The mediating role of anger rumination in the relationship between metacognitive beliefs and uncertainty intolerance with perceived pain intensity in patients with chronic pain

The purpose of the present study was to investigate the mediating role of anger rumination in the relationship between metacognitive beliefs and intolerance of uncertainty with perceived pain intensity in patients with chronic pain. The method of descriptive-correlation research was structural equation modeling. The statistical population was the patients with chronic pain referred to Hazrat Abolfazl Hospital (AS) in Tehran in 2022, who were diagnosed with chronic pain by doctors or pain specialist fellowship, and among them, 400 people were selected as a sample. The research tools include perceived pain intensity (PNMS, van Korff, 1990), metacognitive beliefs (QMB, Wells and Cartwright-Houghton, 2004), uncertainty intolerance (UIQ, Friston et al., 1994), and anger rumination. (ARQ, Sakhodolski et al., 2001). The data were analyzed by structural equation analysis. The findings showed a good fit of the data with the proposed research model. Metacognitive beliefs, uncertainty intolerance, and anger rumination had a direct and significant effect on perceived pain intensity (P<0.01). Also, metacognitive beliefs and intolerance of uncertainty with the mediation of anger rumination had an indirect and significant effect on the perceived pain intensity of patients (P<0.01). From these findings, it can be concluded that paying attention to metacognitive beliefs and intolerance of uncertainty increases the rumination of anger and increases the intensity of perceived pain in patients.