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Fatoye F, Mbada CE, Oladayo TO, Idowu OA, Oyewole OO, Fatoye C, Oke KI. Validation of the Yoruba Version of the Pain Self-Efficacy Questionnaire in Patients with Chronic Low Back Pain. Spine (Phila Pa 1976) 2021; 46:E528-E533. [PMID: 33315774 DOI: 10.1097/brs.0000000000003870] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Cultural adaptation and psychometric analysis. OBJECTIVE This study determined the test-retest reliability, acceptability, internal consistency, divergent validity of the Yoruba pain self-efficacy questionnaire (PSEQ-Y). It also examined the ceiling and floor effects and the small detectable change (SDC) of the PSEQ-Y among patients with chronic low back pain (LBP). SUMMARY OF BACKGROUND DATA There are various indigenous language translations of the PSEQ and none adapted to African language. However, translations of the PSEQ into Nigerian languages are not readily available. METHODS The validity testing phase of the study involved 131 patients with LBP, while 83 patients with LBP took part in the reliability phase. Following the Beaton recommendation for cultural adaptation of instruments, the PSEQ was adapted into the Yoruba language. The psychometric properties of the PSEQ-Y determined comprised: internal consistency, divergent validity, test-retest reliability, and SDC. RESULTS The mean age of the participants was 52.96 ± 17.3 years. The PSEQ-Y did not correlate with the Yoruba version of Visual Analogue Scale (VAS-Y) scores (r = -0.05; P = 0.59). The values for the internal consistency and the test-retest reliability of the PSEQ-Y were 0.79 and 0.86, with the 95% confidence interval of the test-retest reliability ranging between 0.82 and 0.90. The standard error of measurement (SEM) and the SDC of the PSEQ-Y were 1.2 and 3.3, respectively. The PSEQ-Y had no floor or ceiling effect, as none of the respondents scored either the minimal or maximal scores. CONCLUSION This is the first study in Nigeria to culturally adapt PSEQ. The PSEQ-Y showed adequate psychometric properties similar to existing versions. Therefore, the tool can be used to assess pain self-efficacy in clinical and research settings and help to improve the health outcomes of patients chronic LBP.Level of Evidence: 3.
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Affiliation(s)
- Francis Fatoye
- Department of Health Professions, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK
| | - Chidozie Emmanuel Mbada
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Timothy Oluwaseun Oladayo
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Opeyemi Ayodiipo Idowu
- Department of Physiotherapy, School of Basic Medical Sciences, College of Medical Sciences, University of Benin, Benin-City, Nigeria
| | - Olufemi O Oyewole
- Department of Physiotherapy, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria
| | - Clara Fatoye
- Department of Health Professions, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK
| | - Kayode Israel Oke
- Department of Physiotherapy, School of Basic Medical Sciences, College of Medical Sciences, University of Benin, Benin-City, Nigeria
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Khan H, Pilitsis JG, Prusik J, Smith H, McCallum SE. Pain Remission at One-Year Follow-Up With Spinal Cord Stimulation. Neuromodulation 2017; 21:101-105. [PMID: 29058361 DOI: 10.1111/ner.12711] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 08/15/2017] [Accepted: 09/05/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Spinal Cord Stimulation (SCS) is an effective treatment for chronic pain. How often pain remission follows SCS has not been evaluated. This is a retrospective analysis of patients who underwent an implantation of spinal cord stimulators for various chronic pain conditions. The objective of the study was to elucidate characteristics and features of patients with pain relief greater than 80% after one year of treatment. METHODS A total of 86 patients with thoracic SCS and 12-month follow-up data were identified. Patients were divided into a remission group (>80% improvement in Numeric Pain Rating Scale [NRS] pain scale), average responders (20-80% improvement) and a non-responder group (less than 20% improvement). These patient groups were compared via the following outcome measures: NRS, Oswestry Disability Index (ODI), Pain Catastrophizing Scale (PCS), McGill Pain Questionnaire (MPQ), and Insomnia Severity Index (ISI). Correlations with age, body mass index (BMI), tobacco and alcohol usage, patient satisfaction with SCS, disability status, and opioid usage were assessed. RESULTS Nineteen of 86 patients (22%) were remitters at one year follow-up, including 17 patients who had an NRS = 0 at that time. Upon analyzing the three patient groups (non-responders, average responders, and remitters), remitter patients showed the greatest change over the one-year post-operative period in ODI (F(2) = 8.101, p < 0.01) and PCS (F(2) = 7.607, p < 0.01). Moreover, remission was less likely when the patients were on disability prior to implant (χ2 (2) = 6.469, p < 0.05) and on opioids pre-operatively (χ2 (2) = 17.688, p < 0.01). CONCLUSIONS Our study demonstrates a remission rate of 22% with SCS at one-year follow with a total of 19.8% of our total patient cohort having an NRS of 0. Greater decreases in PCS and ODI correlate with remission. Further, pre-operative disability and opioid use correlate with lower likelihood of remission.
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Affiliation(s)
- Hirah Khan
- Department of Neurosurgery, Albany Medical College, Albany, NY, USA
| | - Julie G Pilitsis
- Department of Neurosurgery, Albany Medical College, Albany, NY, USA.,Department of Neuroscience Experimental Therapeutics, Albany Medical College, Albany, NY, USA
| | - Julia Prusik
- Department of Neurosurgery, Albany Medical College, Albany, NY, USA.,Department of Neuroscience Experimental Therapeutics, Albany Medical College, Albany, NY, USA.,Department of Neurology, Albany Medical College, Albany, NY, USA
| | - Heather Smith
- Department of Neurosurgery, Albany Medical College, Albany, NY, USA
| | - Sarah E McCallum
- Department of Neuroscience Experimental Therapeutics, Albany Medical College, Albany, NY, USA
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The Behavioral Activation and Inhibition Systems: Implications for Understanding and Treating Chronic Pain. THE JOURNAL OF PAIN 2016; 17:529.e1-529.e18. [DOI: 10.1016/j.jpain.2016.02.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 01/14/2016] [Accepted: 02/01/2016] [Indexed: 02/07/2023]
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Johansson AC, Öhrvik J, Söderlund A. Associations among pain, disability and psychosocial factors and the predictive value of expectations on returning to work in patients who undergo lumbar disc surgery. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2015; 25:296-303. [DOI: 10.1007/s00586-015-3820-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 02/15/2015] [Accepted: 02/15/2015] [Indexed: 10/23/2022]
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Piva SR, Lasinski S, Almeida GJ, Fitzgerald GK, Delitto A. Association between Disability and Psychological Factors and Dose of Neuromuscular Electrical Stimulation in Subjects with Rheumatoid Arthritis. ACTA ACUST UNITED AC 2013; 34:57-66. [PMID: 24967156 DOI: 10.3233/ppr-130020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND The therapeutic effect of neuromuscular electrical stimulation (NMES) on muscle strengthening and hypertrophy depends on its dose. Patients must tolerate high doses of NMES to maximize gains in muscle function. It is unknown why some patients are able to achieve high NMES dose while others are not. Disability and psychological attributes may play a role in a patient's tolerance of NMES dose. PURPOSE To explore if disability and psychological attributes associate with the ability to achieve high doses of NMES in patients with rheumatoid arthritis (RA). METHODS Cross-sectional study. Forty subjects with RA participated in 2 sessions of NMES intervention to the quadriceps muscles. The highest NMES dose achieved by each subject was recorded. Dose was defined as the torque produced by the NMES as a percentage of the torque produced during a maximum voluntary isometric contraction. Subjects were then grouped in high or low NMES dose. Variables investigated in this study included disability, pain coping strategies, pain acceptance, sense of mastery or control, anxiety, and depression. Correlations were sought between these factors and NMES dose. MAIN RESULTS In unadjusted models, disability, coping self-statements, catastrophizing, and anxiety were predictors of NMES dose. In adjusted models only disability (OR = 0.17 [95% CI: 0.04, 0.77]) and catastrophizing (OR = 0.85 [95% CI: 0.72, 0.99]) predicted NMES dose. CONCLUSION Patients with RA with lower disability and lower catastrophising achieve higher doses of NMES. Identifying factors associated with achieving high NMES dose may guide strategies to improve effectiveness of this intervention.
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Affiliation(s)
- Sara R Piva
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA
| | - Stephanie Lasinski
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA
| | - Gustavo Jm Almeida
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA
| | - G Kelley Fitzgerald
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, Director of Physical Therapy Clinical and Translational Research Center, University of Pittsburgh, Pittsburgh PA
| | - Anthony Delitto
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh PA
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Raspe HH, Kohlmann T. [Clinical diagnosis and documentation of chronic-rheumatic pain syndromes the state of the art 1990.]. Schmerz 2012; 5:S38-51. [PMID: 18415166 DOI: 10.1007/bf02530069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- H H Raspe
- Medizinische Universität Lübeck Institut für Sozialmedizin, Sophienstraße 2, 2400, Lübeck
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Abstract
BACKGROUND In 1980 the Waddell score, consisting of 8 non-organic or behavioural signs, was developed to measure illness behaviour in patients with low back pain. There is some debate about whether the Waddell score is a valid screening instrument for illness behaviour and psychological distress, or whether it merely reflects elevated pain levels and diminished functional physical capacities. OBJECTIVE The purpose of this study was to examine the construct validity of the Waddell score. METHODS In this cross-sectional study, a total of 20 hypotheses about the associations between the Waddell score and measures from different domains were formulated a priori, based on a Medline database search (1980-2010). These hypotheses were tested in a sample of 229 patients with chronic low back pain who attended an outpatient rehabilitation centre. RESULTS The percentage of hypotheses that were confirmed for the association between the Waddell score and the domain pain was 100%, for the domain physical 80%, for the domain illness behaviour 80% and 50% for the domain psychological. Correlation coefficients and kappa values varied between 0.06 and 0.44 for the measures that were expected to be associated with the Waddell score. CONCLUSION Most of our challenging a priori hypotheses were accepted, and the Waddell score was found to have satisfactory cross-sectional construct validity. However, the presence of Waddell signs does not indicate exactly what the specific problems are and must therefore be conceptualized and understood in the total clinical picture of the patient. The association between the Waddell score and measures from different domains is weak. The Waddell score cannot be regarded as a straightforward psychological "screener".
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van der Hulst M, Vollenbroek-Hutten MM, Schreurs KM, Rietman JS, Hermens HJ. Relationships between coping strategies and lumbar muscle activity in subjects with chronic low back pain. Eur J Pain 2012; 14:640-7. [DOI: 10.1016/j.ejpain.2009.10.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2009] [Revised: 08/28/2009] [Accepted: 10/20/2009] [Indexed: 01/24/2023]
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Heutink M, Post MW, Bongers-Janssen HM, Dijkstra CA, Snoek GJ, Spijkerman DC, Lindeman E. The CONECSI trial: Results of a randomized controlled trial of a multidisciplinary cognitive behavioral program for coping with chronic neuropathic pain after spinal cord injury. Pain 2012; 153:120-128. [DOI: 10.1016/j.pain.2011.09.029] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2010] [Revised: 08/08/2011] [Accepted: 09/29/2011] [Indexed: 11/26/2022]
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Abstract
RÉSUMÉStimuler l'autonomie chez les gens de plus de 65 ans, dont plus de 80 pour cent éprouvent des troubles médicaux, constitue un défi de taille pour le personnel des politiques, les planificateurs de programme et les prestateurs de services, qui doivent prendre en considération les aspects physiques, sociaux et psychologiques de l'autonomie. Cet article présente une analyse bibliographique systématique et une synthèse rigoureuse de 65 rapports de recherche détaillés sélectionnés à partir de 238 études publicées sur les approches de soins favorisant la promotion de l'autonomie des personnes àgées. Cet article témoigne en faveur des programmes d'exercices et de promotion de la santé pour toutes les personnes âgées, ainsi que de la gestion à domicile des soins de santé et des programmes de prévention des chutes pour les aîné(e)s frêles. De plus, les conclusions soulignent l'importance d'accorder plus d'attention aux politiques sur les appareils accessoires fonctionnels et le besoin d'avoir plus de recherches sur l'efficacité des programmes de santé publique, sur les stratégies de promotion de soins médicaux préventifs et sur les facteurs psychosociaux qui influent sur l'auto-efficacité des personnes âgées.
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Heutink M, Post MWM, Luthart P, Pfennings LEMA, Dijkstra CA, Lindeman E. A multidisciplinary cognitive behavioural programme for coping with chronic neuropathic pain following spinal cord injury: the protocol of the CONECSI trial. BMC Neurol 2010; 10:96. [PMID: 20961406 PMCID: PMC2984384 DOI: 10.1186/1471-2377-10-96] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2010] [Accepted: 10/20/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Most people with a spinal cord injury rate neuropathic pain as one of the most difficult problems to manage and there are no medical treatments that provide satisfactory pain relief in most people. Furthermore, psychosocial factors have been considered in the maintenance and aggravation of neuropathic spinal cord injury pain. Psychological interventions to support people with spinal cord injury to deal with neuropathic pain, however, are sparse. The primary aim of the CONECSI (COping with NEuropathiC Spinal cord Injury pain) trial is to evaluate the effects of a multidisciplinary cognitive behavioural treatment programme on pain intensity and pain-related disability, and secondary on mood, participation in activities, and life satisfaction. METHODS/DESIGN CONECSI is a multicentre randomised controlled trial. A sample of 60 persons with chronic neuropathic spinal cord injury pain will be recruited from four rehabilitation centres and randomised to an intervention group or a waiting list control group. The control group will be invited for the programme six months after the intervention group. Main inclusion criteria are: having chronic (> 6 months) neuropathic spinal cord injury pain as the worst pain complaint and rating the pain intensity in the last week as 40 or more on a 0-100 scale. The intervention consists of educational, cognitive, and behavioural elements and encompasses 11 sessions over a 3-month period. Each meeting will be supervised by a local psychologist and physical therapist. Measurements will be performed before starting the programme/entering the control group, and at 3, 6, 9, and 12 months. Primary outcomes are pain intensity and pain-related disability (Chronic Pain Grade questionnaire). Secondary outcomes are mood (Hospital Anxiety and Depression Scale), participation in activities (Utrecht Activities List), and life satisfaction (Life Satisfaction Questionnaire). Pain coping and pain cognitions will be assessed with three questionnaires (Coping Strategy Questionnaire, Pain Coping Inventory, and Pain Cognition List). DISCUSSION The CONECSI trial will reveal the effects of a multidisciplinary cognitive behavioural programme for people with chronic neuropathic spinal cord injury pain. This intervention is expected to contribute to the rehabilitation treatment possibilities for this population. TRIAL REGISTRATION Dutch Trial Register NTR1580.
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Affiliation(s)
- Matagne Heutink
- Rudolf Magnus Institute of Neuroscience and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and Rehabilitation Center De Hoogstraat, Utrecht, The Netherlands
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Verhagen A, Karels C, Schellingerhout J, Willemsen S, Koes B, Bierma-Zeinstra S. Pain severity and catastrophising modify treatment success in neck pain patients in primary care. ACTA ACUST UNITED AC 2010; 15:267-72. [DOI: 10.1016/j.math.2010.01.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2009] [Revised: 12/30/2009] [Accepted: 01/11/2010] [Indexed: 11/27/2022]
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Karels CH, Bierma-Zeinstra SM, Verhagen AP, Koes BW, Burdorf A. Sickness absence in patients with arm, neck and shoulder complaints presenting in physical therapy practice: 6 months follow-up. ACTA ACUST UNITED AC 2010; 15:476-81. [PMID: 20570208 DOI: 10.1016/j.math.2010.04.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2009] [Revised: 03/29/2010] [Accepted: 04/15/2010] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To describe sickness absence in patients with arm, neck and/or shoulder complaints and to evaluate determinants of sickness absence during 6 months follow-up. METHODS A prospective cohort study in physical therapy practice with follow-up measurements at 3 and 6 months. The main outcome measure was the occurrence of sickness absence due to arm, neck and shoulder complaints during 6 months follow-up. Determinants were tested in univariate and multivariate GEE (Generalized Estimating Equations) analysis. RESULTS At baseline 161 patients (33%) reported absence from work. The multivariate analysis showed that self-reported work-relatedness of complaints, previous musculoskeletal trauma, higher severity of complaints at baseline, more somatization and low decision authority at work were associated with sickness absence during the follow-up period. CONCLUSION In physical therapy practice, social and psychological factors (at work) influence the occurrence of sickness absence in patients with arm, neck and/or shoulder complaints. These factors can be taken into account when developing and evaluating interventions to reduce sickness absence among these patients.
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Affiliation(s)
- Celinde H Karels
- Department of General Practice, Erasmus Medical Centre University, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
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Whyte A, Carroll LJ. The relationship between catastrophizing and disability in amputees experiencing phantom pain. Disabil Rehabil 2009; 26:649-54. [PMID: 15204503 DOI: 10.1080/09638280410001672508] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE In recent years, researchers have noted that catastrophizing predicts both self-reported and objective measures of disability in a variety of chronic pain conditions. The present study sought to examine this in a working-age amputee population experiencing phantom pain. METHOD Participants completed a postal questionnaire incorporating measures of pain, disability and coping. A response rate of 62% resulted in 315 completed data sets being incorporated into the study. RESULTS Utilizing the three subscales of the Sickness Impact Profile, catastrophizing uniquely predicted 11% of the variance in overall level of disability, 6% in physical disability and 13% in psychosocial disability after accounting for demographic, amputation and pain-related variables. CONCLUSION The findings suggest that catastrophizing is a significant predictor of self-reported disability in an amputee population. This population have lifetime rehabilitation needs in that prostheses have to be remade on a regular basis. The service provided tends to focus on physical rehabilitation with the goal of providing amputees with limbs that most closely resemble the appearance and function of the intact limb. This study provides tentative support for development of an intervention that specifically targets catastrophizing.
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Affiliation(s)
- A Whyte
- Department of Psychology, Liverpool John Moores University, Liverpool, UK.
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Irachabal S, Koleck M, Rascle N, Bruchon-Schweitzer M. Stratégies de coping des patients douloureux : adaptation française du coping strategies questionnaire (CSQ-F). Encephale 2008; 34:47-53. [DOI: 10.1016/j.encep.2006.11.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2006] [Accepted: 11/27/2006] [Indexed: 10/22/2022]
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Thompson P, Carr E. Content analysis of general practitioner-requested lumbar spine X-ray reports. Br J Radiol 2007; 80:866-71. [DOI: 10.1259/bjr/11719131] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Karels CH, Bierma-Zeinstra SMA, Burdorf A, Verhagen AP, Nauta AP, Koes BW. Social and psychological factors influenced the course of arm, neck and shoulder complaints. J Clin Epidemiol 2007; 60:839-48. [PMID: 17606181 DOI: 10.1016/j.jclinepi.2006.11.012] [Citation(s) in RCA: 101] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2005] [Revised: 11/14/2006] [Accepted: 11/17/2006] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To investigate the clinical course and prognostic factors of complaints of arm, neck, and shoulder. STUDY DESIGN AND SETTING A prospective cohort study in physical therapy practice. Participating physiotherapists recruited new consulters with musculoskeletal complaints of the neck and/or upper extremities. Participants filled in questionnaires at baseline, 3 months, and 6 months. The main outcome measure was the persistence of complaints over 6-month follow-up. Possible predictors like social and psychological factors, physical factors, and complaint specific factors were tested in univariate and multivariate logistic regression analyses for repeated measurements. RESULTS Of the 624 participants at baseline 543 (87%) returned at least one follow-up questionnaire. At 6-month follow-up, 40% had persisting pain and discomfort. Somatization, kinesiophobia, catastrophizing, and a long duration of complaints at baseline were significantly related to the persistence of complaints over 6 months in the total population. In those with paid work (77%), catastrophizing, low decision authority at work, and a long duration of complaints at baseline were significantly related to the persistence of complaints over 6 months. CONCLUSION 40% of the participants had persisting pain and discomfort after 6 months and mainly social and psychological factors played a role in this course.
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Affiliation(s)
- C H Karels
- Department of General Practice, Erasmus MC, The Netherlands.
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Lim HS, Chen PP, Wong TCM, Gin T, Wong E, Chan ISF, Chu J. Validation of the Chinese Version of Pain Self-Efficacy Questionnaire. Anesth Analg 2007; 104:918-23. [PMID: 17377107 DOI: 10.1213/01.ane.0000255731.24092.a5] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Self-efficacy is a person's belief in his or her ability to perform a certain behavior that achieves a desired outcome. Belief in self-efficacy influences the use of pain-coping strategies, physical and psychological function, and rehabilitation outcome in chronic pain patients. We conducted this prospective study to validate the psychometric properties of a Chinese version of the Pain Self-Efficacy Questionnaire (PSEQ-HK). METHODS A previously translated PSEQ-HK was evaluated with the author's consent. Forward-backward translation was conducted, followed by critical appraisal by an expert panel. Reliability was examined by completing the PSEQ-HK twice over a 1-wk interval. One-hundred-twenty Chinese patients with chronic nonmalignant pain were asked to self-complete a set of health-related instruments in Chinese: Numeric Pain Rating Scale, Hospital Anxiety and Depression Scale, Roland-Morris Disability Questionnaire, Pain Catastrophizing Scale, and Medical Outcome Study Short-Form 36 (SF36) Health Survey. RESULTS PSEQ-HK had good retest reliability (intraclass correlation coefficient 0.75) and high internal consistency (Cronbach's alpha 0.93). Exploratory factor analysis showed a one-factor model that accounted for 61% of the total variance, with minimal factor loading of 0.69. It was significantly correlated with the Hospital Anxiety and Depression Scale, Pain Catastrophizing Scale, and five domains of SF36 (bodily pain, vitality, social functioning, role emotion, and mental health). Moderate correlations were observed with Roland-Morris Disability Questionnaire and two domains of SF36 (role physical, general health). It had no correlation with pain score and medication use. CONCLUSIONS PSEQ-HK is a reliable Chinese clinical assessment tool with satisfactory psychometric properties. Our results provided preliminary support for the construct validity of PSEQ-HK in a heterogeneous Chinese population with chronic nonmalignant pain.
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Affiliation(s)
- Huey S Lim
- Department of Anaesthesia and Intensive Care, Chinese University of Hong Kong, Hong Kong, China.
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Samwel HJA, Evers AWM, Crul BJP, Kraaimaat FW. The Role of Helplessness, Fear of Pain, and Passive Pain-Coping in Chronic Pain Patients. Clin J Pain 2006; 22:245-51. [PMID: 16514324 DOI: 10.1097/01.ajp.0000173019.72365.f5] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The goal of this study was to examine the relative contribution of helplessness, fear of pain, and passive pain-coping to pain level, disability, and depression in chronic pain patients attending an interdisciplinary pain center. METHODS One hundred sixty-nine chronic pain patients who had entered treatment at an interdisciplinary pain center completed various questionnaires and a pain diary. RESULTS Helplessness, fear of pain, and passive pain-coping strategies were all related to the pain level, disability, and depression. When comparing the contribution of the predictors in multiple regression analyses, helplessness was the only significant predictor for pain level. Helplessness and the passive behavioral pain-coping strategies of resting significantly predicted disability. The passive cognitive pain-coping strategy of worrying significantly predicted depression. CONCLUSIONS These findings indicate a role for helplessness and passive pain-coping in chronic pain patients and suggest that both may be relevant in the treatment of pain level, disability, and/or depression.
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Affiliation(s)
- Han J A Samwel
- Department of Medical Psychology, University Medical Center St. Radboud Nijmegen, Nijmegen, The Netherlands.
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Palyo SA, Beck JG. Post-traumatic stress disorder symptoms, pain, and perceived life control: associations with psychosocial and physical functioning. Pain 2006; 117:121-7. [PMID: 16099099 PMCID: PMC1363367 DOI: 10.1016/j.pain.2005.05.028] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2004] [Revised: 05/20/2005] [Accepted: 05/27/2005] [Indexed: 10/25/2022]
Abstract
The symptoms of PTSD and pain frequently co-occur following a traumatic event; however, very little is known about how these two conditions are associated with physical and psychosocial functioning. The current study intended to first examine the differential association of co-occurring pain complaints and PTSD symptoms with disability in the domains of psychosocial and physical functioning, and second, to test whether perceived life control is a mediator of these relationships. All participants experienced a motor vehicle accident (MVA) and reported pain due to accident-related injuries (n=183). Structural equation modeling was used to develop two models hypothesizing a relationship between PTSD symptomatology, pain severity, and perceived life control. Separate models were constructed for psychosocial and physical functioning, based on the hypothesis that pain and PTSD would be differentially related to disability in these two domains. Results suggested that more severe PTSD symptoms and greater pain complaints were related to psychosocial impairment, however, only pain was significantly related to impairment in physical functioning. Perceptions of life control were shown to further explain these interrelationships.
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Affiliation(s)
- Sarah A Palyo
- Department of Psychology, University at Buffalo-SUNY, 216 Park Hall, Buffalo, NY 14260, USA.
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Sorbi MJ, Peters ML, Kruise DA, Maas CJM, Kerssens JJ, Verhaak PFM, Bensing JM. Electronic Momentary Assessment in Chronic Pain I: Psychological Pain Responses as Predictors of Pain Intensity. Clin J Pain 2006; 22:55-66. [PMID: 16340594 DOI: 10.1097/01.ajp.0000148624.46756.fa] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES AND METHODS Electronic momentary assessment was employed to substantiate the relevance of psychological functioning in chronic pain. More than 7,100 electronic diaries from 80 patients with varying IASP classified types of chronic pain served to investigate to what extent fear-avoidance, cognitive and spousal solicitous and punishing pain responses explained fluctuations in pain intensity and whether patients with pre-chronic, recently chronic and persistently chronic pain differed in this regard. RESULTS Psychological pain responses explained 40% of the total variance in pain intensity: almost 24% concerned pain variance that occurred between the CPD patients and 16% pertained to pain variance due to momentary differences within these patients. Separately tested fear-avoidance and cognitive responses each explained about 28% of the total pain variance, while spousal responses explained 9%. Catastrophizing emerged as the strongest pain predictor, followed by pain-related fear and bodily vigilance. Results did not differ with the duration of chronicity. DISCUSSION Exaggerated negative interpretations of pain, and fear that movement will induce or increase pain strongly predicted CPD pain intensity. Spousal responses-assessed only when the spouse was with the patient who at that moment was in actual pain-may more strongly affect immobility due to pain than pain intensity per se (see part II of the study). The findings substantiate the importance of catastrophizing, fear and vigilance identified primarily in low back pain and extend this to other forms of chronic pain. The compelling evidence of momentary within-patients differences underscores that these must be accounted for in chronic pain research and practice.
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Affiliation(s)
- Marjolijn J Sorbi
- Department of Health Psychology, Utrecht University, Utrecht, The Netherlands.
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22
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Tan G, Jensen MP, Thornby J, Anderson KO. Ethnicity, control appraisal, coping, and adjustment to chronic pain among black and white Americans. PAIN MEDICINE 2005; 6:18-28. [PMID: 15669947 DOI: 10.1111/j.1526-4637.2005.05008.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To identify similarities and differences among non-Hispanic black and white patients in pain appraisal, beliefs about pain, and ways of coping with pain. We also examined the association between these factors (i.e., appraisals, beliefs, coping) and patient perception or subjective experience of their functioning in each ethnic group. DESIGN Cross-sectional survey of patients with chronic pain at pretreatment assessment. SETTING Integrated pain management program at a Veterans Affairs Medical Center in Texas. PATIENTS A total of 128 non-Hispanic black Americans and 354 non-Hispanic white Americans completed self-report measures of pain appraisal, coping, and adjustment that included the Multidimensional Pain Inventory, Survey of Pain Attitudes, Coping Strategies Questionnaire, and Chronic Pain Coping Inventory. RESULTS Although the analyses indicated many similarities between the two groups concerning pain-related beliefs and coping, the black patients reported lower perceived control over pain, more external pain-coping strategies, and a stronger belief that others should be solicitous when they experience pain. The black patients also reported significantly higher levels of depression and disability, even after controlling for pain severity. Regression analyses revealed that the coping and appraisal factors predicting physical and psychological functioning were the same for both white and black patients, with ethnicity accounting for a nonsignificant amount of the total variance. CONCLUSIONS The current findings suggest similarities as well as differences between non-Hispanic black and white patients in the ways they view and cope with pain. However, the association between psychological factors (attitudes and beliefs, coping responses) and adjustment to chronic pain was comparable for both ethnic groups. If replicated, the findings suggest that specific tailoring of cognitive behavioral therapies to different racial/ethnic groups may not be needed to maximize treatment outcome.
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Affiliation(s)
- Gabriel Tan
- Houston VA Medical Center, Houston, Texas 77030, USA.
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Hastie BA, Riley JL, Fillingim RB. Ethnic differences in pain coping: factor structure of the coping strategies questionnaire and coping strategies questionnaire-revised. THE JOURNAL OF PAIN 2004; 5:304-16. [PMID: 15336635 DOI: 10.1016/j.jpain.2004.05.004] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 12/09/2003] [Revised: 03/23/2004] [Accepted: 05/13/2004] [Indexed: 10/26/2022]
Abstract
UNLABELLED Coping has been examined extensively in the pain literature, although coping instruments have been typically validated in clinical populations with little ethnic diversity. This study examined the factor structure of the Coping Strategies Questionnaire (CSQ) and the CSQ-Revised (CSQ-R) in 650 healthy male and female African American (44%) and white (56%) subjects and explored associations of coping to health and pain-related measures. Factor analyses revealed 6 components for each ethnic group, accounting for comparable amounts of variance and resembling previously reported CSQ subscales. Internal consistency for both ethnic groups was acceptable (0.72-0.91). There were significant main effects for ethnicity on 4 of the CSQ-R scales (P < .05). No ethnic differences in pain or health variables emerged, although when split into high-pain versus minimal-pain groups, differences were revealed on catastrophizing. Results indicate that the factor structure of the CSQ-R in healthy adults is similar to clinical populations and is comparable across African American and white subjects. Group differences on CSQ-R scales suggest potentially important ethnic influences on pain coping. These findings support the use of the CSQ-R to assess coping in African Americans and in healthy young adults. Additional clinical research is needed to determine the practical importance of group differences in pain coping. PERSPECTIVE Coping has been examined extensively in the pain literature, although coping instruments typically have been validated in clinical populations with little ethnic diversity. This study examines the factor structure of the CSQ-Revised in an ethnically diverse population and supports the use of the CSQ-R to assess coping in African Americans and in healthy young adults.
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Affiliation(s)
- Barbara A Hastie
- University of Florida College of Dentistry, Division of Public Health Services and Research, Gainesville 32608, USA.
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Woby SR, Watson PJ, Roach NK, Urmston M. Are changes in fear-avoidance beliefs, catastrophizing, and appraisals of control, predictive of changes in chronic low back pain and disability? Eur J Pain 2004; 8:201-10. [PMID: 15109970 DOI: 10.1016/j.ejpain.2003.08.002] [Citation(s) in RCA: 148] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2003] [Accepted: 08/21/2003] [Indexed: 01/30/2023]
Abstract
Interventions for chronic low back pain (CLBP) often attempt to modify patients' levels of catastrophizing, their fear-avoidance beliefs, and their appraisals of control. Presumably, these interventions are based on the notion that changes in these cognitive factors are related to changes in measures of adjustment. The aim of the present study was to explore whether changes on these cognitive factors were related to changes in CLBP and disability. Fifty-four CLBP patients completed a series of self-report measures prior to beginning a cognitive-behavioral based intervention and again upon discharge. Change scores (post-treatment score minus pre-treatment score) were calculated for each of the self-report measures. The study found that changes in the cognitive factors were not significantly associated with changes in pain intensity. In contrast, reductions in fear-avoidance beliefs about work and physical activity, as well as increased perceptions of control over pain were uniquely related to reductions in disability, even after controlling for reductions in pain intensity, age and sex. The final model explained 71% of the variance in reductions in disability.
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Affiliation(s)
- Steve R Woby
- Department of Exercise and Sport Science, Manchester Metropolitan University, Alsager, Stoke-on-Trent, UK.
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25
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Kraaimaat FW, Evers AWM. Pain-coping strategies in chronic pain patients: psychometric characteristics of the pain-coping inventory (PCI). Int J Behav Med 2004; 10:343-63. [PMID: 14734263 DOI: 10.1207/s15327558ijbm1004_5] [Citation(s) in RCA: 115] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
This article presents a series of studies aimed at validating a comprehensive pain-coping inventory (PCI) that is applicable to various types of patients with chronic pain. Item and scale analyses were performed for patients with rheumatoid arthritis (RA), patients with chronic headache, and pain clinic outpatients. The following 6 scales were derived from a simultaneous component analysis: Pain Transformation, Distraction, Reducing Demands, Retreating, Worrying, and Resting, all of which were internally reliable. A higher order factor analysis grouped the PCI scales into active (transformation, distraction, reducing demands) and passive (retreating, worrying, resting) pain-coping dimensions. Differences in use of strategy found between RA patients and headache patients indicated that the PCI scales were sufficiently sensitive to measure differences between groups. Concurrent validity was assessed for patients with RA and patients with fibromyalgia and predictive validity was assessed for patients with recently diagnosed RA after 1 and 3 years. In both analyses the validity of the scales was supported, in particular the predictive validity of passive coping scales for future outcomes.
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Affiliation(s)
- Floris W Kraaimaat
- Department of Medical Psychology, University Medical Center, University of Nijmegen, Nijmegen, The Netherlands.
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26
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27
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Azevedo DC, Samulski DM. Assessment of psychological pain management techniques: a comparative study between athletes and non-athletes. REV BRAS MED ESPORTE 2003. [DOI: 10.1590/s1517-86922003000400003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
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28
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Abstract
This cross-sectional study investigated the relationships between individual differences in coping and catastrophizing, and markers of adaptation to chronic pain associated with breast cancer. Sixty-eight breast cancer patients with chronic pain due to either cancer or cancer-treatment were administered self-report instruments that assess active and passive coping, catastrophizing, pain, disability, and mood disturbance. Regression analyses were performed to investigate the unique contribution of differences in coping and catastrophizing to the various markers of adaptation. Both active and passive coping explained unique variance in self-reported disability; active coping was associated with less disability while passive coping was associated with greater disability. Catastrophizing explained unique variance in anxiety and depression scores; higher levels of catastrophizing were associated with greater emotional distress. The results suggest that coping and catastrophizing may contribute to different outcomes in chronic pain in breast cancer patients and provides preliminary evidence that they may be important targets of psychological treatments.
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Affiliation(s)
- Scott R Bishop
- Centre for Addiction and Mental Health, Toronto, Canada.
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30
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Abstract
Research has demonstrated the importance of psychological factors in coping, quality of life, and disability in chronic pain. Furthermore, the contributions of psychology in the effectiveness of treatment of chronic pain patients have received empirical support. The authors describe a biopsychosocial model of chronic pain and provide an update on research implicating the importance of people's appraisals of their symptoms, their ability to self-manage pain and related problems, and their fears about pain and injury that motivate efforts to avoid exacerbation of symptoms and further injury or reinjury. They provide a selected review to illustrate treatment outcome research, methodological issues, practical, and clinical issues to identify promising directions. Although there remain obstacles, there are also opportunities for psychologists to contribute to improved understanding of pain and treatment of people who suffer from chronic pain. The authors conclude by noting that pain has received a tremendous amount of attention culminating in the passage of a law by the U.S. Congress designating the period 2001-2011 as the "The Decade of Pain Control and Research."
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Affiliation(s)
- Dennis C Turk
- Department of Anesthesiology, University of Washington School of Medicine, Seattle 98195, USA.
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31
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LaChapelle DL, Hadjistavropoulos HD, McCreary DR, Asmundson GJ. Contributions of pain-related adjustment and perceptions of control to coping strategy use among cervical sprain patients. Eur J Pain 2002; 5:405-13. [PMID: 11743706 DOI: 10.1053/eujp.2001.0261] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Coping is a cyclical process in which an individual evaluates stressful events, chooses and implements coping strategies, re-evaluates the outcome of the coping effort and modifies the strategy if necessary. The intent of the present study was to evaluate the extent to which pain-related adjustment (i.e. pain severity, pain interference, negative affect) and perceptions of control are associated with the implementation of particular coping strategies. Participants were 136 patients assessed at an interdisciplinary pain clinic for cervical sprain injuries. As part of a routine assessment, participants completed a questionnaire package regarding background, pain severity, pain interference, negative affect, perceived control and use of particular coping strategies. Results of hierarchical multiple regression analyses revealed that pain interference, after controlling for all other variables, was associated with greater use of less physically demanding strategies (i.e. resting, guarding, asking for assistance, seeking social support and coping self-statements). Negative affect, on the other hand, after controlling for other variables, was associated with reduced use of task persistence. Finally, perceived control, independent of other variables, was associated with greater use of cognitive and social coping strategies (i.e. asking for assistance, seeking social support and coping self-statements). The results of the study shed light on the complex relationship between use of particular coping strategies and situational variables of pain-related adjustment and perceived control. Implications for clinicians who assist patients via implementation or modification of particular coping techniques are discussed.
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Affiliation(s)
- D L LaChapelle
- Clinical Research and Development Program, Regina Health District and Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
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32
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Abstract
This study examined the relationship between pain self-efficacy beliefs and a range of pain behaviours, as measured by the pain behaviour questionnaire (PBQ), using a prospective design. A heterogeneous sample of 145 chronic pain patients completed sets of questionnaires on four occasions over a nine-month period. Multiple hierarchical regression analyses revealed that the subjects' confidence in their ability to perform a range of tasks despite pain (assessed at baseline), was predictive of total pain behaviour and avoidance behaviour over the nine-month study period. This finding was particularly significant because the analyses controlled for the possible effects of pain severity (at each measurement occasion), pain chronicity, age, gender, physical disability, depression, neuroticism and catastrophising. These findings suggest that pain self-efficacy beliefs are an important determinant of pain behaviours and disability associated with pain, over and above the effects of pain, distress and personality variables. In particular, higher pain self-efficacy beliefs are predictive of reduced avoidance behaviours over an extended period.
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Affiliation(s)
- Ali Asghari
- School of Psychology, University of Shahed, P.O. Box 14155-7137, Tehran, Iran University of Sydney Pain Management and Research Centre, Royal North Shore Hospital, St. Leonards, New South Wales 2065, Australia
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Sullivan MJ, Thorn B, Haythornthwaite JA, Keefe F, Martin M, Bradley LA, Lefebvre JC. Theoretical perspectives on the relation between catastrophizing and pain. Clin J Pain 2001; 17:52-64. [PMID: 11289089 DOI: 10.1097/00002508-200103000-00008] [Citation(s) in RCA: 1568] [Impact Index Per Article: 68.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The tendency to "catastrophize" during painful stimulation contributes to more intense pain experience and increased emotional distress. Catastrophizing has been broadly conceived as an exaggerated negative "mental set" brought to bear during painful experiences. Although findings have been consistent in showing a relation between catastrophizing and pain, research in this area has proceeded in the relative absence of a guiding theoretical framework. This article reviews the literature on the relation between catastrophizing and pain and examines the relative strengths and limitations of different theoretical models that could be advanced to account for the pattern of available findings. The article evaluates the explanatory power of a schema activation model, an appraisal model, an attention model, and a communal coping model of pain perception. It is suggested that catastrophizing might best be viewed from the perspective of hierarchical levels of analysis, where social factors and social goals may play a role in the development and maintenance of catastrophizing, whereas appraisal-related processes may point to the mechanisms that link catastrophizing to pain experience. Directions for future research are suggested.
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Affiliation(s)
- M J Sullivan
- Department of Psychology, Dalhousie University, Halifax, Nova Scotia, Canada.
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Sullivan MJ, Rodgers WM, Kirsch I. Catastrophizing, depression and expectancies for pain and emotional distress. Pain 2001; 91:147-54. [PMID: 11240087 DOI: 10.1016/s0304-3959(00)00430-9] [Citation(s) in RCA: 220] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The present research addressed the relation between catastrophizing, depression and response expectancies in anticipation of an experimental pain procedure. One hundred and twenty undergraduates (48 men, 72 women) participated in exchange for course credit. Prior to immersing one arm in a container of ice water, participants were asked to complete measures of catastrophizing and depression, and to estimate the degree of pain and emotional distress they expected to experience. After a 1-min immersion, participants rated their actual experience. Pain expectancies partially mediated the relation between catastrophizing and pain experience. Pain expectancies also mediated the relation between depression and pain experience. Catastrophizing, but not depression, was associated with a tendency to underestimate pain and emotional distress. The implications of these findings for the conceptual distinctiveness of catastrophizing and depression are discussed. Discussion also examines the potential implications of the present findings for pain management interventions.
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Affiliation(s)
- M J Sullivan
- Department of Psychology, Dalhousie University, Nova Scotia B3H 4J1, Halifax, Canada.
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35
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Santavirta N, Björvell H, Solovieva S, Alaranta H, Hurskainen K, Konttinen YT. Coping strategies, pain, and disability in patients with hemophilia and related disorders. ARTHRITIS AND RHEUMATISM 2001; 45:48-55. [PMID: 11308061 DOI: 10.1002/1529-0131(200102)45:1<48::aid-anr83>3.0.co;2-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To analyze the use of various coping strategies in homogeneous groups of patients with hemophilia and von Willebrand's disease and to investigate the relationship between the state of the disease, the use of coping strategies, and management of the disease. METHODS The coping strategies measured by the Coping Strategies Questionnaire were analyzed in 3 homogeneous groups of 224 patients. Psychosocial well-being (PWB) measured by the Rand 36-item Health Survey 1.0 was used as an indicator of management of the disease. The pain factor consisted of the following variables: pain intensity, use of analgesics, Functional Disability Index, and physical activity level. RESULTS The groups of patients differed significantly only in the use of the catastrophizing strategy (CAT). In all pain groups, distraction was the most commonly used coping strategy. A significant interaction effect of pain factor and age on PWB (P = 0.04) was found. The mediating function of the CAT strategy was confirmed by the series of regression analyses. CONCLUSION The coping strategy profile in hemophilia was found to be similar to those in other chronic pain states. The use of the strategies does not depend on the severity of the disease. We confirmed the role of age and the use of the CAT strategy as, respectively, moderator and mediator in the pattern of relationships between the clinical state of the disease and psychosocial well-being.
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Affiliation(s)
- N Santavirta
- Department of Education, Helsinki University, Helsinki University Central Hospital, Finland
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36
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Tan G, Jensen MP, Robinson-Whelen S, Thornby JI, Monga TN. Coping with chronic pain: a comparison of two measures. Pain 2001; 90:127-33. [PMID: 11166978 DOI: 10.1016/s0304-3959(00)00395-x] [Citation(s) in RCA: 85] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Cognitive-behavioral models of chronic pain hypothesize that how a person copes with pain influences how well he or she adjusts to the pain. Several measures have been developed to assess pain coping, but no studies have yet examined whether these measures are complementary or redundant. In the current study, two pain coping measures (the Chronic Pain Coping Inventory, CPCI, and the Coping Strategies Questionnaire, CSQ) were completed by a large number (N=564) of primarily male veterans referred to a chronic pain program. Regression analyses indicated that the CPCI scales did not contribute unique variance to the prediction of depression over and above the CSQ scales. The CSQ Catastrophizing scale was the single most powerful predictor of depression, although several other CSQ scales (Coping Self-Statements, Diverting Attention, and Increasing Behavioral Activities) also contributed. Both the CPCI and the CSQ contributed unique variance to the prediction of disability, although the CPCI scales appear to be more strongly related to disability than the CSQ scales. The CPCI Guarding scale was the single most powerful predictor of disability of all the coping responses assessed in this study. Other scales predicting disability were the CPCI Seeking Social Support, the CSQ Catastrophizing, and the CSQ Increasing Behavioral Activities. While both CSQ and CPCI contribute unique but modest variance to the prediction of pain severity, the CSQ Catastrophizing scale was the single most powerful predictor of pain severity. The findings of this study are consistent with cognitive-behavioral models of pain. Future research will need to determine whether changes in coping responses (catastrophizing and guarding, in particular) merely reflect, or actually influence, adjustment to chronic pain. In the meantime, clinicians would be wise to give these coping responses particular attention in chronic pain programs.
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Affiliation(s)
- G Tan
- Department of Veterans Affairs, Medical Center, 2002 Holcombe Boulevard, Houston TX 77030, USA
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37
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Éditorial: Énoncé de politique sur une approche individualisée à la promotion de la santé des personnes âgées. Can J Aging 2001. [DOI: 10.1017/s0714980800012939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Editorial: Canadian Association on Gerontology Policy Statement on Health Promotion for Individual Seniors. Can J Aging 2001. [DOI: 10.1017/s0714980800012927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Groth-Marnat G, Fletcher A. Influence of neuroticism, catastrophizing, pain duration, and receipt of compensation on short-term response to nerve block treatment for chronic back pain. J Behav Med 2000; 23:339-50. [PMID: 10984863 DOI: 10.1023/a:1005596716967] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
This study investigated the influence of pain catastrophizing, neuroticism, pain duration, and receipt of compensation for 60 patients undergoing nerve block treatment for chronic back pain. Follow-up assessment 1 week following nerve block treatment found that neither neuroticism nor catastrophizing predicted level of reported pain or extent of disability. However, receipt of compensation and duration of pain were both associated with reduced benefit from treatment. The above four variables combined were able to account for 24% of the outcome variance in both level of pain and extent of disability. Possible causal patterns related to compensation and treatment outcome, limitations of the study, and directions for future research are discussed.
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Affiliation(s)
- G Groth-Marnat
- Curtin University of Technology, School of Psychology, Perth, W.A., Australia.
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40
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Mercado AC, Carroll LJ, Cassidy JD, Côté P. Coping with neck and low back pain in the general population. Health Psychol 2000; 19:333-8. [PMID: 10907651 DOI: 10.1037/0278-6133.19.4.333] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study had 2 objectives: (a) to assess the psychometric properties of the Pain Management Inventory (PMI; G. K. Brown & P. M. Nicassio, 1987) with individuals in the general population with neck or low back pain, and (b) to assess the relationship between pain severity and coping. Data were taken from a mailed survey of a random sample of adults residing in Saskatchewan, Canada. Results validated the 2-factor structure of the PMI and provided evidence for the internal consistency of the coping subscales. Regression analyses revealed that passive coping was associated with being married, greater pain severity, depression, and poor health. Active coping was associated with female gender, higher education, less depression, good health, and frequent exercise. This study provides psychometric data to support the use of the PMI and information about factors associated with use of active and passive coping strategies in pain sufferers.
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Affiliation(s)
- A C Mercado
- Department of Psychology and Institute for Health and Outcomes Research, University of Saskatchewan, Canada
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41
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Riley JL, Robinson ME, Geisser ME. Empirical subgroups of the Coping Strategies Questionnaire-Revised: a multisample study. Clin J Pain 1999; 15:111-6. [PMID: 10382924 DOI: 10.1097/00002508-199906000-00007] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The purpose of this study was to examine the dimensions of coping, measured by the subscales of the new revised Coping Strategies Questionnaire (CSQ-R) using factor analysis, and to perform cluster analysis on these factors to explore the existence of distinct subgroups. No published studies have identifed subgroups of chronic pain patients based on the use of CSQ coping strategies. SOURCE A sample of 419 chronic low back pain patients from a multidisciplinary pain rehabilitation clinic and a sample of 556 chronic pain patients of mixed pain etiology presenting for treatment at an anesthesia pain clinic were used to establish reliability of factors and clusters. RESULTS Both samples yielded very similar two-factor solutions, with initial solutions accounting for 67.1% and 69.1% of the total variance. The factors were characterized as cognitive coping and distraction. Three homogeneous subgroups were then identified that consisted of a group high on cognitive coping, a group with low overall ratings of response CSQ-R items in general, and a group with frequent endorsement of catastrophizing and distraction-related items. CONCLUSION This paper is the first to report empirically derived subgroups from scores on the CSQ or CSQ-R. In addition, the three clusters were significantly different across measures of pain, psychological distress, and levels of physical functioning, demonstrating validity for the clusters.
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Affiliation(s)
- J L Riley
- Claude Pepper Center for Research of Oral Health in Aging, College of Dentistry, University of Florida, Gainesville 32610, USA.
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43
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Riley JL, Robinson ME. Validity of MMPI-2 profiles in chronic back pain patients: differences in path models of coping and somatization. Clin J Pain 1998; 14:324-35. [PMID: 9874012 DOI: 10.1097/00002508-199812000-00010] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To show clinical utility and empirical validity of Minnesota Multiphasic Personality Inventory-2 (MMPI-2) chronic pain patient subgroups by identification of differential multivariate relationships across groups. METHOD This study used structural equation modeling to test cognitive coping strategies and somatization as mediator variables in path models with pain severity and depression used as exogenous (independent) variables and patient's activity level as the final endogenous (dependent) variable, across MMPI-2 profiles. RESULTS Hierarchical cluster analysis, performed on a sample of 569 chronic low back patients, resulted in four cluster profiles identifiable as those found in previous work with the MMPI-2 (within normal limits, V-type, neurotic triad, and depressed-pathological). Somatization mediated the relationship between depression and activity level for the neurotic triad group but not the other three groups. A positive linear relationship was found between somatization and depression for the within normal limits, neurotic triad, and depressed-pathological groups, whereas their linear association was negative for the V-type group. Cognitive coping strategies mediated the relationship between depression and activity level for the within normal limits group. In addition, cognitive coping was predictive of activity level for the within normal limits, V-type, and neurotic triad groups but not for the depressed-pathological group. CONCLUSION Consistent with previous cluster analytic studies, this study replicated four MMPI-2 cluster profile groups in chronic pain patients. These results have also shown that several multivariate relationships between variables are different across MMPI-2 groups, providing evidence for the validity for these MMPI-2 subgroups.
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Affiliation(s)
- J L Riley
- The Claude Pepper Center for Research of Oral Health in Aging, College of Dentistry, University of Florida, Gainesville 32610, USA
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Hildebrandt J, Pfingsten M, Saur P, Jansen J. Prediction of success from a multidisciplinary treatment program for chronic low back pain. Spine (Phila Pa 1976) 1997; 22:990-1001. [PMID: 9152449 DOI: 10.1097/00007632-199705010-00011] [Citation(s) in RCA: 181] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
STUDY DESIGN The study included 90 disabled patients with chronic low back pain recruited from a pain clinic who were admitted to an 8-week program of functional restoration and behavioral support. Initial evaluations included a medical examination, rating of the physical impairment, a personal interview, a visual analogue scale to record pain intensity, an assessment of limitations for daily activities, a pain disability index, a depression and psychovegetative scale, and a scale to evaluate general living standards. The physical assessment included different flexibility measurements, measurement of power and endurance through standardized exercises, and measurements of isokinetic trunk and lifting strength and general endurance. The measurements were repeated at the end of the 8-week program and thereafter an intervals of 6 and 12 months. Final analyses were carried out on 82 patients. OBJECTIVES To determine whether objective or subjective signs most influence the outcome of rehabilitation. SUMMARY OF BACKGROUND DATA In recent years, several studies have shown that active and intensive multimodal treatment of chronic low back pain is successful. Until now there has been lack of information about which patients will respond to the therapy and what is the most effective part of treatment. METHODS Prognostic factors (return to work, pain intensity, self-assessment of treatment success by patients) were tested by studying variance and regression analyses for their ability to predict treatment outcome. RESULTS Certain factors were identified that had a significant impact on determining the probability of a patient's return to work and the reduction of pain intensity. These factors included self-evaluation for predicting a return to work, the length of absence from work, application for pension, and a decrease is disability after treatment. Overall satisfaction with treatment was best determined by the number of medical consultations before treatment, the extent of disability, previous measures taken for coping with the disease, and reduction of disability during treatment. Medical background, medical diagnosis, and physical impairment had no predictive value. Physical variables (i.e., mobility, strength, endurance, and physical performance) also demonstrated only limited predictive value. CONCLUSION This study has demonstrated that the most important variable in determining a successful treatment of chronic low back pain is the reduction of subjective feelings of disability in patients.
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Affiliation(s)
- J Hildebrandt
- Department of Algesiology, Georg-August-University of Göttingen, FRG, Germany
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Abstract
The objectives of this descriptive study were to examine pain, coping, and depressed mood in patients with moderate to severe burn injuries. A secondary objective was to evaluate the appropriateness of prescribed analgesic regimens. Subjects (N = 31) reported high levels of pain intensity, pain distress, and depressed mood, and used many strategies to cope with their pain. The tendency to think the worst or catastrophize was positively associated with pain intensity (r = 0.51; P < .01) and pain distress (r = 0.42; P < 0.05). Depressed mood was significantly correlated with pain intensity (r = 0.45; P < 0.05), but not pain distress. A personal belief in control over pain (r = -0.45; P < 0.05) and one's ability to decrease pain (r = -0.48; P < 0.01) were negatively associated with depressed mood. Significant relationships also were found between severity of injury and depressed mood (r = 0.43; P < 0.05), and between surgical intensity and pain distress (r = 0.36; P < 0.05). Based on the pain management index, 91% of the routine and 84% of the procedural pain regimens were in the acceptable range. Generally, analgesics were prescribed on an "as needed" basis and subjects seldom received more than 50% of their prescribed dose. The finding that pain and depressed mood remain significant problems for burn-injured patients suggests that thoughtful pain assessment, pain management, and quality review are needed.
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Affiliation(s)
- J F Ulmer
- Center for Advancing Care in Serious Illness, University of Pennsylvania, School of Nursing, Philadelphia 19104, USA
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Santavirta N, Björvell H, Koivumäki E, Hurskainen K, Solovieva S, Konttinen YT. The factor structure of coping strategies in hemophilia. J Psychosom Res 1996; 40:617-24. [PMID: 8843040 DOI: 10.1016/0022-3999(95)00645-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The purpose of the present study was to analyze the factor structure of the Coping Strategies Questionnaire (CSQ). In order to find factors that are reproducible across samples and to evaluate their relationship to pain, disability, and depressive mood, the subjects used were a group of 224 patients with congenital coagulation defects. Factor analysis identified 4 factors in the Coping Strategies Questionnaire that could be categorized as Distraction, Pain Control, Reinterpreting Pain Sensations, and Catastrophizing. There were positive correlations between pain and Catastrophizing (p < 0.005) and between disability and Catastrophizing (p < 0.005). There was also a relationship between Catastrophizing and emotional well-being indicating that the lower the feeling of well-being, the greater the use of Catastrophizing strategies. The present results confirm that a 4- to 5-factor solution gives reasonable reproducibility across samples and methods.
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Affiliation(s)
- N Santavirta
- Department of Medicine, Karolinska Institute, Stockholm, Sweden
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Kröner-Herwig B, Jäkle C, Frettlöh J, Peters K, Seemann H, Franz C, Basler HD. Predicting subjective disability in chronic pain patients. Int J Behav Med 1996; 3:30-41. [PMID: 16250765 DOI: 10.1207/s15327558ijbm0301_3] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Subjective disability is considered as the variable that reflects the impact of chronic pain on a patient's life. This study examines the questions of which syndrome or patient characteristics determine subjective disability and whether there are differences between samples of patients with chronic headaches and low back pain. Direct pain variables and depression, pain coping strategies, and pain-related self-statements (including catastrophizing) are introduced into multivariate regression analyses as potential predictors of disability using a sample of 151 pain patients. Disability is not predicted by pain severity in patients with headaches or back pain. Psychological variables, especially coping strategies, are far more influential. Coping explains more variance in disability in the headache sample than in the chronic law hack pain group, whereas depression is more relevant for the degree of disability in the back pain sample. In this study, we present a critical analysis of possible interpretations of our results. We point to an overlap of concepts underlying some of the variables used: this overlap also considerably invalidates conclusions drawn from a multitude of studies done in this field, including the one presented. We strongly argue for a conceptual clarification, and consequently for the revision of assessment instruments, before further empirical work in this area is done.
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Affiliation(s)
- B Kröner-Herwig
- Clinical Psychology, Georg August University, Göttingen, Germany
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48
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Abstract
This study assessed the validity of active and passive coping dimensions in chronic pain patients (n = 76) using the Coping Strategies Questionnaire and the Vanderbilt Pain Management Inventory. The validity of active and passive coping dimensions was supported; passive coping was strongly related to general psychological distress and depression, and active coping was associated with activity level and was inversely related to psychological distress. In addition, the Coping Strategies Questionnaire was found to be a more psychometrically sound measure of active and passive coping than the Vanderbilt Pain Management Inventory.
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Affiliation(s)
- Lynn A Snow-Turek
- Department of Psychology, Texas A&M University, College Station, TX 77843-4235 USA Psychology Service (116B), Houston Veterans Administration Medical Center, Houston, TX 77030 USA
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Ter Kuile MM, Spinhoven P, Linssen CGA, van Houwelingen HC. Cognitive coping and appraisal processes in the treatment of chronic headaches. Pain 1996; 64:257-264. [PMID: 8740602 DOI: 10.1016/0304-3959(95)00135-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The purpose of the present study was to investigate the active cognitive ingredients of change in psychological treatments for long-term chronic headache complaints. The primary questions this study addressed were: (1) Is a cognitive self-hypnosis training which explicitly attempts to change appraisal and cognitive coping processes more effective in producing these changes than a relaxation procedure, and (2) are changes in pain appraisal and cognitive coping related to changes in pain and adjustment in the short and long term? A total of 144 patients were assigned at random to a cognitive self-hypnosis (CSH) treatment or autogenic training (AT) with a duration of 7 weeks. Measures used were: Headache Index (HI), Symptom Checklist-90 (SCL-90), Coping Strategy Questionnaire (CSQ), Multidimensional Locus of Pain Control Questionnaire (MLPC) and treatment expectations. The results indicated that patients successfully changed their use of coping strategies and pain appraisals. Cognitive therapy was more effective than relaxation training in changing the use of cognitive coping strategies which were the direct targets of treatment. However, treatment effects were only related with changes in the use of coping strategies and appraisal processes to a limited extent and the mediational role of cognitive processes in pain reduction and better adjustment was inconclusive.
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Affiliation(s)
- Moniek M Ter Kuile
- Department of Psychiatry, University of Leiden, 2300 RC Leiden The Netherlands Department of Medical Statistics, University of Leiden, 2300 RC Leiden, The Netherlands
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Jacobsen PB, Butler RW. Relation of cognitive coping and catastrophizing to acute pain and analgesic use following breast cancer surgery. J Behav Med 1996; 19:17-29. [PMID: 8932659 DOI: 10.1007/bf01858172] [Citation(s) in RCA: 140] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
This study investigated the relation of cognitive coping and catastrophizing to acute postoperative pain and analgesic use. Fifty-nine women who had just undergone breast cancer surgery rated their pain on 3 consecutive days and completed a self-report measure of cognitive coping and catastrophizing prior to hospital discharge. Analgesic use over the 3-day period was tabulated from pharmacy records. Based on prior research, it was hypothesized that increased catastrophizing and decreased use of cognitive coping strategies would be associated with greater pain and analgesic use. Results partially confirmed these hypotheses. Catastrophizing, but not cognitive coping, was associated with individual differences in pain intensity and analgesic use. Additional analyses indicated that age was a significant predictor of both catastrophizing and postoperative pain. Specifically, younger patients were more likely to catastrophize and to report increased postoperative pain. Theoretical and clinical implications of these findings are discussed.
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Affiliation(s)
- P B Jacobsen
- Department of Psychology, University of South Florida, Tampa, USA
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