Health Psychology Commons^™

Doctor Recommendations Are Related To Patient Interest And Use Of Behavioral Treatment For Chronic Pain And Addiction, Lisa M. Mcandrew, Alexandria Brunkow, Margeaux Cannon, Fiona S. Graff, Jessica L. Martin, Leslie R.M. Hausmann

Educational & Counseling Psychology Faculty Scholarship

The opioid crisis has highlighted the importance of improving patients’ access to behavioral treatments for chronic pain and addiction. What is not known is if patients are interested in receiving these treatments. In this cross-sectional study, over 1000 participants with chronic pain were surveyed using an anonymous online questionnaire on Amazon Mechanical Turk (Mturk) to investigate participants’ use of and interest in pharmacological and behavioral treatments for chronic pain and addiction. Participants also indicated whether their doctor had recommended these treatments. The majority of participants reported using medication for their pain (83.19%) and that their doctor recommended medication (85.05%), whereas …

Coping With Medically Unexplained Physical Symptoms: The Role Of Illness Beliefs And Behaviors, Lisa M. Mcandrew, Nicole Sullivan, L. Alison Phillips, Wilfred R. Pigeon, Karen S. Quigley, Fiona Graff, David R. Litke, Drew A. Helmer, Joseph F. Rath

Educational & Counseling Psychology Faculty Scholarship

Background: Medically unexplained syndromes (MUS) are both prevalent and disabling. While illness beliefs and behaviors are thought to maintain MUS-related disability, little is known about which specific behavioral responses to MUS are related to disability or the way in which beliefs and behaviors interact to impact functioning. The purpose of the present study was to examine the relationship between illness beliefs and disability among patients with MUS, and assess the extent to which behaviors mediate this relationship. Methods: The study examined data from the baseline assessment of a multi-site randomized controlled trial (RCT). Participants were 248 veterans with MUS. Illness …

Concordance Of Illness Representations: The Key To Improving Care Of Medically Unexplained Symptoms, Lisa M. Mcandrew, Myrna L. Friedlander, L. Alison Phillips, Susan L. Santos, Drew A. Helmer

Educational & Counseling Psychology Faculty Scholarship

How can effective patient-provider relationships be developed when the underlying cause of the health condition is not well understood and becomes a point of controversy between patient and provider? This problem underlies the difficulty in treating medically unexplained symptoms and syndromes (MUS; e.g., fibromyalgia, chronic fatigue syndrome), which primary care providers consider to be among the most difficult conditions to treat.¹ This difficulty extends to the patient-provider relationship which is characterized by discord over MUS.¹ In this article, we argue that the key to improving the patient provider relationship is for the patient and provider to develop congruent …

Longitudinal Relationship Between Onset Of Physical Symptoms And Functional Impairment, Lisa M. Mcandrew, Drew A. Helmer, Shou-En Lu, Helena K. Chandler, Sarah Slotkin, Karen S. Quigley

Educational & Counseling Psychology Faculty Scholarship

Patients with chronic physical symptoms (e.g., chronic pain) often have significant functional impairment (i.e., disability). The fear avoidance model is the dominant theoretical model of how the relationship between chronic physical symptoms and functional impairment develops and proposes a cyclical/bidirectional relationship. There has never been a definitive test of the proposed bi-directional relationship. The current study followed 767 Operation Enduring Freedom/Operation Iraqi Freedom soldiers from pre-deployment, when they were relatively healthy, to one year after deployment, when it was anticipated that symptoms would increase or develop. Over the four assessment time points, physical symptom severity consistently predicted worse functional impairment …

High Healthcare Utilization At The Onset Of Medically Unexplained Symptoms, Lisa M. Mcandrew, L. Alison Phillips, Drew A. Helmer, Kieran J. Maestro, Charles C. Engel, Lauren M. Greenberg, Nicole Anastasides, Karen S. Quigley

Educational & Counseling Psychology Faculty Scholarship

Objective: Patients with medically unexplained syndromes (MUS) often do not receive appropriate healthcare. A critical time for effective healthcare is the inception of MUS. The current study examined data from a prospective longitudinal study of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans to understand the relationship of increasing physical symptom burden to healthcare utilization.

Methods: Data was examined from a prospective study of OEF/OIF veterans assessed before and one year after deployment (n=335). Physical symptom burden was measured with the Patient Health Questionnaire (PHQ-15). Analyses were conducted with polynomial regression and response surface analysis (RSA).

Results: Increases in physical symptom …

The Common Sense Of Counseling Psychology: Introducing, Lisa M. Mcandrew, Jessica L. Martin, Myrna L. Friedlander, Katherine Shaffer, Jessica Y. Breland, Sarah Slotkin, Howard Leventhal

Educational & Counseling Psychology Faculty Scholarship

The goal of therapy is typically to improve clients’ self-management of their problems, not only during the course of therapy but also after therapy ends. Although it seems obvious that therapists are interested in improving client’s self-management, the psychotherapy literature has little to say on the topic. This article introduces Leventhal’s Common-Sense Model of Self-Regulation, a theoretical model of the self-management of health, and applies the model to the therapeutic process. The Common-Sense Model proposes that people develop illness representations of health threats and these illness representations guide self-management. The model has primarily been used to understand how people self-manage …

Telephone-Based Versus In-Person Delivery Of Cognitive Behavioral Treatment For Veterans With Chronic Multisymptom Illness: A Controlled, Randomized Trial, Lisa M. Mcandrew, Lauren M. Greenberg, Donald S. Ciccone, Drew A. Helmer, Helena K. Chandler

Educational & Counseling Psychology Faculty Scholarship

Background:The goal of this randomized clinical trial was to examine the efficacy of a cognitive behavioral stress reduction treatment for reducing disability among veterans with chronic multisymptom illness (CMI).Method: Veterans (N=128) who endorsed symptoms of CMI were randomized to: usual care (n=43), in-person (n=42) or telephone-delivered cognitive behavioral stress management (n=43). Assessments were conducted at baseline, three months, and twelve months. The primary outcome was limitation in roles at work and home (i.e., ‘role physical’). Reductions in catastrophizing cognitions were evaluated as a mechanism of action. Results: Intent-to-treat analyses showed …

Less Engagement In Pleasure Activities Is Associated With Poorer Quality Of Life For Veterans With Comorbid Post-Deployment Conditions, Lisa M. Mcandrew, Held F. Rachel, Abbi Bhavna, Karen S. Quigley, Drew A. Helmer, Radhika V. Pasupuleti, Helena K. Chandler

Educational & Counseling Psychology Faculty Scholarship

Objective: The presence of multiple comorbid conditions is common after combat deployment and complicates treatment. A potential treatment approach is to target shared mechanisms across conditions that maintain poorer health-related quality of life (HRQOL). One such mechanism may be decrements in pleasurable activities. Impairment in pleasurable activities frequently occurs after deployment and may be associated with poorer HRQOL.

Method: In this brief report, we surveyed 126 Veterans who had previously sought an assessment at a Veterans Affairs post-deployment health clinic and assessed pleasurable activities, HRQOL, and post-deployment health symptoms.

Results: Forty-three percent of Veterans met our criteria for all three …