Presenting a model of pain outcomes in patients with chronic low back pain based on mood and anxiety symptoms and emotional schemas: The mediating role of experiential avoidance and self-compassion

Introduction: Various psychological factors, such as mood and anxiety symptoms, can affect pain outcomes. Aim: The present research was conducted to identify these factors aiming at providing a conceptual model of pain outcomes based on emotional schemas and symptoms mediated by experiential avoidance, pain acceptance, and self-compassion of patients with chronic pain. Method: In this descriptive correlational research, the statistical population consisted of men and women (aged 30-50) with chronic low back pain referring to pain clinics in Akhtar, Labafinejad, and Imam Hossein hospitals, Tehran, Iran, in 2019-2020. We selected 400 people using a convenience sampling method considering the inclusion criteria. The tools included the Mood and Anxiety Symptoms Questionnaire (MASQ), Emotional Schemas-Short Form, Acceptance and Action Questionnaire (AAQ), Chronic Pain Acceptance Questionnaire (CPAQ) and the Self-Compassion Scale (SCS). Data were analyzed with SPSS-21 and LISREL-8.8 using Structural Equation Modeling (SEM). Results: The fitted model showed that the direct effect of mood and anxiety symptoms on increasing emotional schemas (p<0.05) was equal to 5, and the direct effect of emotional schemas was significant on increasing experiential avoidance, reducing pain acceptance and self-compassion (p<0.05). Also, the indirect effect of mood and anxiety symptoms through increasing emotional schemas, increasing experiential avoidance, decreasing pain acceptance, and self-compassion on increasing pain outcomes was significant (p<0.05). Conclusion: Experiential avoidance, pain acceptance, and self-compassion could mediate the relationship between emotional symptoms and emotional schemas to pain outcomes. Therefore, developing therapeutic interventions based on emotional schemas to reduce emotional schemas and experiential avoidance and increase pain acceptance and self-compassion could help reduce pain outcomes in patients with chronic pain.