Social support comes in many forms: text messages, flowers, and physically being there are a few to name. In a recently published four-part study seen on Frontiers, social support appears to be an effective way to help patients cope with physical pain. Led by Charlotte Krahé from the Department of Psychology at the Institute of Psychiatry at King's College London, these researchers developed a psychometric evaluation for social support and pain, and then assessed responses of support from loved ones and healthcare professionals. The study found the social support and pain questionnaire to be effective, and observed positive effects in pain patients due to increased social support.

Developing a Proper Measure for Social Support and Pain

The Responses and Attitudes to Support during Pain (RASP) questionnaire is a 57-item tool designed to assess how one's experience of pain is affected by social support. Those who qualify to provide social support in the RASP questionnaire include partners, friends, and healthcare professionals. The following actions counted as a form of social support:

  • Social presence
  • Social reassurance
  • Empathy
  • Touch
  • Offering help
  • Informational support (this form was not acknowledged in this particular study due to variability in quality)

The RASP questionnaire accounted for unique situations, sources of support, and forms of support. For instance, healthcare professionals are generally not allowed to touch patients for purposes unrelated to medical procedure. In addition to recording the types of support, Krahé also documented how much the patient desired social support. Pain was measured in conjunction with social support using the following four criteria:

  • Pain intensity
  • Pain distress and anxiety
  • Worry of pain consequences
  • Pain behaviors

The efficacy of the RASP questionnaire was tested in four studies. The studies recruited participants online to complete the survey and helped collect demographic data.

Four Studies Testing the Efficacy of the RASP Questionnaire

The first study was completed online by 179 individuals using the full version of the RASP questionnaire. The next part of Krahé's experiment involved assessing three sections of the RASP questionnaire. The purpose of the modified studies was to analyze the efficacy of the RASP questionnaire as a whole. Krahé observed patients in three different situations to address the specific components of the RASP questionnaire:

  • Women in relationships experiencing menstrual pain: A total of 256 women completed a 32-item RASP questionnaire, reported their pain, and completed the Experiences in Close Relationships Revised Questionnaire (ECRQ-R). The ECRQ-R helped assess attachment anxiety.
  • Individuals in a relationship experiencing musculoskeletal pain: This scenario focused on social support coming from partners and healthcare professionals. A total of 120 individuals who had recently suffered a break, fracture, or tear completed a 22-item version of the RASP questionnaire.
  • People from the general population experiencing pain: A 22-item version of the RASP questionnaire, the Pain Catastrophizing Scale (PCS), the Multidimensional Scale of Perceived Social Support (MSPSS), and the COPE Inventory were completed by 180 individuals. The PCS assessed tendency to exaggerate threat and pain, the MSPSS measured perceived social support from a significant other, and the COPE Inventory observed how much a patient sought after emotional support.

Efficacy of the RASP Questionnaire

Krahé modified the RASP questionnaire with each study. The study on women with menstrual pain revealed five underlying dimensions to the questionnaire:

  • General partner support
  • Emotional support from healthcare professionals
  • Anxiety in context of healthcare professionals
  • Pain behaviors in context of partner
  • Distraction by partner

This five-component model appeared again in the following two studies on the individuals experiencing musculoskeletal pain and on the general population. The study on the general population yielded the following data:

  • Individuals showed more pain catastrophizing in context with their partners and showed high levels of anxiety with their healthcare professionals.
  • MSPSS scores revealed that people perceived more support due to general partner support, emotional support from healthcare professionals, and distraction by their partners.
  • Levels of desire for emotional support positively correlated with general partner support, pain behaviors in context of partner, and distraction by partner.

The results from all studies show that the RASP questionnaire is an effective, multidimensional, and concise measure of the attitudes and responses to social support in relation to pain. Krahé hopes to continue testing the functionality of the RASP questionnaire by performing more studies on different situations such as painful experiences caused healthcare professionals during wisdom tooth removal.

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Jeremy Schwartz, LCSW
Carrie Potter, M.A.
Lindsay Scharfstein, Ph.D.



King's College London

Charlotte Krahé, Yannis Paloyelis, Chiara F. Sambo, and Aikaterini Fotopoulou. I like it when my partner holds my hand: development of the Responses and Attitudes to Support during Pain questionnaire (RASP). Frontiers, 19 September 2014; DOI: 10.3389/fpsyg.2014.01027

Date of original publication:

Updated: October 23, 2015