Kotelnikova A.V., Tikhonova A.S., Zentsova N.I. Typology of Coping with Chronic Pain: Interrelationship of Responsibility Attribution, Behavioral Activity, and Self-Efficacy
Anastasiya V. Kotelnikova, D.Sc. (Psychology), associate professor, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; bld. 8–2, Trubetskaya st., Russia, Moscow, 119048; kotelnikova_a_v@staff.sechenov.ru
Anastasiya S. Tikhonova, Moscow Centre for Research and Practice in Medical Rehabilitation, Restorative and Sports Medicine named after S.I. Spasokukotsky, Moscow, Russia; bld. 53, Zemlyanoy Val st., Moscow, Russia, 105120; seyli1992@list.ru
Natalia I. Zentsova, Ph.D (Psychology), associate professor, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; bld. 8–2, Trubetskaya st., Moscow, Russia, 119048; zentsova_n_i@staff.sechenov.ru
Chronic pain, affecting up to 30% of the adult population, is a significant medical and social problem, leading to a decrease in quality of life and economic losses. Despite the recognition of the role of psychological factors in adaptation, the problem of integrating cognitive (attribution of responsibility) and behavioral (activity) components of coping into a single model remains unresolved.
In connection with the above, the purpose of the study was to identify and analyze patterns of coping with chronic pain determined by a combination of responsibility attribution and personal activity.
Four coping patterns based on a combination of activity/passivity and internality/externality were identified in a sample of 84 patients with chronic back pain using the questionnaire "Psychological Factors of Attitudes to Illness and Treatment" and factorial, correlation, and nonparametric analyses.
The "Activity + Internality" profile turned out to be the most adaptive (72.6% of the sample), characterized by realistic self-efficacy and willingness to cooperate in treatment. Paradoxically, high but dysfunctional self-efficacy was revealed in the "Passivity + Externality" group (16.7%), where patients demonstrated aggressive attitudes and irrational faith in the omnipotence of external forces while maintaining their own inactivity. Groups with mismatched profiles ("Activity + Externality" – 7.1% and "Passivity + Internality" – 3.6%) showed the lowest self-efficacy associated with frustration, blaming others, or paralyzing feelings of guilt. Self-efficacy did not depend on demographic factors or pain duration.
The results confirm that the mismatch between attribution of responsibility and behavioral activity forms maladaptive patterns with dysfunctional self-efficacy. The proposed typology has predictive value for clinical practice, allowing clinicians to differentiate the targets of psychocorrection (correction of unrealistic expectations, transformation of guilt into responsibility) and predict the risks of low compliance. Limitations include sample homogeneity and the cross-sectional design.
Key words: chronic back pain, attribution of responsibility, externality, internality, self-efficacy
For citation: Kotelnikova, A.V., Tikhonova, A.S., Zentsova, N.I. (2026). Typology of Coping with Chronic Pain: Interrelationship of Responsibility Attribution, Behavioral Activity, and Self-Efficacy. New Psychological Research, No. 1, 135–150. DOI: 10.51217/npsyresearch_2026_06_01_07
Keywords: chronic back pain attribution of responsibility externality internality self-efficacy
Received: 27th march 2026
Published: 27th march 2026