropathic pain (mean age: 44.11 (9.83); 85.4% women; mean duration of the pain condition (in years): M = 12.5, SD = 9.70). The following variables were measured with self-report questionnaires: body appreciation (BAS, Tylka & Wood-Barcalow, 2015), body functionality appreciation (FAS, Alleva et al., 2017), trust in the body (MAIA-2, Mehling et al., 2018), pain catastrophizing (PCS, Sullivan et al., 1995), kinesiophobia (TSK, Wobi et al., 2005), pain intensity, and interference of pain (BPI, Tan et al., 2004). Pearson’s correlations showed negative, significant associations between all the protective factors, and the non-adaptive coping strategies, as well as intensity and interference of pain. A path analysis performed with lavaan in R showed that only body trust (MAIA-2) was a significant, negative predictor of pain catastrophizing which, in turn, predicted both pain outcomes (intensity and interference of pain). The fit indexes were adequate (χ2 (6) = 17864.14, p = .009, CFI = .92, SRMR = .08), and the explained variance of intensity and interference of pain were 21.4% and 45.5%, respectively. This study points out the relevant role of positive BI and positive embodiment in shaping the personal experience of chronic pain. Specifically, this study shows that the positive bond and the confidence one has in their body may constitute a protective variable against developing a negative cognitive-affective response to pain -specifically pain catastrophizing-, and in turn, may impact positively in relevant pain outcomes. However, future studies should replicate these results with longitudinal and experimental designs, in larger samples, and specific chronic pain conditions. These preliminary findings suggest the potential usefulness of mind-body approaches as complementary treatments for managing chronic pain.