Chronic pain is a worldwide problem that has a high prevalence rate and is often comorbid with depression. Coping flexibility, which is defined as the ability to discontinue an ineffective coping strategy-evaluation coping-and to produce and implement an alternative strategy-adaptive coping-has attracted much interest as an important factor that attenuates pain-induced stress responses, including depression. This study hypothesized that greater coping flexibility would be associated with lower depression in both women with chronic pain and those with menstrual pain. The participants included women with chronic pain ( = 292) and those with menstrual pain ( = 181) who completed questionnaires on pain intensity, pain acceptance, psychological inflexibility, and coping flexibility for chronic pain. The hierarchical multiple regressions revealed that both evaluation coping and adaptive coping predicted depression even after controlling for the effects of pain intensity, pain acceptance, and psychological inflexibility, which are well-known for their association with depression in patients with chronic pain. The hypothesis was supported in our samples. Our findings may contribute to the development of self-management without self-medication using over-the-counter analgesics by acquiring coping flexibility for chronic pain.
